HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics.

Book/Report

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics.

October 30, 2019

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. Washington DC: US Department of Health and Human Services. October 2019.

Deprescribing has the potential to result in patient harm. This publication reviews considerations for physicians to safely discontinue or taper long-term opiate therapy. Elements of the guidance discuss assessment of risk, individualized care plans, shared decision making, and patient support as components of safe practice.

Available at

Related Resources From the Same Author(s)

Partnership for Patients.

April 13, 2011

Partnering to Heal: Teaming-Up Against Healthcare-Associated Infections.

July 20, 2011

New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings.

May 21, 2014

Heparin-containing medical devices and combination products: recommendations for labeling and safety testing. Draft guidance for industry and Food and Drug Administration staff.

August 5, 2015

The National Healthcare System Action Alliance for Patient and Workforce Safety.

November 14, 2022 - November 14, 2022

Medication Management: Detailed Use Case.

July 4, 2007

Adverse Events in Hospitals: Medicare's Responses to Alleged Serious Events.

November 16, 2011

Drive to Deprescribe.

June 23, 2021

National Action Alliance to Advance Patient and Workforce Safety Webinar Series.

September 26, 2023 - September 26, 2023

National Action Plan to Improve Health Literacy.

June 16, 2010

Medicare and Medicaid programs; reform of requirements for long-term care facilities; proposed rule.

July 29, 2015

AHRQ Health Services Research Project: Partners Enabling Diagnostic Excellence (R01).

April 3, 2019

Assessing the Evidence Base for Context-Sensitive Effectiveness and Safety of Patient Safety Practices: Developing Criteria.

August 27, 2008

Opioids in Medicare Part D: Concerns About Extreme Use and Questionable Prescribing.

August 9, 2017

Trends in Nursing Home Deficiencies and Complaints.

October 29, 2008

Physician-Owned Specialty Hospital's Ability to Manage Medical Emergencies.

January 23, 2008

Request for comments on the proposed measures and 2020 targets for the National Action Plan for Adverse Drug Event Prevention: inpatient and outpatient measures for reduction of adverse drug events from anticoagulants, diabetes agents, and opioid analgesics.

November 2, 2016

AHRQ Health Services Research Projects: Making Health Care Safer in Ambulatory Care Settings and Long Term Care Facilities (R01).

March 4, 2015

Five Steps to Safer Health Care.

March 27, 2005

Adverse Events in Hospitals: National Incidence Among Medicare Beneficiaries.

November 24, 2010

Adverse Events in Hospitals: Methods for Identifying Events.

March 17, 2010

Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries.

July 27, 2016

Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries.

January 9, 2019

Hospital Incident Reporting Systems Do Not Capture Most Patient Harm.

January 18, 2012

Few Adverse Events in Hospitals Were Reported to State Adverse Event Reporting Systems.

August 1, 2012

Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries.

March 19, 2014

Medicare’s Oversight of Compounded Pharmaceuticals Used in Hospitals.

February 11, 2015

Adverse Events Toolkit: Medical Record Review Methodology.

July 26, 2023

Adverse Events Toolkit: Clinical Guidance for Identifying Harm

July 19, 2023

Adverse Events in Hospitals: Care Study of Incidence Among Medicare Beneficiaries in Two Selected Counties.

February 18, 2009

Adverse Events in Hospitals: State Reporting Systems.

January 14, 2009

Adverse Events in Hospitals: Overview of Key Issues.

January 14, 2009

National Action Plan for Adverse Drug Event Prevention.

September 24, 2014

Goals and Priorities for Health Care Organizations to Improve Safety Using Health IT. Revised Report.

June 29, 2016

Adverse Events in Hospitals: Public Disclosure of Information About Events.

January 20, 2010

Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors.

July 18, 2007

Patient Safety Organizations: Hospital Participation, Value, and Challenges.

October 16, 2019

The STOP Measure. Safe and Transparent Opioid Prescribing to Promote Patient Safety and Reduced Risk of Opioid Misuse.

July 1, 2019

Sentinel Event Program.

August 14, 2013

Long-term risk of overdose or mental health crisis after opioid dose tapering.

July 13, 2022

Same Day Surgery in the US; Findings of Two Inaugural Leapfrog Surveys 2019.

