{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:55:09Z","timestamp":1782996909570,"version":"3.54.5"},"reference-count":113,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The opioid epidemic has put pressure on clinicians to taper their chronic pain patients (CPPs) from opioids. This has resulted in rapid or forced tapers and opioid discontinuation. Partially responsible is lack of information on how to taper (tapering protocols).The objectives of this narrative review were then the following: compile all the published opioid tapering\/detoxification protocols from the pain\/drug rehabilitation\/psychiatric literature whether for inpatient or outpatient use; organize these into general types; compare the types for advantages\/disadvantages for use by a clinician in an outpatient setting; and answer some commonly asked questions relating to opioid tapering.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Relevant references were identified by a search strategy utilizing the terms tapering, tapering protocols, detoxification, detoxification protocols, withdrawal, dependence, addiction, and drug rehabilitation. These were explored with the term opioids. Identified abstract were reviewed for any study relating to the objectives of this review. Those studies were then included in this review. As this is a narrative review, no quality ratings of these references were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1,922 abstracts identified by this search strategy, 301 were reviewed in detail for potential inclusion. Of these, 104 were utilized in this review. Nine types of opioid tapering protocols were identified and compared in tabular form. Twenty-two questions in reference to opioid tapering were addressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on this review, the protocol utilizing the opioid of current use is the simplest to use as it requires no rotation to another opioid and thereby avoids rotation errors. It also has behavior advantages.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pm\/pnab019","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T20:14:33Z","timestamp":1611087273000},"page":"1676-1697","source":"Crossref","is-referenced-by-count":11,"title":["Opioid Tapering\/Detoxification Protocols, A Compendium: Narrative Review"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-5755","authenticated-orcid":false,"given":"David A","family":"Fishbain","sequence":"first","affiliation":[{"name":"Departments of Psychiatry, Miller School of Medicine at the University of Miami, Miami, Florida, USA"},{"name":"Neurological Surgery, Miller School of Medicine at the University of Miami, Miami, Florida, USA"},{"name":"Anesthesiology, Miller School of Medicine at the University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"issue":"21","key":"2021072609410056600_pnab019-B1","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1001\/jama.2019.5188","article-title":"Limits on opioid prescribing leave patients with chronic pain vulnerable","volume":"321","author":"Rubin","year":"2019","journal-title":"JAMA"},{"issue":"5","key":"2021072609410056600_pnab019-B2","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/MLR.0000000000000505","article-title":"A detailed exploration into the association of prescribed opioid dosage and overdose deaths among patients with chronic pain","volume":"54","author":"Bohnert","year":"2016","journal-title":"Med Care"},{"key":"2021072609410056600_pnab019-B3","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1093\/pm\/pny228","article-title":"Commentary: International stakeholder community of pain experts and leaders call for an urgent action on forced opioid tapering","volume":"20","author":"Darnell","year":"2019","journal-title":"Pain Med"},{"issue":"4","key":"2021072609410056600_pnab019-B4","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1111\/j.1526-4637.2009.00620.x","article-title":"Alleged medical abandonment in chronic opioid analgesic therapy: Case report","volume":"10","author":"Fishbain","year":"2009","journal-title":"Pain Med"},{"key":"2021072609410056600_pnab019-B5"},{"issue":"2","key":"2021072609410056600_pnab019-B6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jpain.2008.10.008","article-title":"Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain","volume":"10","author":"Chou","year":"2009","journal-title":"J