Opioid Taper: How to Wean off Opioids Safely

An opioid taper can help gently ease you off opioids, paving the way for a recovery from opioid use.

The prospect of quitting opioids can be scary. One concern that may hold some people back from attempting to stop opioids can be the fear of uncomfortable withdrawal symptoms. However, strategies exist to minimize withdrawal symptoms. One such method is opioid tapering, in which the dose of your opioid is steadily decreased over time. Learning about opioid tapering can help you prevent withdrawal symptoms by working with your doctor to gradually reduce your opioid dose.

What Is Opioid Tapering?

An opioid taper means that your opioid dose is gradually decreased over time until the medication can be safely stopped. This allows your body to become used to steadily smaller doses of the opioid. In the process, you can avoid withdrawal symptoms. Tapers can occur in both residential and outpatient treatment settings.

Your doctor will monitor your progress during an opioid taper. If you begin to show signs of opioid withdrawal, your doctor may pause your taper or reduce your dose even more slowly.

Why Taper off Opioids?

A taper is a gentle alternative to a sudden, rapid decrease of your opioid dose or stopping an opioid entirely. Both lead to withdrawal symptoms. Your doctor may decide to taper your opioid for multiple reasons. But typically, it is centered around the fact that the risk of the opioid may exceed its benefits. These include:

• Addiction potential: Opioids are controlled substances that carry a risk of abuse, addiction and physical dependence.
• Continued pain: Opioids can actually increase a person’s pain sensitivity instead of working to relieve the pain.
• Opioid use disorder: A person with a history of opioid use disorder may be at risk of relapse on opioid therapy.

How to Taper off Opioids

An opioid taper is tailored to the person needing the taper. While some people may be able to tolerate rapid tapers, other people may require a slower taper. Sometimes, a person may even need the taper to be stopped or slowed. 

Your doctor will monitor the progress of your taper. They can adjust it accordingly to help ease you off opioids while avoiding withdrawal symptoms. Medical supervision is key to having a successful taper that prevents withdrawal symptoms.

Your doctor will determine your first opioid dose reduction based on your medical history. Different dose reductions can be used. However, a common strategy is to start with a 10% opioid dose decrease. This strategy allows the doctor to see how the person responds.

In some cases, an opioid taper may not be feasible. For example, someone who uses illicit opioids or has an opioid use disorder should not taper off opioids. Instead, medication-assisted treatment with methadone or buprenorphine-based products like Suboxone may be used. Switching to one of these medications and then tapering can help you avoid withdrawal symptoms and overcome opioid use.

Can You Taper off Opioids Without Withdrawal

It is possible to taper off opioids without experiencing withdrawal symptoms. In fact, the entire point of a taper is to ease you off an opioid. Having withdrawal symptoms means that your taper may be moving too quickly. It also indicates your taper may need to be stopped or slowed. If you experience withdrawal symptoms while tapering an opioid, talk to your doctor.

Sometimes, certain medications can be prescribed to help limit any breakthrough withdrawal symptoms during a taper. This is especially effective when tapering an illicit opioid. These medications include clonidine and lofexidine. 

Using methadone or buprenorphine is the top choice for managing withdrawal from illegal opioids. In cases where these medications can’t be used, clonidine and lofexidine can also help with symptom management.

Signs of Opioid Withdrawal

Everyone’s opioid withdrawal journey is different. However, certain withdrawal symptoms are more common than others. Typical opioid withdrawal symptoms include:

• Sweating
• Yawning
• Goosebumps
• Large pupils
• Runny eyes 
• Runny nose
• Agitation
• Anxiety
• Muscle aches
• Trouble sleeping
• Abdominal cramps
• Nausea or vomiting
• Diarrhea

In rare cases, opioid withdrawal can lead to serious complications. In some cases, they can even be fatal. Generally, this is because of dehydration from excessive vomiting and diarrhea. As a result, this dehydration can lead to elevated sodium levels in the blood and heart failure. Detoxing under medical supervision helps in preventing withdrawal symptoms and avoiding complications.

Medical Detox Treatment

Medical detox is the first step in your recovery journey. During detox, you are weaned off opioids, and your system is cleansed of their presence. Medication-assisted treatment with methadone or buprenorphine-based products may be available as well. They can help ease you off opioids as medically appropriate.

Remember — opioid recovery is a lifelong process. Detox is only the beginning. Following detox, the hard work of rehab begins to help teach you strategies to avoid opioids over the long term. You may also explore the reasons you began to rely on opioids to begin with. Enrolling in both detox and rehab can greatly increase your chances of staying opioid-free long-term.

Opioid Addiction Treatment at The Recovery Village Indianapolis

At The Recovery Village Indianapolis Drug and Alcohol Rehab, we believe that recovery is a continuum and that it is important to support you every step of the way on your journey. To this end, we offer not only a medical detox program to wean you off opioids but also residential and outpatient care to help keep you off opioids for the long term after detox is complete. Don’t wait: contact a recovery advocate today to learn more about how we can help you taper off opioids for good.