Understanding Opioid Tapering: A Guide for Chronic Pain Patients, Study notes of Medicine

Download Understanding Opioid Tapering: A Guide for Chronic Pain Patients and more Study notes Medicine in PDF only on Docsity! ten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment This booklet was created to help you learn about tapering. You probably have lots of questions about opioid tapering and your pain treatment, and this booklet is here to help answer some of them. To help your care team best support you, there is space for you to document your well-being and to jot down other questions you have. 5 Tapering is a process of gradually reducing your opioid medication. This doesn’t necessarily mean that your dose will go down to zero, since you may still need some medication. You and your care team will work on a plan that’s right for you. This may include trying alternative treatments like physical therapy, meditation, or acupuncture. What is tapering? 6 Why is my care team asking me to taper? New research has found that high doses of opioid medications are not as safe as doctors once thought they were. Your care team may ask you to taper: – because a lower dose of opioids may provide enough pain relief and be safer – to avoid or decrease negative side effects of opioids – because you’re on a high dose of pain medication but still experiencing severe pain (the meds aren’t working as intended to reduce pain intensity) After tapering, you may see long-term improvements in function without worsening pain. Some people even experience a decrease in pain after they are no longer on high doses of opioid medication. Opioids are rarely a permanent solution to chronic pain. 7 Why would I want to try tapering? Taking opioids long-term has clear and serious risks. Opioids can cause you to experience negative side effects such as decreased memory, drowsiness, and nausea. If you are taking opioids, you may already find yourself experiencing these or other side effects. Other reasons include: – You want to take fewer medications in the long run. Some people are concerned about the long-term effects of opioids on their health. You may be able to replace some or all of your prescriptions with alternative treatments. – You want more freedom in your day-to-day life. Taking opioids can mean centering every day around a rigid dosing schedule. – You want to have more control over your pain treatment. Because of new clinical guidelines, getting high doses of opioid medications may be harder in the future. 10 When you reduce the amount of pain medicine you are taking, you can experience symptoms of withdrawal. Withdrawal symptoms can show up when a person’s body doesn’t get a substance it’s dependent on. One goal of creating a tapering plan is to maximize your function while minimizing symptoms of withdrawal. This is why it is important to reach out to your care team if you run into any problems. The Self-Support Checklist beginning on page 15 offers some guidance on when to ask for help. How will tapering make me feel? During the tapering process, you may experience some uncomfortable physical symptoms such as nausea, cramping, or trouble sleeping. 11 There are some medicines that can help. You can find some at your local pharmacy. If you need a prescription, ask your care team. Your care team can also suggest alternative treatment options for your pain, which may include physical therapy, support groups, and /or acupuncture. How can I treat any uncomfortable symptoms? While they may be uncomfortable, many withdrawal symptoms are treatable. Over-the-Counter Prescription Pain or fever: 200mg Ibuprofen (1– 2 tabs) every 6 hours Diarrhea: 2mg Imodium every 2 hours Cramps: Dicyclomine Trouble sleeping: Trazodone Nausea: Ondansetron Restlessness: Clonidine 12 What if I think we are tapering too fast? It’s important to keep an open line of communication with your care team during the tapering process. Tell your doctor why you think you are going down on the medication too fast, so that you can adjust your plan together. In some cases, you might want to pause the taper so your body has more time to adapt to lower doses of medicine. Are there certain activities or times during the day when your pain is worse? Self-Support Checklist A tool that helps you know when you’re on track and when you should ask for help. Tapering isn’t easy, and you’ll likely have good days and bad. The checklist on the following pages can help you know when you’re on track with your tapering plan and when you should ask for help. If you find yourself identifying with any of the statements in the Caution and Warning sections, reach out to your care team for support. Most days here: Okay OK Caution Warning Too many days here: Ask for help 16 Tapering is a process and is different for everyone. Sometimes it can be hard to figure out how you’re doing overall. 17 OK You’re in the ideal zone. You might have good days and bad days, but you’re sticking with your tapering plan and your pain and /or withdrawal symptoms are at a manageable level. Keep track of how you feel, what helps and hurts, and take it easy when you need to. What are you having success with? Function: Impact on daily activities 2 I’m able to do what I need to do each day. 2 I’m still able to do my job, my chores, etc. Behavior: Impact on actions 2 I’m sticking to the tapering plan that my care team and I decided on. 2 I’m taking my medicines as directed. 2 Tapering hasn’t impacted my relationships with friends and family. Symptoms: Impact on physical state 2 My pain level is manageable. 2 My withdrawal symptoms are manageable. Feeling: Impact on emotional state 2 Overall, I feel like my tapering plan is a good fit for me. 2 I feel like I’m moving in the right direction. 2 I feel like I have some control over any anxiety and /or depression. Glossary Words your care team may use when working with you on a tapering plan. 21 Care team—your doctor, your behavioral therapist, and all other staff that aid in your treatment Chronic pain—pain that persists for 3 or more months Cold turkey—when you stop taking an addictive substance abruptly Comorbidity—when you have more than one illness or disorder; also referred to as co-occurring disorders Compulsive—an action that is often overpowering, repeated, and irrational Craving—an intense and urgent desire for a substance Dependence—when your body feels like it needs a substance in order to function Detox—a process that enables your body to rid itself of a drug Fentanyl—an opioid medicine used to relieve severe pain Function—your ability to do what you need (and want) to do each day Half-life—the time required for half the quantity of a drug or other substance to be used up or eliminated by your body 12-step program—a self-help program that uses a set of steps to help you reach a goal Acute pain—pain that is severe or sudden and normally heals within 3 months Addiction—a chronic disease that causes you to uncontrollably want to use a substance for reward instead of just for relief Agonist—a medicine that acts like another medicine and stimulates an effect Analgesic—a medication that relieves pain Antidepressant—a medicine that helps treat depression and may be prescribed to treat some types of pain Antiepileptic—a medicine that helps treat seizures and may be prescribed to treat some types of pain Benzodiazepines—sleeping aids or anti-anxiety medicines; sometimes referred to as “benzos” Buprenorphine—a medication used to relieve moderate to severe pain and to treat opioid use disorder 22 Methadone—an agonist medicine that can help you taper down from opioids Morphine—an opioid medicine used to relieve severe pain Naloxone—a medicine used to treat overdose from opioids Narcan—the brand name for naloxone, a medicine used to treat overdose from opioids Narcotic—a drug, usually an opioid such as morphine or oxycodone, which can relieve pain Narcotic Bowel Syndrome (NBS)—a condition with abdominal pain that gets worse when the effect of a narcotic drug wears off; in addition to pain, other symptoms may include nausea, bloating, vomiting, and constipation Neuropathic pain—pain caused by nerve damage Opioids—medication used to relieve severe pain Opioid use disorder—a pattern of using opioids in a way that causes you distress and has a negative impact on how you function each day Overdose—taking a substance in an amount that causes illness or death OxyContin—a time-released medicine used to relieve severe pain; also known as “oxycodone extended release” Oxycodone—an immediate-release drug that is the active ingredient in OxyContin® Protocol—a way of doing something that is followed for legal, medical, and/or planning reasons Side effects—an often harmful or unwanted effect from a medicine or medical treatment Self-medication—using substances that are not approved by a healthcare provider Stigma—a perceived cultural norm or stereotype used to discredit the character of a person or group of people Tapering—the process of gradually reducing the amount of a medication Tolerance—when your body needs more of something to get the same effect Withdrawal—symptoms that occur when you stop taking, or reduce the amount of, a substance that you are dependent on