How To Taper Patients Off Of Chronic Opioid Therapy


Internet Enduring Material Sponsored by the Stanford University School of Medicine. Presented by the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine

Course Description

This CME activity will enable doctors to recognize when risks of chronic opioid therapy outweigh benefits, and how to safely and compassionately taper patients off of chronic opioid therapy (including the use of buprenorphine to make this transition). A real life patient case scenario will be used to illustrate these principles in practice, including what to say to patients to communicate risks and provide support through the difficult period of withdrawal. When to refer for addiction treatment will also be discussed.

Intended Audience

This course is designed to meet the educational needs of physicians and nurses in primary care, family practice, internal medicine, neurology, oncology, psychiatry, addiction medicine, and interested Allied Health Professionals.

Dates, Duration and Fee

  • Release Date: August 2, 2018
  • Expiration Date: August 2, 2021
  • Estimated Time to Complete: 1.25 hours
  • CME Credits Offered: 1.25
  • Registration Fee: FREE

To Obtain CME Credits

  • Review the information below and complete the entire activity.
  • Complete the CME Post-test, CME Evaluation Survey, and CME Activity Completion Statement at the end of the activity.
  • You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have three attempts to answer each multiple-choice question (or one attempt for questions with only two options) to pass the post-test.
  • Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
  • Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

Learning Objectives

  • Recognize when risks of chronic opioid therapy outweigh benefits and effectively communicate this information to patients.
  • Employ language to prepare patients in advance for the opioid taper, and to provide emotional support in the midst of withdrawal.
  • Integrate the key features of a successful outpatient taper off of chronic opioid therapy: go slowly, take breaks, never go backwards.
  • Distinguish the signs and symptoms of opioid use disorder (addiction), and intervene with compassion when, in the process of a taper, an opioid use disorder comes to light.
  • Counsel patients on non-opioid alternatives to chronic pain.


  • Introduction
  • Test Your Knowledge
  • Course Wrap-up
  • Resources and References
  • Help!


  • The following planner, speakers and author has indicated that she has no relationships with industry to disclose relative to the content of this activity:
  • Anna Lembke, MD
    Associate Professor of Psychiatry and Behavioral Sciences
    Program Director for the Stanford University Addiction Medicine Fellowship
    Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic
    Stanford University School of Medicine
    Course Director
  • Laura
    The patient in the course, using the pseudonym Laura, has indicated that she has no relationships with industry to disclose relative to the content of this activity.

Technical Design and Development

Hardware/Software Requirements

  • Computer with Internet connection
  • Current version of Chrome, Firefox, or Safari browser. You must have javascript enabled.

Accreditation and Designation of Credits

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Please check with your state’s credentialing board for their requirements.

Commercial Support Acknowledgement

Stanford University School of Medicine has received and has used undesignated program funding from Pfizer, Inc. to facilitate the development of innovative CME activities designed to enhance physician competence and performance and to implement advanced technology. A portion of this funding supports this activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.

You are encouraged to visit the Multicultural Health Portal: http:/ /

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If you are having technical problems or have questions related to CME credit, requirements or course content, contact the CME Online support team at


  • Selemon LD. A role for synaptic plasticity in the adolescent development of executive function. Transl Psychiatry. 2013;3:e238.
  • Steketee JD, Kalivas PW. Drug wanting: behavioral sensitization and relapse to drug-seeking behavior. Pharmacol Rev. 2011;63(2):348-365.
  • Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD; 2013.
  • Sullivan MD, Howe CQ. Opioid therapy for chronic pain in the United States: promises and perils. Pain. 2013;154 Suppl :S94-S100.
  • For a complete list, please view the References/Bibliography Module in the Course.
  • ©2018 Stanford University School of Medicine

Course Details

  • Original Release Date:  08/02/18
  • Expiration Date: 08/02/21
  • Estimated Time to Complete: 1.25 hours
  • CME Credits Offered: 1.25
  • Registration Fee: FREE

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Contact Information

For further information regarding the content, CME credit, or if you experience any technical difficulties with this enduring material please send us an email. 

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