November 6, 2019

Findings of Two Inaugural Leapfrog Surveys 2019.

November 6, 2019

The Food and Drug Administration's National Drug Code Directory.

September 6, 2006

Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids.

August 25, 2021

Evidence Brief: Implementation of High Reliability Organization Principles.

July 24, 2019

Improving Diagnostic Quality & Safety/Reducing Diagnostic Error: Measurement Considerations.

December 11, 2019

Patient Suicide on a Locked Mental Health Unit at the West Palm Beach VA Medical Center, Florida.

September 4, 2019

Professional Conduct Toolkit.

February 9, 2011

2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report.

March 20, 2024

ONC Health IT Certification Program: Enhanced Oversight and Accountability.

November 30, 2016

Keeping Patients Safe: Transforming the Work Environment of Nurses.

May 11, 2005

Disclosure of Adverse Events to Patients.

November 16, 2005

Medication use evaluation of high-dose long-term opioid de-prescribing in multiple Veterans Affairs medical centers.

January 18, 2023

Greater Focus on Credentialing Needed to Prevent Disqualified Providers From Delivering Patient Care.

March 13, 2019

Toward a High Performance Health System: Public-Private Efforts to Make Health Care Safer and More Effective.

October 19, 2005

Long-term care healthcare-associated infections in 2021: an analysis of 17,971 reports.

July 13, 2022

Patient Safety Reporting System.

April 26, 2006

MRIs and sandbags filled with metal shot.

June 14, 2006

Evaluating the relationship between health information technology and safer-prescribing in the long-term care setting: a systematic review.

March 17, 2021

Approaches and Challenges to Electronically Matching Patients' Records Across Providers.

March 6, 2019

Patient Options for Safe and Effective Disposal of Unused Opioids.

September 25, 2019

Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

November 6, 2019

Medicare's Oversight of Ambulatory Surgery Centers Report.

October 23, 2019

Nurses' perceptions of safety culture in long-term care settings.

July 8, 2009

Long-term effects of teamwork training on communication and teamwork climate in ambulatory reproductive health care.

October 28, 2020

Short- and long-term effects of an electronic medication management system on paediatric prescribing errors.

January 18, 2023

Long-term impacts faced by patients and families after harmful healthcare events.

December 15, 2021

Hospital Performance Report.

October 28, 2021

Quality Improvement and Patient Safety Competencies Across the Learning Continuum.

January 1, 2019

For-profit long-term care homes and the risk of COVID-19 outbreaks and resident deaths.

August 19, 2020

20 Years After “To Err is Human”, Leapfrog Hospital Safety Grades Prove Transparency Can Save Lives.

November 20, 2019

Healthcare-associated infections in Veterans Affairs acute-care and long-term healthcare facilities during the coronavirus disease 2019 (COVID-19) pandemic.

April 5, 2023

Suspicious insulin injections, nearly a dozen deaths: inside an unfolding investigation at a VA hospital in West Virginia.

October 23, 2019

Utilizing a Systems and Design Thinking Approach for Improving Well-Being Within Health Professional Education and Health Care.

January 16, 2019

Healthcare Inspection—Emergency Department Patient Deaths: Memphis VAMC, Memphis, Tennessee.

November 13, 2013

Differences between professionals' views on patient safety culture in long-term and acute care? A cross-sectional study.

September 22, 2021

Medication administration errors for older people in long-term residential care.

February 1, 2012

Long-term care nurses' experiences with patient safety incident management: a qualitative study.

August 4, 2021

Healthcare-associated adverse events in alternate level of care patients awaiting long-term care in hospital.

September 14, 2022

Best Practices in Developing Proprietary Names for Human Prescription Drug Products Guidance for Industry.

December 23, 2020

Testing and Labeling Medical Devices for Safety in the Magnetic Resonance (MR) Environment.

June 2, 2021

Detach yourself: the positive effect of psychological detachment on patient safety in long-term care.

September 29, 2021

Safety Considerations for Container Labels and Carton Labeling Design to Minimize Medication Errors: Guidance for Industry.

May 25, 2022

Best Practices in Developing Proprietary Names for Human Nonprescription Drug Products.

