What's The Best Way To Stop Taking Powerful Prescription Drugs?

Aug 15, 2016
Originally published on August 15, 2016 5:59 am
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And millions of people take powerful prescription medication to treat their chronic pain. But with all the concern about opioid addiction, some patients are worried and want to stop. NPR's Patti Neighmond reports that the best method may be to taper off the drugs rather than going cold turkey.

PATTI NEIGHMOND, BYLINE: The way Betts Tully tells it, the painkillers not only took away the chronic back pain she suffered from a car accident years before. They also made her feel, well, just fabulous.

BETTS TULLY: I was a 53-year-old woman then. And I felt like I was 22. I felt like Superwoman. I felt like I could do everything.

NEIGHMOND: It was the beginning of what Tully now describes as addiction. And because the body adapts to painkillers, over time she needed more and more to get the same effect. Tully ended up taking 14 times what was originally prescribed. After six years, she says, she felt like a zombie.

TULLY: I had gone from being productive all my life to not wanting to move out of my house, not being able to drive, not wanting to talk to my family, my friends or anything else.

NEIGHMOND: Tully knew she had to stop. But she had trouble finding a treatment program she thought would work for her. So she decided to go it alone.

TULLY: It took me probably three weeks of throwing up because it's those last days of having nothing in your system, and your body starts to scream for it. And you're very sick. You know, some doctors like to talk as if, oh, it's nothing more than a cold. It's way more than a cold. And I'm here to tell you it's a scary thing.

NEIGHMOND: But not unusual, says pain specialist Dr. Michael Hooten, who works at the Mayo Clinic. He says many people just give up. Withdrawal symptoms can be so overwhelming and made even worse because years of opioid use decreases the body's production of natural painkillers.

MICHAEL HOOTEN: So if they stop cold turkey, more than likely what they will experience is an amplification of the primary pain problem that they have. So if a person has low back pain, they will experience low back pain more intensely. But secondarily, they may have other areas of pain that may emerge, primarily in the muscles and joints.

NEIGHMOND: Medical supervision can make all the difference, he says. Doctors can prescribe certain muscle relaxers and sedatives to help ease withdrawal symptoms, making it easier to taper bit by bit, reducing dose by 10 percent every week.

HOOTEN: That approach, it may - depending on the baseline dose - may take several weeks or even months. But if it's structured and in a controlled manner, the risks of having opioid withdrawal and the risks of really worsening or amplifying pain will be minimal.

NEIGHMOND: Hooten says behavioral techniques can also be beneficial. Psychologist Judith Turner at the University of Washington helps patients taper. She teaches them how to control certain brain activities so they don't focus on their pain, using breathing exercises and muscle relaxation.

JUDITH TURNER: Take the example of focusing on your right hand, making a fist, clenching it, holding it, noticing that tension and then just letting it go, letting all the tension flow out of the hand and work through different muscle groups of the body that - that way. So if you start with the top of your head, you know, you tense your forehead muscles, squint your eyes shut, work your way down your jaw muscles.

NEIGHMOND: Patients are often skeptical at first, she says, until it starts to make a difference.

TURNER: One person I worked with recently told me he was absolutely amazed. When he did this, he had no pain at all. He was really surprised.

NEIGHMOND: Turner recently did a small pilot study, which found techniques like this reduced pain for most patients. For Betts Tully, she was eventually successful and stopped taking opioids.

TULLY: I don't take anything more for my back pain than Advil. Any day that I have really bad pain, I am willing to take that pain before I would ever go back to being on chronic opioid therapy.

NEIGHMOND: Both Tully and the patients in Turner's study are not completely pain-free, but their pain is diminished and no longer interferes with their lives. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.