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Key Points Question For patients receiving stable long-term opioid therapy compared with a stable opioid dosage, what is the association of opioid dosage tapering or abrupt discontinuation with opioid overdose or suicide? Findings In this comparative effectiveness study of 415 123 episodes of stable long-term opioid therapy among 199 836 individuals, opioid tapering was associated with a small absolute increase in opioid overdose or suicide compared with a stable opioid dosage. No significant difference in outcomes between abrupt discontinuation and stable opioid therapy was identified. Meaning These findings do not support opioid dosage tapering as a strategy to reduce harms for patients receiving stable long-term opioid therapy without evidence of misuse.

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