Test your knowledge about tapering opioid therapy with this interactive quiz.
Disclosure: Kristen Schmidt, MD, MPH, has disclosed no relevant financial relationships. Sarah, a 53-year-old woman, was diagnosed with rheumatoid arthritis 7 years ago and has tried various disease-modifying antirheumatic drugs and biologic therapies to manage her pain, without success. Dr Bennett, her rheumatologist, prescribed a daily 40 mg extended-release hydrocodone regimen to alleviate her chronic joint pain and stiffness.
Dr Bennett reviews Sarah's medical history, including her journey with RA, previous treatments, and an assessment of the benefits and risks associated with her opioid therapy. Recognizing the need for change, Dr Bennett considers tapering Sarah's opioid. Dr Bennett and Sarah should evaluate the benefits and risks of opioid therapy in the context of Sarah's experience.
If the benefits do not outweigh the risks, clinicians should optimize other therapies and work closely with patients to gradually taper to lower dosages or discontinuation, based on the individual clinical circumstances of the patient.In Sarah's case, the absence of evidence of benefit from the higher opioid dosage raises concerns. According to the 2022 CDC Clinical Practice Guideline, opioid therapy should be limited to circumstances where benefits of therapy outweigh risks.
Pain Arthralgia Painful Joint Joint Pain Addiction Clinical Guidelines Guidelines Abdominal Pain Georgia Pain Management Adverse Effects Side Effects Fellowship Fellows Residency Residents Diagnostic And Statistical Manual Of Mental Disord DSM Disease-Modifying Antirheumatic Drugs Dmards DMARD Overdose Drug Overdose Rheumatoid Arthritis RA - Rheumatoid Arthritis
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