The following is a summary of “Two-Phase Inpatient Withdrawal Programme for Long-Term Opioid Use in Non-Cancer Pain,” published in the March 2025 issue of European Journal of Pain by Streitberger et al. 

The growing prevalence of high-dose, long-term opioid use for chronic non-cancer pain (CNCP) in industrialized nations poses a significant burden, complicated by the challenges of opioid tapering and withdrawal.  

Researchers conducted a retrospective study to assess a two-phase inpatient opioid withdrawal (OW) program designed to safely discontinue opioid use in individuals with CNCP.  

They performed the study from 2018 to 2023 at a Swiss tertiary care center, enrolling individuals with CNCP on long-term opioid therapy (≥6 months, ≥100 mg morphine equivalent daily dose) who had unsuccessful outpatient withdrawal attempts. The program included a withdrawal phase (Phase 1) followed by multimodal pain rehabilitation (Phase 2). Outcomes measured were the proportion of individuals opioid-free after Phase 2 (primary) and at 3 months, along with changes in pain intensity and adverse events (secondary).  

The results showed that among the 38 enrolled individuals (58% female, median age 54 years [IQR 49, 62]), 34 (89%) completed both phases of the program, and 32 (84%) achieved opioid-free status at the end of Phase 2. At 3 months, 23 individuals (61%) remained opioid-free, 4 (11%) resumed opioid use, and 11 (29%) were lost to follow-up. Median pain intensity remained stable after discharge and 1 individual died by suicide 10 days post-withdrawal.  

Investigators concluded a structured inpatient program facilitated opioid discontinuation in patients with CNCP and without exacerbating pain, with sustained opioid abstinence at 3 months. 

Source: onlinelibrary.wiley.com/doi/10.1002/ejp.70010