<unk>  is the reduction of<unk>  doses over time.<unk>  is typically done in people taking<unk> s for chronic pain.<unk>  may be conducted in medically-supervised inpatient or outpatient settings. Community-based<unk>  increased after the 2016 “Center for Disease Control Guideline for Prescribing<unk> s in Chronic Pain” was published, and many prescribers and organizations instigated<unk>  practices in order to reduce<unk>  prescribing. While the CDC guideline was intended to inform primary care physicians on new prescription initiation, in many cases it was misapplied beyond this narrow scope and used to inform<unk>  practices among patients taking long-term prescription<unk> s for chronic pain. Voluntary patient-centered<unk>  has shown success with engagement and reduction of moderate and high-dose<unk>  doses over the course of months. Principles of patient-centered<unk>  include: patient consent to taper, patient ability to control the pace of the taper, and pause the taper if desired. Recent published national study protocols ascribe to these principles. Some healthcare providers have expressed concern about negative consequences of rapid forced<unk>  including suicidality. Human Rights Watch has called the negative consequences of forced prescription<unk>  in chronic pain to be a “human rights issue." In April 2019, the Federal Drug Administration issued a drug safety communication warning against sudden discontinuation of<unk>  pain medicines and requires label changes to guide prescribers on gradual, individualized<unk> . In October 2019, U.S. Health and Human Services published the HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term<unk>  Analgesics. The document calls for a patient-centered approach, cautions against a blanket assumption that less<unk> s is always best, and provides an implementation guide for<unk>  for patients for whom reduction is best.
Opioid tapering
Stimulant maintenance
Monoamine releasing agent
Appetite stimulant
Dopamine releasing agent
Alcohol detoxification
Mood stabilizer
Cholinergic blocking drugs