The U.S. Department of Health & Human Services released a guide for clinicians on tapering or discontinuing long-term opioid prescriptions.  Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks.  But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm and should include a thorough, deliberative case review and discussion with the patient.  While rates of prescribing have declined in recent years, the Centers for Disease Control and Prevention reports data showing opioid prescribing rates have been significantly higher in nonmetropolitan counties than in metropolitan counties.