January 13, 2021

Patient Safety and Quality Improvement; Final Rule.

October 22, 2008

Utilizing quality improvement methods to prevent falls and injury from falls: enhancing resident safety in long-term care.

February 1, 2012

I-PSI: short- and long-term efficacy of a comprehensive initiative to promote patient safety event reporting by trainees.

August 25, 2021

Amid the COVID-19 pandemic, meaningful communication between family caregivers and residents of long-term care facilities is imperative.

June 24, 2020

TeamSTEPPS: Strategies and Tools to Enhance Performance and Patient Safety.

July 23, 2023

Health Care Comes Home: The Human Factors.

August 3, 2011

FDA Funding Available for Research Aimed at Reducing Preventable Harm from Medication

November 6, 2019

Implementing the clinical occurrence reporting and learning system: a double-loop learning incident reporting system in long-term care.

March 24, 2021

Evaluation of medication incidents in a long-term care facility using electronic medication administration records and barcode technology.

October 5, 2022

Addressing Health Worker Burnout.

June 8, 2022

Impact of the initial response to COVID-19 on long-term care for people with intellectual disability: an interrupted time series analysis of incident reports.

October 14, 2020

Assessing quality of older persons' emergency transitions between long-term and acute care settings: a proof-of-concept study.

May 18, 2022

‘Fear of falling’: how hospitals do even more harm by keeping patients in bed.

November 6, 2019

New round of Medicare readmission penalties hits 2,583 hospitals.

October 23, 2019

Health IT and Patient Safety: Building Safer Systems for Better Care.

November 16, 2011

Ensuring Healthcare Safety Throughout the COVID-19 Pandemic.

June 10, 2020

Related Resources

Adverse Events Toolkit: Medical Record Review Methodology.

July 26, 2023

Adverse Events Toolkit: Clinical Guidance for Identifying Harm

July 19, 2023

A cluster randomized trial of two implementation strategies to deliver audit and feedback in the EQUIPPED medication safety program.

April 26, 2023

Annual Perspective

Annual Perspective: Topics in Medication Safety

March 31, 2022

Root cause analysis of adverse events involving opioid overdoses in the Veterans Health Administration.

June 23, 2021

Impact of opioid administration in the intensive care unit and subsequent use in opioid-naïve patients.

June 9, 2021

Best Practices in Developing Proprietary Names for Human Nonprescription Drug Products.

January 13, 2021

Best Practices in Developing Proprietary Names for Human Prescription Drug Products Guidance for Industry.

December 23, 2020

Infection Control Deficiencies Were Widespread and Persistent in Nursing Homes Prior to COVID-19 Pandemic.

May 27, 2020

Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look.

May 20, 2020

Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020.

April 22, 2020

Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation.

April 1, 2020

Making Healthcare Safer III.

March 18, 2020

WebM&M Cases

A Mistaken Dose of Naloxone 

December 18, 2019

The STOP Measure. Safe and Transparent Opioid Prescribing to Promote Patient Safety and Reduced Risk of Opioid Misuse.

July 1, 2019

New evidence on stemming low-value prescribing.

May 1, 2019

Changes in practice among physicians with malpractice claims.

April 3, 2019

Advancing the Safety of Acute Pain Management.

March 27, 2019

California doctors alarmed as state links their opioid prescriptions to deaths.

February 6, 2019

Association of pharmaceutical industry marketing of opioid products with mortality from opioid-related overdoses.

February 6, 2019

Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries.

January 9, 2019

Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs.

December 12, 2018

October 3, 2018

Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention's 2016 opioid guideline.

September 12, 2018

Opioid prescribing decreases after learning of a patient's fatal overdose.

August 22, 2018

NAM Action Collaborative on Countering the U.S. Opioid Epidemic.

August 8, 2018

The burden of opioid-related mortality in the United States.

July 18, 2018

Progress Made Towards Improving Opioid Safety, But Further Efforts to Assess Progress and Reduce Risk Are Needed.

July 11, 2018

Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study.

July 11, 2018

Four states with robust prescription drug monitoring programs reduced opioid dosages.

June 27, 2018

See More About The Topic

Physicians

Medicine

Opiates/Narcotics

Educational Outreach/Academic Detailing

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site