Pain"},{"key":"2021072609410056600_pnab019-B7","doi-asserted-by":"crossref","first-page":"k2990","DOI":"10.1136\/bmj.k2990","article-title":"What interventions are effective to taper opioids in patients with chronic pain?","volume":"362","author":"Sandhu","year":"2018","journal-title":"BMJ"},{"issue":"3","key":"2021072609410056600_pnab019-B8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00002508-199209000-00003","article-title":"Detoxification of nonopiate drugs in the chronic pain setting and clonidine opiate detoxification","volume":"8","author":"Fishbain","year":"1992","journal-title":"Clin J Pain"},{"issue":"1","key":"2021072609410056600_pnab019-B9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3109\/10401239309148924","article-title":"Opiate detoxification protocols a clinical manual","volume":"5","author":"Fishbain","year":"1993","journal-title":"Ann Clin Psychiatry"},{"issue":"6","key":"2021072609410056600_pnab019-B10","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.mayocp.2015.04.003","article-title":"Tapering long-term opioid therapy in chronic noncancer pain: Evidence and recommendations for everyday practice","volume":"90","author":"Berna","year":"2015","journal-title":"Mayo Clin Proc"},{"key":"2021072609410056600_pnab019-B11","first-page":"153","article-title":"The MEDD myth: The impact of pseudoscience on pain research and prescribing guideline development","volume":"9","author":"Fudin","year":"2016","journal-title":"J Pain Res"},{"key":"2021072609410056600_pnab019-B12"},{"issue":"2","key":"2021072609410056600_pnab019-B13","doi-asserted-by":"crossref","first-page":"586","DOI":"10.21037\/apm.2019.12.10","article-title":"Tapering opioids: A comprehensive qualitative review","volume":"9","author":"Davis","year":"2020","journal-title":"Ann Palliat Med"},{"issue":"11","key":"2021072609410056600_pnab019-B14","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1097\/j.pain.0000000000000279","article-title":"Sleep-disordered breathing decreases after opioid withdrawal: Results of a prospective controlled trial","volume":"156","author":"Schwarzer","year":"2015","journal-title":"Pain"},{"issue":"5","key":"2021072609410056600_pnab019-B15","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1111\/j.1526-4637.2009.00653.x","article-title":"Do opioids induce hyperalgesia in humans? An evidence-based structured review","volume":"10","author":"Fishbain","year":"2009","journal-title":"Pain Med"},{"issue":"28","key":"2021072609410056600_pnab019-B16","first-page":"4497","article-title":"Opioid-induced hyperalgesia may be more frequent than previously thought","volume":"25","author":"Zylicz","year":"2007","journal-title":"J Clin Oncol"},{"issue":"6","key":"2021072609410056600_pnab019-B17","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1111\/j.1526-4637.2008.00501.x","article-title":"Improved opioid analgesic effect following opioid dose reduction","volume":"9","author":"Vorobeychik","year":"2008","journal-title":"Pain Med"},{"issue":"2","key":"2021072609410056600_pnab019-B18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/bcp.12245","article-title":"Pharmacological strategies for detoxification","volume":"77","author":"Diaper","year":"2014","journal-title":"Br J Clin Pharmacol"},{"issue":"2","key":"2021072609410056600_pnab019-B19","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/add.13512","article-title":"Yes, people can die from opioid withdrawal","volume":"112","author":"Darke","year":"2017","journal-title":"Editor Addict"},{"key":"2021072609410056600_pnab019-B20"},{"issue":"2","key":"2021072609410056600_pnab019-B21","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/02791072.2003.10400007","article-title":"The Clinical Opiate Withdrawal Scale (COWS)","volume":"35","author":"Wesson","year":"2003","journal-title":"J Psychoactive Drugs"},{"issue":"4538","key":"2021072609410056600_pnab019-B22","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1126\/science.6278591","article-title":"Alpha-2 adrenoreceptor-induced hyper-polarization of locus coeruleus neurons: Intracellular studies in vivo","volume":"215","author":"Aghajanian","year":"1982","journal-title":"Science"},{"issue":"1","key":"2021072609410056600_pnab019-B23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/j.1360-0443.1990.tb00634.x","article-title":"Efficacy of clonidine, guanfacine and methadone in the rapid detoxification of heroin addicts: A controlled clinical