{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T08:15:13Z","timestamp":1775376913529,"version":"3.50.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010dose long\u2010term opioid treatment for chronic non\u2010cancer pain (CNCP) has become an increasing burden in industrialised countries. Opioid tapering and withdrawal in patients with CNCP remain challenging. This study evaluated a two\u2010phase inpatient opioid withdrawal (OW) programme aimed at safely discontinuing opioid use in CNCP patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study was conducted from 2018 to 2023 at a Swiss tertiary care centre, involving CNCP patients on long\u2010term opioid therapy (\u2265\u20096\u2009months, \u2265\u2009100\u2009mg morphine equivalent daily dose) who had failed outpatient withdrawal attempts. The programme consisted of a withdrawal phase (Phase 1) followed by multimodal pain rehabilitation (Phase 2). Outcomes included the proportion of patients opioid\u2010free after Phase 2 (primary) and at 3\u2009months, pain intensity changes, and adverse events (secondary).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 38 enrolled patients (58% female, median age 54\u2009years [IQR 49, 62]), 34 (89%) completed both phases, and 32 (84%) were opioid\u2010free at the end of Phase 2. At 3\u2009months, 23 patients (61%) remained opioid\u2010free, while 4 (11%) resumed opioids, and 11 (29%) were lost to follow\u2010up. Median pain intensity remained stable after discharge. One patient died by suicide 10\u2009days post\u2010withdrawal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This two\u2010phase inpatient withdrawal and rehabilitation programme enabled most CNCP patients to discontinue opioids without increased pain intensity, with a majority remaining opioid\u2010free at 3\u2009months. These findings highlight the importance of ongoing psychological support and careful patient selection in OW management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance Statement<\/jats:title><jats:p>This study introduces a structured inpatient opioid withdrawal model tailored for chronic non\u2010cancer pain patients on high\u2010dose opioid therapy, demonstrating that high cessation rates can be achieved without worsening pain intensity. By addressing the gap in care for patients who fail outpatient tapering, this research provides clinical insights into optimising withdrawal protocols and highlights the need for targeted resource allocation for intensive, multidisciplinary pain management. These findings support evidence\u2010based decision\u2010making in designing more effective opioid tapering strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.70010","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T06:34:19Z","timestamp":1742711659000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Two\u2010Phase Inpatient Withdrawal Programme for Long\u2010Term Opioid Use in Non\u2010Cancer Pain"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-2320","authenticated-orcid":false,"given":"Konrad","family":"Streitberger","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-5742","authenticated-orcid":false,"given":"Michael A.","family":"Harnik","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Saliba","sequence":"additional","affiliation":[{"name":"Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Bischoff","sequence":"additional","affiliation":[{"name":"Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-4201","authenticated-orcid":false,"given":"Larissa T.","family":"Bl\u00e4ttler","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5496-3545","authenticated-orcid":false,"given":"Kyrill","family":"Schwegler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kantonsspital Baden  Baden Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Sutter","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6347-0198","authenticated-orcid":false,"given":"Maria M.","family":"Wertli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kantonsspital Baden  Baden Switzerland"},{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542\u2010200603000\u201000025"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00482\u2010008\u20100741\u2010x"},{"key":"e_1_2_10_4_1","unstructured":"Atlanta G. C. N. C.2021.Wide\u2010Ranging Online Data for Epidemiologic Research (WONDER).http:\/\/wonder.cdc.gov."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102021\u2010066375"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny320"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.06.009"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.18472"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.01.014"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n895"},{"key":"e_1_2_10_12_1","volume-title":"The Brief Pain Inventory User Guide","author":"Cleeland C. S.","year":"2009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000001167"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000001062"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201012\u2010174"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012299.pub3"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.002"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002299"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17\u20100598"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1515\/REVNEURO.2005.16.3.255"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2006.08.005"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002298"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002746"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00482\u2010020\u201000472\u2010y"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2011.03.006"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100437"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000907"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12201"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2003.11.003"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1179\/jmt.2009.17.3.163"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304\u20103959(85)90004\u20101"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jnr.24762"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31827c7cf6"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1241"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicines6020044"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201006253\u20108"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000976"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10926\u2010023\u201010115\u20105"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.13812"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11040315"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2020.1746941"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096\u2010010\u20109464\u2010z"},{"key":"e_1_2_10_43_1","volume-title":"A Language and Environment for Statistical Computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2017.08.020"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2003.09.004"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11206161"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.6454"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040\u20103590.7.4.524"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51031"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.08.005"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000160"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.3109\/9781420045130-2"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.j.pain.0000460357.01998.f1"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnaa322"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010017\u20102086\u20106"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1177\/17448069231181973"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.11.002"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.70010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T12:12:36Z","timestamp":1752927156000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.70010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":57,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/ejp.70010"],"URL":"https:\/\/doi.org\/10.1002\/ejp.70010","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]},"assertion":[{"value":"2024-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70010"}}