• Posted July 14, 2026

Pain Patients Should Taper Opioids At Their Own Pace, Study Suggests

About 5 million Americans are thought to be using an opioid painkiller to ease their chronic pain. 

A new study suggests that the safest route to reducing use of the powerful drugs is best left up to the patient.

“For patients, I think the data are reassuring that if opioids are tapered the right way, meaning a patient-centered approach, people can significantly reduce their opioid doses without having increased pain long term,” said study lead author Beth Darnall. She’s a professor of anesthesiology, perioperative and pain medicine at Stanford University in California.

The study was published recently in the Annals of Internal Medicine and involved more than 500 adult patients. 

All had experienced some form of chronic pain for at least six months and had been taking an opioid to ease that pain for at least three months. None were found to have any addiction to the drugs. 

Many had histories of pain and related opioid use that had extended much longer, with patients averaging 12.4 years of opioid use at the time of the study.

Many wanted to lower their dosage and collaborated with their doctors to reach their lowest comfortable dose over the course of one year.

As part of the Stanford program, dosages were lowered by no more than 10% each month. Patients could put a pause in their dosage-lowering efforts whenever they wanted to, in consultation with their doctor.

The study's goal: Dosage reductions of at least 50% with no related increase in pain, or maintaining a certain dose with significantly less pain. 

At the 12-month point, about half of the participants met that level of "successful response," the authors said.

Leaving key decisions around tapering in patients' hands was crucial, Darnall said in a Stanford news release.

“So much of the fear of opioid tapering is about losing control,” she explained. “We really focused on the individual patient and developed methods to ensure that they had maximal control in the process.”

The findings are in line with current U.S. Centers for Disease Control and Prevention (CDC) guidelines, which support a patient-driven approach to tapering off opioids for chronic pain. 

That's in contrast to prior (2016) guidance from the CDC, which offered patients and their physicians no clear direction on how quickly to reduce opioid use.

After 2016, "there were people who had been taking opioids for a long time who were tapered too fast," Darnall said. Many were cut off from opioids abruptly and without their consent, leading to withdrawal symptoms that could spur addiction to illicit drugs and even suicides.

“Ironically, in the name of reducing their risk, we were creating new risks by reducing opioids in the wrong way,” Darnall said. “The data told us that there are risks when you go up on doses, but there are risks when you go on down on doses, too.”

Darnall's team stressed that the approach outlined in their study is not designed to help people who have developed an opioid addiction.

The Stanford group also studied whether certain supportive therapies — eight weekly sessions of cognitive behavioral therapy or six weeks of a peer-led chronic pain self-management program — might significantly boost success rates. 

That was not the case, although cognitive behavioral therapy for chronic pain did appear to ease opioid withdrawal symptoms.

Darnall and her colleagues hope the new findings will provide much-needed guidance to people looking to reduce their use of an opioid. A prior Stanford survey had found that 68% of patients prescribed an opioid had tried, unsuccessfully, to reduce their use of the drugs.

“If they stop abruptly, it’s probably going to be a horrible experience,” Darnall said. “So that’s the experience they have and they think, ‘I need to stay on my dose; I can’t taper opioids.’ But often that’s not true — it was a flawed experiment."

More information

Find out more about the relief of chronic pain at the Cleveland Clinic.

SOURCE: Stanford University, news release, July 9, 2026