trial","volume":"85","author":"San","year":"1990","journal-title":"Br J Addict"},{"issue":"1\u20132","key":"2021072609410056600_pnab019-B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/00952998509016845","article-title":"Comparison of clinician ratings to self-reports of withdrawal during clonidine detoxification of opiate addicts","volume":"11","author":"Kosten","year":"1985","journal-title":"Am J Drug Alcohol Abuse"},{"key":"2021072609410056600_pnab019-B25","first-page":"CD002024","article-title":"Alpha-adrenergic agonists for the management of opioid withdrawal","volume":"5","author":"Gowing","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2021072609410056600_pnab019-B26","author":"Ghodse","year":"1990"},{"key":"2021072609410056600_pnab019-B27","first-page":"37","article-title":"Evaluation of clonidine suppression of opiate withdrawal reactions: A multidisciplinary approach","volume":"35","author":"Cuthill","year":"1989","journal-title":"Can J Psychiatry"},{"issue":"2","key":"2021072609410056600_pnab019-B28","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/0740-5472(89)90038-X","article-title":"Clonidine transdermal patches for use in outpatient opiate withdrawal","volume":"6","author":"Spencer","year":"1989","journal-title":"J Subst Abuse Treat"},{"issue":"2","key":"2021072609410056600_pnab019-B29","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/ADM.0b013e3181e518cc","article-title":"A nonopioid procedure for outpatient detoxification","volume":"5","author":"Ockert","year":"2011","journal-title":"J Addict Med"},{"key":"2021072609410056600_pnab019-B30","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1080\/105504999305749","article-title":"Lofexidine for opiate detoxification: Review of recent randomized and open controlled trials","volume":"8","author":"Strang","year":"1999","journal-title":"Amer J Addictions"},{"issue":"3","key":"2021072609410056600_pnab019-B31","first-page":"CD002025","article-title":"Buprenorphine for the management of opioid withdrawal","author":"Gowing","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"issue":"1551","key":"2021072609410056600_pnab019-B32","first-page":"115","article-title":"The medical letter on drugs and therapeutics","volume":"60","year":"2018","journal-title":"Opioids"},{"issue":"9","key":"2021072609410056600_pnab019-B33","doi-asserted-by":"crossref","first-page":"825","DOI":"10.2146\/ajhp070392","article-title":"Methadone-associated TA. Q-T interval prolongation and torsades de pointes","volume":"66","author":"Stringer","year":"2009","journal-title":"Am J Health Syst Pharm"},{"issue":"3","key":"2021072609410056600_pnab019-B34","article-title":"Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence","author":"Mattick","year":"2009","journal-title":"Cochrane Database Sys Rev"},{"issue":"8 Pt 2","key":"2021072609410056600_pnab019-B35","first-page":"10","article-title":"Substitution-detoxification and its role in the management of chronic benign pain","volume":"43","author":"Halpern","year":"1982","journal-title":"J Clin Psychiatry"},{"key":"2021072609410056600_pnab019-B36","volume-title":"The American Psychiatric Press Textbook of Psychiatry","author":"Frances","year":"1988"},{"key":"2021072609410056600_pnab019-B37","first-page":"1","year":"2015"},{"issue":"11","key":"2021072609410056600_pnab019-B38","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1517\/14656560903037168","article-title":"Opioid dependence treatment: options in pharmacotherapy","volume":"10","author":"Stotts","year":"2009","journal-title":"Expert Opinion Pharmacother"},{"issue":"4","key":"2021072609410056600_pnab019-B39","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1093\/pm\/pnz356","article-title":"Understanding buprenorphine for use in chronic pain: Expert opinion","volume":"21","author":"Webster","year":"2020","journal-title":"Pain Med"},{"issue":"2","key":"2021072609410056600_pnab019-B40","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1001\/jamapsychiatry.2018.3126","article-title":"Prevention and treatment of opioid misuse and addiction","volume":"76","author":"Volkow","year":"2019","journal-title":"JAMA Psychiatry"},{"issue":"9","key":"2021072609410056600_pnab019-B41","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/add.13013","article-title":"Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration","volume":"110","author":"Kao","year":"2015","journal-title":"Addiction"},{"issue":"9358","key":"2021072609410056600_pnab019-B42","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/S0140-6736(03)12600-1","article-title":"1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomized, placebo-controlled