Opioid Tapering: Talking With Patients about Treatment Changes, Video

What to know

A video describing key information about opioid tapering & patient decision making regarding pain.

Language: English (US)
Last updated: December 3, 2024

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Transcript

[Opening Scene: Gentle upbeat music playing softly in the background.]

Dr. Patel (Voiceover):

Hi, I'm Dr. Patel. Today, I'm meeting with one of my patients, Bill Garcia. He's a 42-year-old office manager who has experienced chronic back pain since a car crash two years ago. The crash resulted in a herniated lumbar disc, leading to sciatica and ongoing discomfort.

To manage his pain, Bill takes 15 milligrams of oxycodone twice a day, which equals 45 morphine milligram equivalents daily.

[Background music continues softly.]

Bill often reports experiencing side effects from oxycodone, like difficulty concentrating. Recently, he underwent disc surgery, which provided some relief, and he's found physical therapy especially helpful. Since his pain level has improved and he's experiencing side effects from oxycodone, I’d like to discuss tapering his medication as a next step.

Transitioning medications can be challenging for patients, often due to fear of the unknown. It's essential to have open and supportive conversations to address their concerns, understand their needs, and create a collaborative plan for their treatment.

Let's see these tips in action as I meet with Bill.

[Scene: Dr. Patel gently knocks on the door.]

Dr. Patel:

Hi, Bill. How have you been since our last visit?

Bill Garcia:

Well, I've been thinking that the oxycodone isn’t helping as much as it used to. I’m also having trouble concentrating, and it’s affecting my work.

Dr. Patel:

I’m sorry to hear about your ongoing pain and difficulty concentrating. It’s concerning when these issues start impacting daily life. Over time, your body may have adjusted to the medication, making it less effective.

During our last visit, we talked about tapering your medication. How do you feel about exploring that now?

Bill Garcia:

I’ve thought about it, but I’m worried the pain will get worse if I reduce the medication.

Dr. Patel:

That’s a valid concern. It’s important to weigh the pros and cons of your treatment. We’ve discussed the risks associated with long-term opioid use, and you mentioned the medication isn’t as effective anymore.

Research shows limited evidence that opioids manage chronic pain effectively over the long term. Additionally, higher dosages carry risks like overdose. Considering these factors, tapering might be a good next step.

Bill Garcia:

Okay. How would tapering work for me? What symptoms might I experience? I’m nervous about trying something new.

Dr. Patel:

I understand. Your safety and comfort are our top priorities. We’ll create a gradual plan to reduce your oxycodone dosage over time, allowing your body to adjust.

We’ll start by lowering your dose slightly each month. This gradual approach minimizes withdrawal symptoms like muscle aches, stomach upset, anxiety, or trouble sleeping. You’ll have my full support, and we’ll adjust the plan as needed.

Bill Garcia:

But what if the pain gets worse?

Dr. Patel:

It’s possible you may feel some increased discomfort initially, but we’ll adjust the tapering process based on your progress. If necessary, we can pause or slow down.

I’ll also help you manage your pain through other strategies, like continuing physical therapy, exploring acupuncture, or using non-opioid medications. Together, we’ll find a combination of approaches that work for you.

Bill Garcia:

That sounds better. How long will it take to taper off completely?

Dr. Patel:

It depends on how your body responds. We’ll check in regularly to monitor your progress and make adjustments. If needed, I can coordinate with your orthopedic doctor or connect you with someone to support the mental or emotional aspects of this transition.

Do you have any other concerns?

Bill Garcia:

No, I think that covers it. I’m still a little scared, but I’m willing to give it a try.

Dr. Patel:

That’s great, Bill. I’ll have the nurse give you some printouts with information about the plan. Remember, you can call anytime if you have questions.

[Closing Scene: Gentle upbeat music returns.]

Dr. Patel (Voiceover):

Today’s conversation with Bill highlights the importance of open communication and trust in tapering discussions. By addressing patient concerns, exploring alternative pain management strategies, and working collaboratively, you can create a safe and effective plan.

Remember, not every patient is ready to taper immediately, and that’s okay. Acknowledging progress, no matter how small, is key. Building trust today may prepare your patient for tapering in the future.

[Scene fades out with upbeat music.]