Discontinuing Opioids Too Quickly Can Be Harmful, FDA Warns

By Kelly Burch 04/12/19

The FDA issued guidance to help address the issue of opioid-dependent patients discontinuing or tapering off too quickly and becoming sick. 

person thinking discontinuing opioids

Since the national crackdown on prescription opioids, many pain patients have been forced to taper their dose of painkillers. Now, the Food and Drug Administration is warning doctors that tapering too quickly can have unintended and dangerous consequences. 

“The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased,” the agency said in a statement. “These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.”

The FDA issued guidance to help address the problem. 

“These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued,” the agency wrote. 

The agency said that providers should make an individualized plan for patients who need to taper off opioids, and should never stop the pain pills suddenly. The plan should take into consideration the type of opioid and dosage, as well as the patient’s pain and psychological concerns. 

“Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress,” the FDA wrote. 

The agency also warned that patients should not discontinue opioids without talking to their providers. They should be candid about any side effects they have as their dose of opioids is being tapered. 

“Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal,” the agency warned. “Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.”

Although many public health officials applaud efforts to reduce the amount of opioids prescribed, pain patients say that the regulations have gone too far, and have left vulnerable pain patients unprotected. 

Speaking with The Fix last fall, Lauren DeLuca, a pain patient and founder of the Chronic Illness Advocacy and Awareness Group, said that not being able to access pain medications can be devastating for patients. She said she regularly hears from pain patients who are not able to access enough medications to alleviate their symptoms. Sometimes, these people begin to consider suicide.

“It is borderline genocide,” she said. “You are allowing them to go home and essentially suffer until they kill themselves.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.