Often, the prescriber determines to stop therapy even when the patient wants to continue. The discussion with the patient about the indication to continue is key to successful communication. It also gives the patient and prescriber new information that may indeed lead to a decision to remain on the opioid therapy.
The prescriber should explain the rationale for stopping the therapy. If there is a clear indication for stopping, such as illegal activity or harm, then the discussion is focused on how to help the patient cope without the opioids.
Sometimes the prescriber has evidence that the patient is addicted, which the patient may deny. These are some of the most difficult conversations to have with a patient, but the use of facts that lead to this and the assignment of responsibility to the patient for those behaviors should help to facilitate these discussions.
Source: These recommendations are based on expert consensus.