trial","volume":"361","author":"Kakko","year":"2003","journal-title":"Lancet"},{"issue":"11","key":"2021072609410056600_pnab019-B43","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1176\/appi.ajp.2007.07071058","article-title":"Data do not support buprenorphine as a fine-line treatment of addiction","volume":"164","author":"Byrne","year":"2007","journal-title":"Am J Psychiatry"},{"key":"2021072609410056600_pnab019-B44","first-page":"CD002025","article-title":"Buprenorphine for managing opioid withdrawal","volume":"2","author":"Gowing","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"2021072609410056600_pnab019-B45","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/j.1369-1600.2000.tb00215.x","article-title":"A compressed opiate detoxification regime with naltrexone maintenance: Patient tolerance, risk assessment and abstinence rates","volume":"5","author":"Beaini","year":"2000","journal-title":"Addict Biol"},{"issue":"4","key":"2021072609410056600_pnab019-B46","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/ajad.12869","article-title":"Rapid micro-induction of buprenorphine\/naloxone for opioid use disorder in an inpatient setting: A case series","volume":"28","author":"Klaire","year":"2019","journal-title":"Am J Addict"},{"key":"2021072609410056600_pnab019-B47","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2147\/SAR.S109919","article-title":"Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: The Bernese method","volume":"7","author":"Vogel","year":"2016","journal-title":"Substance Abuse Rehabil"},{"issue":"1","key":"2021072609410056600_pnab019-B48","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13722-020-0177-x","article-title":"Case report: Successful induction of buprenorphine\/naloxone using a microdosing schedule and assertive outreach","volume":"15","author":"Rozylo","year":"2020","journal-title":"Addict Sci Clin Pract"},{"issue":"2","key":"2021072609410056600_pnab019-B49","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/S0376-8716(03)00060-7","article-title":"Buprenorphine: How to use it right","volume":"70","author":"Johnson","year":"2003","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"2021072609410056600_pnab019-B50","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1080\/09595230220119309","article-title":"Buprenorphine dosing regime in the management of out-patient heroin withdrawal","volume":"21","author":"Lintzeris","year":"2002","journal-title":"Drug Alcohol Rev"},{"issue":"2","key":"2021072609410056600_pnab019-B51","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/105504901750227778","article-title":"Gradual dose taper following buprenorphine","volume":"10","author":"Becker","year":"2001","journal-title":"Am J Addict"},{"issue":"1","key":"2021072609410056600_pnab019-B52","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0376-8716(03)00071-1","article-title":"Cessation of methadone maintenance treatment using buprenorphine transfer from methadone to buprenorphine and subsequent buprenorphine reductions","volume":"71","author":"Breen","year":"2003","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"2021072609410056600_pnab019-B53","doi-asserted-by":"crossref","first-page":"52","DOI":"10.2174\/1874473711205010052","article-title":"Buprenorphine-mediated transition from opioid agonist to antagonist treatment: State of the art and new perspectives","volume":"5","author":"Mannelli","year":"2012","journal-title":"Curr Drug Abuse Rev"},{"issue":"1554","key":"2021072609410056600_pnab019-B54","first-page":"137","article-title":"Management of opioid withdrawal symptoms","volume":"60","year":"2018","journal-title":"The Medical Letter on Drugs and Therapeutics"},{"key":"2021072609410056600_pnab019-B55","volume-title":"American Psychiatric Press Textbook of Psychiatry","author":"Frances","year":"1988"},{"issue":"7","key":"2021072609410056600_pnab019-B56","doi-asserted-by":"crossref","first-page":"526","DOI":"10.7326\/0003-4819-127-7-199710010-00004","article-title":"Three methods of opioid detoxification in a primary care setting","volume":"127","author":"O\u2019Connor","year":"1997","journal-title":"Ann Intern