- Explore goals and personal motivation for taper.
- Clearly communicate that the motivation for suggesting tapering is the patient's best interest, rather than institutional or regulatory pressure.
- Acknowledge fears and anxieties about tapering (eg, fear of increased pain or opioid withdrawal symptoms).
- Explore and recognize the emotional challenges associated with opioid tapering.
- Let the patient know that tapering might not be easy, but that the clinician will provide support throughout the process.
- Negotiate the planned taper rate and strategy with the patient.
- Reassure the patient that the clinician will not abandon the patient, whatever the outcome of the opioid taper.
- Involve family members and/or housemates.
- Consider the implications of tapering decisions and document factors contributing to those decisions, especially in complex situations (eg, continuing opioid prescription when discontinuation might put the provider-patient relationship at risk). Ask for supervision and support when necessary.
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