Considerations when stopping medication-assisted treatment of opioid dependence (MATOD)
When planning to stop medication-assisted treatment of opioid dependence (MATOD), consider whether factors are present that may promote positive long-term outcomes, as outlined in Factors to consider when planning to stop medication-assisted treatment of opioid dependence. The minimum duration of MATOD is ideally 12 months (although longer treatment is likely to offer more benefit); this allows time for the patient to address other life concerns with the aim of reducing risk of relapse. Discuss the fact that relapse can happen (particularly if a patient requires opioids for surgery) and recommend that patients seek treatment again early if relapse should occur.
Stopping MATOD requires support and relapse prevention strategies. Specialist advice is available and contact is encouraged when planning MATOD tapering. Most commonly, treatment is gradually tapered over months with careful monitoring.
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Patient factors |
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minimal or stable use of nonprescribed substances including alcohol good physical and mental health positive social factors (housing, work, recreation, support from friends and family) central role in decision-making and good understanding of the process of stopping MATOD |
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Treatment process factors |
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plan agreed to taper MATOD over months with regular review of progress coping strategies and ways jointly devised to reduce risk of lapses and relapses |