Adding Cognitive Behavioral Therapy, Self-Management Does Not Improve Opioid Taper Success

WEDNESDAY, July 22, 2026 (HealthDay News) — Adding cognitive behavioral therapy (CBT) or self-management to patient-centered opioid tapering does not improve taper success at 12 months, according to a study published online July 7 in the Annals of Internal Medicine.

Beth D. Darnall, Ph.D., from the Stanford University School of Medicine in Palo Alto, California, and colleagues determined and compared the effectiveness of three opioid tapering and pain control strategies in a randomized controlled trial conducted at 11 U.S. sites involving adults with pain for at least six months (without moderate or severe opioid use disorder) receiving a morphine equivalent daily dose of 10 or higher for at least three months. Patient-centered opioid tapering was administered as taper only, taper plus cognitive behavioral therapy for chronic pain (pain-CBT), or taper plus a chronic pain self-management program (CPSMP; 191, 203, and 168 patients, respectively).

The researchers found that the taper success rate was 50.9, 48.6, and 44.5 percent for taper only, taper plus plain-CBT, and taper plus CPSMP, respectively. In terms of taper success, there was no benefit seen for tapering with CBT or tapering with CPSMP over taper only. The taper-only group had the highest rate of study-related adverse event risk (including opioid withdrawal symptoms) compared with taper plus pain-CBT and taper plus CPSMP (66 versus 54 and 64 percent, respectively).

“For patients, I think the data are reassuring that if opioids are tapered the right way, meaning a patient-centered approach, people can significantly reduce their opioid doses without having increased pain long term,” Darnall said in a statement.

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