How To Taper Off Opiates Without Withdrawal

Many factors determine what is the best opiate taper rate to avoid withdrawal symptoms. Learn more about what to take into account before tapering from an opiate.

Opiates are a class of drugs used in both clinical and recreational settings. Some of the most common opiates include morphine, codeine and opium. Opioids and opiates are among the most misused compounds in the world. In 2016, these drugs accounted for over 50,000 overdose fatalities — out of 64,000 total drug overdoses.

However, despite their apparent similarities, in name and otherwise, opiates and opioids are not necessarily the same. Opioids originate in professional labs and black market production locations around the world. Such painkillers and narcotics are fully or partially synthetic and completely man-made. Examples of opioids include oxycodone (the opioid component in Percocet) and hydrocodone (the opioid component in Vicodin).

In addition, more potent drugs of abuse such as fentanyl and carfentanil fit this label. Opiates are natural in origin. Morphine and codeine are synthesized from opium poppy plants — even heroin begins this way before transforming into the volatile drug we all know.

So, opiates are natural and opioids are not. What other differences are there between the two? Overall, all opiates are also considered opioids, but not the other way around. This distinction can get confusing and technical at times. It is best to simply understand that both drugs act on the brain in the same way to varying results.

Despite their differences, both opioids and opiates contribute mercilessly to the opioid epidemic sweeping the United States. This is a wicked problem with a dreary outlook for years to come. However, no person is resigned to a bleak fate — treatment is possible. One opioid addiction treatment method is known as “tapering off opiates.” Here, you will find out more about this approach, as well as how opiate taper calculators work and other tools at your disposal.

Tapering Off Opiates

Tapering has two main objectives: reduce or eliminate an otherwise unbearable opiate withdrawal and acclimate the user’s body to the absence of opiates entirely, the later of which is a potentially years-long endeavor. A withdrawal is the most immediate and pressing aspect to address when tapering off opiates.

The intensity of such withdrawals directly correlates to a medical patient or recreational user’s opiate-use behavior. The individual’s level of tolerance, degree of dependence, and biological makeup as it relates to their opioid addiction also come into play. If that weren’t enough, opiates are characterized as short-or-long acting compounds. As the names imply, one lasts a short duration in the body while the other lasts longer. This distinction is important because opioid withdrawal symptoms pop up much sooner for short-acting opiates. Withdrawal symptoms include trouble sleeping, flu-like side effects, vomiting, fever, spasms, aching, sweating, depression, anxious behavior and much more.

How to Taper Off Opiates

Note: physicians advise that self-detox is not as safe or successful as the clinical alternative. Additionally, quitting opioids or opiates cold turkey often does more harm than good.

This is vital information to begin any discussion on how to taper off opiates. For most, no matter how effective an at-home effort may be, the same procedure will be more efficient and safe under the supervision of medical professionals.

Opiate tapers occur at various rates depending on an individual’s needs — some last mere days while others span years or the course of a lifetime. Four typical rates, as defined by the U.S. Department of Veterans Affairs, will put this into perspective:

• Slowest Taper: Reduction of opiate use by 2-10 percent every one or two months for several years.
• Slow Taper: Reduction of opiate use by 5-20 percent each month. This is the most common approach in certain subpopulations.
• Fast Taper: Reduction of opiate use by 10-20 percent each week. This is the taper commonly recommended by the Centers for Disease Control.
• Fastest Taper: Reduction of opiate use by 10-20 percent daily. This method should only be used patients who have been using short-acting opiates for only a short time. Any taper faster than this can be dangerous and any slower can prove ineffective.

Opiate Taper Calculator

Morphine Equivalent Dose calculators, or MED for short, are used by licensed physicians in some tapering programs. An opioid taper calculator is designed to establish an equivalent dosage amount of morphine compared to the opiate a patient is using. All opiates (not opioids) can be traced back to morphine as the source. Some also convert to morphine in the brain.

Morphine is the oldest known opiate and was considered the standard of care (or yardstick by which opiates are measured) for decades, so everything is translated into morphine measurements, even if the opioid in question (like fentanyl) has nothing to do with morphine. With a baseline morphine dose, healthcare providers can craft a personalized tapering schedule and determine the best medication to replace the opiate with. Methadone and Suboxone are prime examples of medicines used for opiate substance use recovery.

With the right professional care, safe opiate withdrawal is possible. The Recovery Village offers medically supervised detox services with experienced, medical professionals. Reach out to an intake coordinator at  877.399.0063 today to get started. 

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more