A Group-Based Intervention to Reduce Opioid Use for Chronic Pain/Reply

Sandhu et al respond to comments on their group-based intervention to reduce opioid use for chronic pain. The I-WOTCH study results are most relevant to our population of interest: people treated in primary care using strong opioids, as defined by the British National Formulary at the time we developed the study. We do not know how successful our approach might be in a pain clinic population. They comment that they are surprised that Drs Quinlan and Wiech appear to be suggesting that there are no health benefits from tapering lower doses of opioid drugs, by their assessment, up to 60 mg morphine equivalent per day. Medicare data showed that people prescribed 35 mg of morphine had more opioid-related adverse effects than those taking 20 mg daily and those who were in the process of reducing their opioid dose. There are potential health benefits from tapering from any baseline opioid use level.