Indications for Stopping Opioid Therapy

Definitive Indications for Stopping Opioid Therapy
  • No benefit identified (See “Assessing the Benefits of Opioid Therapy“).  One does not have to prove diversion or addiction in order to stop opioid therapy.
  • There is evidence of illegal activity or diversion of medication (e.g. forged or stolen prescription).
  • Patient exhibits harms from treatment, such as overdose (intentional or unintentional), over-sedation, constipation requiring hospitalization, etc.
  • Patient cannot keep medications safe (e.g. recurrent stolen medication from family member, recurrent lost medication, etc.).
  • Patient with active addiction requiring treatment (not stable).
  • Violent or abusive behaviors toward practice staff or clinicians.
  • Patient unable or unwilling to comply with monitoring requirements.
Strong Indications for Stopping Opioid Therapy BUT that Require Clinical Judgment

Sources:

These recommendations are based on expert consensus.

Webster LR, Dove B. Avoiding Opioid Abuse While Managing Pain: A Guideline for Practitioners. 1st Edition. North Branch, MN: Sunrise Press; 2007.