Can I “Taper Off” Opioids?

Suppose you have been taking opioids prescribed by your doctor or using them illicitly and decide you want to stop using them. It is common to ask, “should I quit cold turkey?” or “Can I taper off opioids?” Read on to find out the answers to these and other questions.

What Are Opioids?

Opioids can consist of synthetic and naturally-derived drugs used to treat pain. The most common prescription opioids are hydrocodone, morphine, oxycodone, and fentanyl. There are also illegal opioids, like heroin and opium.

What Do Opioids Do?

Opioids bind to the opioid receptors in the brain, which are responsible for deciphering pain signals sent from nerve endings through the central nervous system. Once they bind to the receptors, they interrupt pain signals. Opioids also cause an increase in dopamine, the “feel-good” neurotransmitter that is associated with pleasure.

Why Should I Not Quit Opioids Cold Turkey?

Opioids cause chemical changes in the brain that make it difficult to stop using them cold turkey. When the drug is stopped suddenly, there is a chemical imbalance. As a result, the body experiences unpleasant withdrawal symptoms as it attempts to restore balance.

Most people that attempt to stop cold turkey are rarely successful because of the more intense withdrawal symptoms. In addition, as the body builds tolerance to opioids, it is not uncommon to increase the amount taken. As such, the longer opioids have been taken, and at higher doses, it can cause severe and life-threatening withdrawal symptoms when someone stops cold turkey.

How Can I Taper Off Opioids?

Tapering off opioids is the best way to discontinue their use and avoid intense and severe withdrawal symptoms. When someone seeks help at a medical detox center, it is common to create a tapering schedule as part of the individual’s detox treatment plan.

The tapering schedule is a gradual decrease in the amount one takes over a certain period of time. The length of detox will vary based on several factors, such as:

The length of time opioids were used.
The opioid dosage taken.
The frequency they were taken.
The overall health and mental well-being of the person.

Therefore, it is probable detox will take longer than detoxing from other substances. However, tapering is the safest and most effective detox method.

How Does Opioid Tapering Work?

Opioid tapering at a medical detox center incorporates medication-assisted treatment (MAT), which prescribes various medications to help reduce the severity and intensity of withdrawal symptoms while mimicking some of the effects of opioids.

Unlike opioids, MAT medications are less addictive since they block the euphoria one experiences while on opioids. They also reduce cravings and help restore the brain’s chemical balance.

In addition to using MAT, a gradual weaning of the opioid medication could be part of someone’s detox plan. For example, they received an Oxycodone prescription. While undergoing detox, their dosage of oxycodone is gradually reduced and replaced with a MAT medication until they no longer are taking oxycodone.

Can MAT Continue After Detox?

Yes, MAT can continue after detox, in some cases. For example, people that misused opioids or took them long-term can benefit from ongoing MAT. Continuing MAT is not just providing access to medications but also includes therapy and counseling. Furthermore, continued MAT can help reduce the risk of lapses and relapses.

Why Is Opioid Tapering Essential?

Opioid tapering is essential because it is very difficult to stop using these drugs without experiencing severe and intense withdrawal symptoms, including:

Seizures
Hallucinations
Stomach and Gastrointestinal Cramping and Pain
Confusion
Anxiety
Depression
Vomiting
Muscle and Body Aches and Pain

Is Tapering Needed If I Only Took Opioids for a Week or Two?

Most people do not require tapering when they only take opioids for a week or two or less. For example, a doctor prescribes hydrocodone to a patient after a surgical procedure to help them get through the first several days of recovery and minimize their pain. Once the medication runs out, they should not experience any noticeable withdrawal symptoms.

When Is Opioid Tapering Needed?

When someone has been taking opioids for more than two weeks, a tapering process is probably necessary. If someone’s doctor prescribed the drugs, talk to them about a tapering schedule. If someone has been taking them illicitly, then they should consider getting help at a medical detox center.

Even though someone may not be craving opioids after a few weeks, dependence develops quickly. Dependence is where a person needs to be under the effects of opioids to function, which can lead to addiction. However, once one becomes addicted, quitting without tapering is dangerous.