Caring for chronic pain patients under opioid therapy is challenging. Opioid treatments above 50 milligrams morphine equivalents (MME) per day are associated with an increased risk of morbidity and mortality. A tapering or a discontinuation should be discussed. Shared decision-making with individualized goals and motivational interviewing principles should be used. Tapering should be slow, with initial rate based on the duration of opioid use and with regular monitoring of patients. Inability to taper may require further reassessment of opioid dependence. Temporary increases in pain may occur at the start of tapering, but pain may improve or remain unchanged upon completion of tapering.