Patient and Public Safety Maximized by Rapid Opioid Taper

To the Editor In their Teachable Moment in a recent issue of JAMA Internal Medicine, Guillod and colleagues¹ reported a case of a middle-aged patient taking opioids for chronic pain who did not achieve adequate subjective pain control from narcotics. To mitigate further risk for ventilatory compromise decades into opioid consumption, the authors commendably abruptly discontinued 1620 mg of morphine equivalents. This strategy is reminiscent of naloxone antagonist delivered to patients who have overdosed on heroin, causing ultra-rapid agonist reversal of high-dose opioids to save lives.