Med"},{"issue":"3","key":"2021072609410056600_pnab019-B57","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3109\/00952990.2011.653426","article-title":"Opioid detoxification and naltrexone induction strategies: Recommendations for clinical practice","volume":"38","author":"Sigmon","year":"2012","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"9","key":"2021072609410056600_pnab019-B58","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1001\/jamapsychiatry.2017.1838","article-title":"Efficacy of tramadol extended-release for opioid withdrawal: A randomized clinical trial","volume":"74","author":"Dunn","year":"2017","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"2021072609410056600_pnab019-B59","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s002130100839","article-title":"Effect of gabapentin-like compounds on development and maintenance of morphine-induced conditioned place preference","volume":"157","author":"Andrews","year":"2001","journal-title":"Psychopharmacol"},{"issue":"5","key":"2021072609410056600_pnab019-B60","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/JCP.0b013e31822bb378","article-title":"Importance of gabapentin dose in treatment of opioid withdrawal","volume":"31","author":"Salehi","year":"2011","journal-title":"J Clin Psychopharmacol"},{"issue":"4","key":"2021072609410056600_pnab019-B61","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1037\/a0033724","article-title":"Randomized, placebo-controlled pilot trial of gabapentin during an outpatient, buprenorphine-assisted detoxification procedure","volume":"21","author":"Sanders","year":"2013","journal-title":"Exp Clin Psycho Pharmacol"},{"issue":"1","key":"2021072609410056600_pnab019-B62","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1533-2500.2005.05105.x","article-title":"Chronic pain and ultrarapid opioid detoxification","volume":"5","author":"Kaye","year":"2005","journal-title":"World Institute Pain"},{"issue":"2","key":"2021072609410056600_pnab019-B63","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1080\/135562102200120479","article-title":"24-hour opiate detoxification and antagonist induction at home\u2014the \u2018Asturian method\u2019: A report on 1368 procedures","volume":"7","author":"Carre\u00f1o","year":"2002","journal-title":"Addict Biol"},{"issue":"4","key":"2021072609410056600_pnab019-B64","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3109\/00952999609001675","article-title":"Rapid opiate detoxification 1996","volume":"22","author":"Bartter","year":"1996","journal-title":"Am J Drug Alcohol Abuse"},{"key":"2021072609410056600_pnab019-B65","year":"2007"},{"key":"2021072609410056600_pnab019-B66","first-page":"CD002021","article-title":"Opioid antagonists with minimal sedation for opioid withdrawal","volume":"2","author":"Gowing","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"2021072609410056600_pnab019-B67","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0376-8716(99)00125-8","article-title":"Combined use of trazodone-naltrexone versus clonidine-naltrexone in rapid withdrawal from methadone treatment: A comparative inpatient study","volume":"59","author":"Pozzi","year":"2000","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"2021072609410056600_pnab019-B68","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1056\/NEJMra1604339","article-title":"Treatment of opioid-use disorders","volume":"375","author":"Schuckit","year":"2016","journal-title":"N Engl J Med"},{"key":"2021072609410056600_pnab019-B69","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD007522.pub2","article-title":"Pharmacological therapies for management of opium withdrawal","author":"Rahimi-Movaghar","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"2021072609410056600_pnab019-B70","first-page":"1090","article-title":"Ziedonis D, and the buprenorphine study protocol group. A multi-center randomized trial of buprenorphine-naloxone versus clonidine for opioid detoxification: Findings from the National Institute on Drug Abuse","volume":"100","author":"Ling","year":"2005","journal-title":"Clin Trials Netw Addict"},{"issue":"3","key":"2021072609410056600_pnab019-B71","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/j.1521-0391.2010.00033.x","article-title":"Opioid detoxification: From controlled clinical trial to clinical practice","volume":"19","author":"Dijkstra","year":"2010","journal-title":"Am J