Patients’ perspectives on tapering programmes for prescription opioid use disorder: a qualitative study

ObjectivesApproximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients’ experiences with tapering programmes for prescription OUD could help improve such progra...

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Bibliographic Details
Published in:BMJ open 2023-12, Vol.13 (12), p.e075246-e075246
Main Authors: Davies, Lisa Eveline Maria, Koster, Ellen S, Damen, Katinka FM, Beurmanjer, Harmen, van Dam, Vivienne WT, Bouvy, Marcel L, Schellekens, Arnt FA
Format: Article
Language:English
Subjects:
Addiction
Addictions
Chronic pain
Consortia
Drug withdrawal
Females
Interviews
Medical research
Methadone
Narcotics
pain management
Patients
Prescription drugs
Primary care
Qualitative research
substance misuse
Substance use disorder
Video teleconferencing
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Summary:ObjectivesApproximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients’ experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme.DesignA qualitative study using semi-structured interviews on experiences with initiation and completion of opioid tapering was audio recorded, transcribed and subject to directed content analysis.SettingThis study was conducted in two facilities with specialised opioid tapering programmes in the Netherlands.ParticipantsTwenty-five adults with chronic pain undergoing treatment for prescription OUD participated.ResultsParticipants indicated that tapering is a personal process, where willingness and motivation to taper, perceived (medical) support and pain coping strategies have an impact on the tapering outcome. The opportunity to join a medical-assisted tapering programme, shared decision-making regarding tapering pace, tapering location, and receiving medical and psychological support facilitated completion of an opioid tapering programme.ConclusionsAccording to patients, a successful treatment of prescription OUD requires a patient-centred approach that combines personal treatment goals with shared decision-making on opioid tapering. Referral to a specialised tapering programme that incorporates opioid rotation, non-judgmental attitudes, and psychological support can create a safe and supportive environment, fostering successful tapering and recovery.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2023-075246