Long-Term Opioid Therapy Tapering and Risk of Substance Use Disorder and Overdose: Differences by Opioid Dose and Duration - Report - MDSpire

Long-Term Opioid Therapy Tapering and Risk of Substance Use Disorder and Overdose: Differences by Opioid Dose and Duration

  • By

  • Patrick D. Quinn

  • Richard Meraz

  • Olena Mazurenko

  • Zheng Chang

  • Arvid Sjölander

  • Austin R. Medlin

  • Adam T. Hirsh

  • Toyya A. Pujol

  • Kurt Kroenke

  • Brian M. D’Onofrio

  • June 24, 2026

  • 0 min

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Evaluating the Impact of Opioid Dose and Duration on Risks During Tapering

Overview

This study examines the association between tapering long-term opioid therapy (LTOT) and the risks of substance use disorder (SUD) and overdose, utilizing a self-controlled design to analyze data from LTOT recipients.

Background

The tapering of LTOT is increasingly common amid efforts to reduce opioid prescribing, yet it presents clinical complexities and potential adverse effects, including overdose and SUD. Observational studies indicate that patients who taper or discontinue LTOT may face higher risks compared to those who maintain stable doses.

Data Highlights

No numerical data provided in the source material.

Key Findings

  • LTOT tapering is associated with increased risks of SUD and overdose.
  • Risks may be influenced by pre-existing factors.
  • Tapering from higher doses or longer durations may pose greater risks.
  • Some risks may emerge prior to tapering.
  • Decisions regarding LTOT tapering are often made with inadequate evidence.

Clinical Implications

Monitoring for signs of SUD and overdose during the tapering process is essential.

Conclusion

The study emphasizes the importance of understanding the risks associated with LTOT tapering.

Related Resources & Content

  1. Pain Medicine — Association of opioid tapering with pain-related emergency department visits, hospitalizations, and primary care visits: a retrospective cohort study
  2. Drugs - Real World Outcomes — An Extensive Observational Analysis of Trends and Risk Factors Associated with Opioid Overdose: Insights from Real-World Data for Improved Opioid Prescribing
  3. American Journal of Epidemiology — Link Between Swift Opioid Tapering or Cessation and Incidences of Self-Harm, Suicide Attempts, and Suicide Mortality in High-Dose, Long-Term Opioid Users in North Carolina, 2006-2018
  4. VA/DoD Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain
  5. FDA is Requiring Opioid Pain Medicine Manufacturers to Update Prescribing Information Regarding Long-Term Use: Drug Safety Communication | FDA
  6. JAMA Network Open — Adjunctive Psychosocial Interventions and Opioid Abstinence Among Patients Receiving Buprenorphine: A
  7. VA/DoD Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain
  8. FDA is Requiring Opioid Pain Medicine Manufacturers to Update Prescribing Information Regarding Long-Term Use: Drug Safety Communication | FDA
  9. Association Between Opioid Dosage Tapering and Opioid Overdose Among Long-Term Higher-Dose Opioid Users - ScienceDirect

Original Source(s)

Long-Term Opioid Therapy Tapering and Risk of Substance Use Disorder and Overdose: Differences by Opioid Dose and Duration

  • by Patrick D. Quinn, Richard Meraz, Olena Mazurenko, Zheng Chang, Arvid Sjölander, Austin R. Medlin, Adam T. Hirsh, Toyya A. Pujol, Kurt Kroenke, Brian M. D’Onofrio

  • June 24, 2026

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