Addict"},{"issue":"2","key":"2021072609410056600_pnab019-B72","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1056\/NEJMra1508490","article-title":"Relationship between nonmedical prescription-opioid use and heroin use","volume":"374","author":"Compton","year":"2016","journal-title":"N Engl J Med"},{"issue":"5","key":"2021072609410056600_pnab019-B73","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1001\/jamainternmed.2017.8709","article-title":"Patient-centered prescription opioid tapering in community outpatients with chronic pain","volume":"178","author":"Darnall","year":"2018","journal-title":"JAMA Internal Med"},{"key":"2021072609410056600_pnab019-B74","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/00002508-199909000-00005","article-title":"Validity of self -reported drug use in chronic pain patients","volume":"15","author":"Fishbain","year":"1999","journal-title":"Clin J Pain"},{"issue":"11","key":"2021072609410056600_pnab019-B75","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1093\/pm\/pny231","article-title":"Does opioid tapering in chronic pain patients result in improved pain or same pain vs increased pain at taper completion? A structured evidence-based systematic review","volume":"20","author":"Fishbain","year":"2019","journal-title":"Pain Med"},{"issue":"12","key":"2021072609410056600_pnab019-B76","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1093\/pm\/pny320","article-title":"Intensity of withdrawal symptoms during opioid taper in patients with chronic pain-individualized or fixed starting dosage?","volume":"20","author":"Bienek","year":"2019","journal-title":"Pain Med"},{"key":"2021072609410056600_pnab019-B77","author":"Turk","year":"1983"},{"key":"2021072609410056600_pnab019-B78","author":"Fordyce","year":"1976"},{"key":"2021072609410056600_pnab019-B79","first-page":"790","volume-title":"Textbook of Pain","author":"Turk","year":"1984"},{"issue":"3","key":"2021072609410056600_pnab019-B80","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/0304-3959(94)90166-X","article-title":"Opiate reduction in CPPs: A comparison of patient controlled reduction and staff controlled cocktail method","volume":"56","author":"Ralph","year":"1994","journal-title":"Pain"},{"key":"2021072609410056600_pnab019-B81","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1001\/archpsyc.1977.01770150119014","article-title":"Withdrawal from methadone maintenance: Rate of withdrawal and expectation","volume":"34","author":"Seney","year":"1977","journal-title":"Arch Gen Psychiatry"},{"key":"2021072609410056600_pnab019-B82","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/bs.irn.2018.07.022","article-title":"Optimizing placebo and minimizing nocebo to reduce pain, catastrophizing, and opioid use: A review of the science and an evidence-informed clinical toolkit","volume":"139","author":"Darnall","year":"2018","journal-title":"International Rev Neurobiol"},{"issue":"4","key":"2021072609410056600_pnab019-B83","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/j.1533-2500.2012.00584.x","article-title":"Intentional intrathecal opioid detoxification in 3 patients: Characterization of the intrathecal opioid withdrawal syndrome","volume":"13","author":"Jackson","year":"2013","journal-title":"Pain Practice"},{"issue":"3","key":"2021072609410056600_pnab019-B84","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1176\/ajp.150.3.423","article-title":"Organic mood syndrome associated with detoxification from methadone maintenance","volume":"150","author":"Kanof","year":"1993","journal-title":"Am J Psychiatry"},{"issue":"1","key":"2021072609410056600_pnab019-B85","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1300\/J069v23n01_06","article-title":"Unexpected delirium during rapid opioid detoxification","volume":"23","author":"Golden","year":"2004","journal-title":"J Addict Dis"},{"issue":"1","key":"2021072609410056600_pnab019-B86","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0304-3959(88)90280-1","article-title":"Atypical oxycodone (Percocet) withdrawal syndrome in a chronic pain patient","volume":"35","author":"Fishbain","year":"1988","journal-title":"Pain Manage"},{"issue":"11","key":"2021072609410056600_pnab019-B87","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1111\/pme.12463","article-title":"The pain suicidality association: A narrative review","volume":"15","author":"Fishbain","year":"2014","journal-title":"Pain Med"},{"key":"2021072609410056600_pnab019-B88","doi-asserted-by":"crossref","DOI":"10.1016\/j.genhosppsych.2017.04.011","article-title":"Suicidal ideation and suicidal self-directed violence following clinician-initiated prescription opioid discontinuation among long-term opioid users","author":"Demidenko","year":"2017","journal-title":"Gen Hosp Psychiatry"},{"issue":"S1","key":"2021072609410056600_pnab019-B89","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1016\/j.jsat.2009.12.007","article-title":"Pain and continued opioid use in individuals receiving buprenorphine-naloxone for opioid detoxification: Secondary analyses from the Clinical Trials Network","volume":"38","author":"Potter","year":"2010","journal-title":"J Sub Abuse Treatment"},{"key":"2021072609410056600_pnab019-B90","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1016\/j.ejpain.2011.03.006","article-title":"Potential risk factors associated with risk for drop-out and relapse during and following withdrawal of opioid prescription medication","volume":"15","author":"Heiwe","year":"2011","journal-title":"Eur J Pain"},{"issue":"5","key":"2021072609410056600_pnab019-B91","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1111\/j.1360-0443.2007.01759.x","article-title":"Persistent pain is associated with substance use after detoxification: A prospective cohort analysis","volume":"102","author":"Larson","year":"2007","journal-title":"Addiction"},{"issue":"7","key":"2021072609410056600_pnab019-B92","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1111\/add.13782","article-title":"Volatility and change in chronic pain severity predict outcomes of treatment for prescription opioid addiction","volume":"112","author":"Worley","year":"2017","journal-title":"Addiction"},{"issue":"8","key":"2021072609410056600_pnab019-B93","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1002\/ejp.1241","article-title":"Tapering off long-term opioid therapy in chronic non-cancer pain patients: A randomized clinical trial","volume":"22","author":"Kurita","year":"2018","journal-title":"Eur J Pain"},{"key":"2021072609410056600_pnab019-B94","doi-asserted-by":"crossref","DOI":"10.1093\/pm\/pnaa029","article-title":"Outcomes in long-term opioid tapering and buprenorphine transition: A retrospective clinical data analysis","author":"Sturgeon","year":"2020","journal-title":"Pain Med"},{"issue":"1","key":"2021072609410056600_pnab019-B95","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s11606-019-05227-9","article-title":"Opioid taper is associated with subsequent termination of care: A retrospective cohort study","volume":"35","author":"Perez","year":"2020","journal-title":"J Gen Intern Med"},{"issue":"4","key":"2021072609410056600_pnab019-B96","doi-asserted-by":"crossref","first-page":"S78","DOI":"10.1016\/j.jpain.2013.01.650","article-title":"Immediate and lasting improvements in depression following rapid opioid detoxification","volume":"14","author":"Baker","year":"2013","journal-title":"J Pain"},{"issue":"4","key":"2021072609410056600_pnab019-B97","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1016\/j.jpain.2013.01.641","article-title":"Improvements in cognition following opioid detoxification program","volume":"14","author":"Foti","year":"2013","journal-title":"J Pain"},{"key":"2021072609410056600_pnab019-B98","first-page":"327","volume-title":"Headache Diagnosis and Treatment.","author":"Fishbain","year":"1963"},{"issue":"12","key":"2021072609410056600_pnab019-B99","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1111\/pme.12201","article-title":"Opioid use 12 months following interdisciplinary pain rehabilitation with weaning","volume":"14","author":"Huffman","year":"2013","journal-title":"Pain Med"},{"issue":"4","key":"2021072609410056600_pnab019-B100","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1093\/pm\/pnz291","article-title":"Does integrative medicine reduce prescribed opioid use for chronic pain? A systematic literature review","volume":"21","author":"Hassan","year":"2020","journal-title":"Pain Med"},{"issue":"18","key":"2021072609410056600_pnab019-B101","doi-asserted-by":"crossref","first-page":"E659","DOI":"10.1503\/cmaj.170363","article-title":"for opioid therapy and chronic noncancer pain","volume":"189","author":"Busse","year":"2017","journal-title":"CMAJ"},{"key":"2021072609410056600_pnab019-B102","article-title":"Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification","author":"Amato","year":"2011","journal-title":"Cochrane Sys Rev"},{"key":"2021072609410056600_pnab019-B103","article-title":"Interventions for the reduction of prescribed opioid use in chronic non-cancer pain","author":"Eccleston","year":"2017","journal-title":"Cochrane Syst Rev-Intervent"},{"issue":"3","key":"2021072609410056600_pnab019-B104","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.jpain.2016.11.003","article-title":"Prescription opioid taper support for outpatients with chronic pain: A randomized controlled trial","volume":"18","author":"Sullivan","year":"2017","journal-title":"J Pain"},{"issue":"10","key":"2021072609410056600_pnab019-B105","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1093\/pm\/pnw078","article-title":"Patients\u2019 perspectives on tapering of chronic opioid therapy: A qualitative study","volume":"17","author":"Frank","year":"2016","journal-title":"Pain Med"},{"issue":"2","key":"2021072609410056600_pnab019-B106","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jpain.2018.09.001","article-title":"Patients experience with opioid tapering: A conceptual model with recommendations for clinicians","volume":"20","author":"Henry","year":"2019","journal-title":"J Pain"},{"issue":"2","key":"2021072609410056600_pnab019-B107","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1046\/j.1526-4637.2003.03021.x","article-title":"Medico-legal rounds: Medico-legal issues and alleged breaches of \u201cstandards of medical care\u201d in opioid rotation to Methadone: A case report","volume":"4","author":"Fishbain","year":"2003","journal-title":"Pain Med"},{"issue":"3","key":"2021072609410056600_pnab019-B108","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1526-4637.2009.00606.x","article-title":"Correlates of self-reported violent ideation against physicians in acute and chronic pain patients","volume":"10","author":"Fishbain","year":"2009","journal-title":"Pain Med"},{"issue":"2","key":"2021072609410056600_pnab019-B109","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1046\/j.1526-4637.2002.02013.x","article-title":"Medico-legal rounds: Medico-legal issues and breaches of \u201cstandards of medical care\u201d in opioid tapering for alleged opioid addiction","volume":"3","author":"Fishbain","year":"2002","journal-title":"Pain Med"},{"issue":"3","key":"2021072609410056600_pnab019-B110","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/j.1533-2500.2010.00410.x","article-title":"Exploration of anger constructs in acute and chronic patients vs. community patients","volume":"11","author":"Fishbain","year":"2011","journal-title":"Pain Pract"},{"issue":"10","key":"2021072609410056600_pnab019-B111","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1111\/pme.12794","article-title":"Violence toward chronic pain care providers: A national survey","volume":"16","author":"David","year":"2015","journal-title":"Pain Med"},{"issue":"3","key":"2021072609410056600_pnab019-B112","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1526-4637.2006.00248.x","article-title":"Chronic pain and violent ideation: Testing a model of patient violence","volume":"8","author":"Bruns","year":"2007","journal-title":"Pain Med"},{"issue":"2","key":"2021072609410056600_pnab019-B113","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1046\/j.1526-4637.2000.00013.x","article-title":"Risk of violent behavior in patients with chronic pain: Evaluation and management in pain facility setting","volume":"1","author":"Fishbain","year":"2000","journal-title":"Pain Med"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/painmedicine\/advance-article-pdf\/doi\/10.1093\/pm\/pnab019\/37084755\/pnab019.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/7\/1676\/39312267\/pnab019.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/7\/1676\/39312267\/pnab019.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T06:58:48Z","timestamp":1670828328000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/22\/7\/1676\/6120823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,27]]},"references-count":113,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,1,27]]},"published-print":{"date-parts":[[2021,7,25]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnab019","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"value":"1526-2375","type":"print"},{"value":"1526-4637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,1,27]]}}}