Tapering Starts Here

When you feel opioids are no longer helpful for chronic pain. We prescribe slow opioid tapers.

Evening and weekend appointments available

We Accept Insurance:

Specialized Medical Care for Tapering in the Comfort of Your Home

Our online tapering program serves clinics throughout California. If you are a provider that no longer feels comfortable prescribing opioids for a patient, we take over the prescribing and taper patients slowly off opioids. Simply refer the patient to our practice through our online portal, let your patient know we will take over their opioid prescribing, and we will see your patient within one week. Check CURES at your next appointment to ensure the opioid has been started by our provider and stop prescribing opioids. We take it from there.

After a comprehensive consultation and transitioning patients to a long-acting opioid we prescribe a tapering plan based on nationally recognized guidelines. For long-term dependence, these typically start at a 5-10% reduction a month and are personalized to each individual's needs.

How it Works

1

  • Complete your insurance verification, scheduling, and intake online and from the privacy of home.

2

  • Click your online link to join your video visit privately from your home. Your provider will be waiting for you. No waiting rooms or paperwork.

3

  • Your prescription is securely and electronically sent to your pharmacy at your visit. No drop off and wait -they can call you when its ready.

Testimonials

  • "My doctor stopped prescribing my anxiety medications and basically accused me of drug seeking. I went into withdrawal two days later. I set up an appointment online with Dr. Raheem and he heard my whole story. He checked my records to confirm my meds and started me on the same dose I was on. We are now tapering every month at a pace I can deal with. "

    Meg

  • "I was on pain meds for over 10 years. My doctor retired and nobody would prescribe my meds. I couldn't drive and live life. I started with this tapering clinic and they use one med to taper you off slowly. I sometimes miss my old pain meds but I'm back to driving and feel much better."

    Susan

  • "I was dealing with protracted withdrawal for many months. I did a lot of research before coming to this program. I read several forums and the ashton manual. They get it and really understand tapering. I learned a lot in my visits and didn't realize how many options I had for treatment. It feels good to finally find someone that understands this.

    Lauren

Tapering Tracks

Benzodiazepines

  • Benzodiazepines should only be prescribed for short term use (days to weeks) unless in rare circumstances. When patients are on benzos for months, they may require a taper if they experience withdrawal symptoms. The Ashton Manual is the evidence-based manual we use to slowly taper our patients off benzodiazepines.

  • Patients will undergo an initial evaluation of their medical history. This includes lab tests and confirmation of the last dose of benzodiazepines through the state database (CURES). If patients qualify for the tapering program, they will enter the tapering program program. Patients who have a substance use disorder will be transitioned to our addiction medicine clinic.

  • After stabilizing on their medication, patients reduce their medication by 5-20% every 4 weeks. Patients undergo lab testing to confirm benzodiazepines levels. Weekly psychotherapy and support groups are encouraged.

Opioids

  • Opioids are intended for short term use (weeks to months) except in rare cases. Patients should not be abruptly stopped from their opioids. Our clinic uses the Department of Health’s Tapering guidelines that call for a slow taper.

  • Patients will undergo an initial evaluation of their medical history. This includes lab tests and confirmation of the last dose of opioids through the state database (CURES). If patients qualify, they will enter the tapering program program. Patients who have a substance use disorder will be transitioned to our addiction medicine clinic and started on MAT/MOUD.

  • Patients are cross-tapered off all their opioids and onto one long-acting opioid called buprenorphine because it provides a slower taper with less side effects. This medication is reduced monthly by 5-20%. Lab tests are conducted to confirm the level of opioids. Physical therapy, movement, and therapy for chronic pain are encouraged.

Others

  • There is limited data on the long-term effects of medications like stimulants, antidepressants, and Z-drugs. Our clinic is not opposed to these medications. However our focus is on helping people taper off these medications.

  • Patients undergo an initial medical evaluation. This includes lab tests and with certain medications, confirmation of the last dose on the state database (CURES). If patients medical symptoms are stable and they qualify for a taper, they enter our tapering program.

  • The research is limited on tapering protocols. Tapers will be conducted gradually and individualized based on patients symptoms. Lab tests will be conducted and medications will be reduced at regular intervals.

Our Providers

We believe the medical science works and our mission is to simply increase access to it. Our approach is nonjudgmental, motivational, and compassionate.

Amer Raheemullah, MD | Medical Director

Dr. Amer Raheemullah, MD, specializes in tapering benzodiazepines and opioids and oversees all patients at the clinic. He is an Associate Clinical Professor at Stanford University in the Psychiatry and Behavioral Sciences Department and Director of the Addiction Inpatient Medical Service at Stanford Hospital. His research focuses on tapering and chemical dependence and his clinical care focuses on the latest evidence-based approaches. He previously served as Senior Vice President at Lucid Lane, a national benzodiazepine and opioid tapering digital health company. He completed his Addiction Medicine Fellowship Training at Stanford University School of Medicine. He is double board certified in Addiction Medicine and Internal Medicine and approaches tapering from this framework, as protracted withdrawal is often confused with addiction or other medical conditions. A list of publications can be seen here.

Marie Magana, PMHNP-BC

Marie brings a unique and comprehensive approach to mental health care. Her expertise lies in assessing, diagnosing, and treating individuals struggling with substance use disorders. She provides a crucial bridge between psychiatry and addiction medicine. With a deep understanding of both the physiological and psychological aspects of addiction, she offers personalized treatment plans that address the complexities of each client's situation. Marie is focused on widening access to addiction treatment by providing underutilized, evidence-based therapies. She is client-focused and uses the principles of CBT and MI to offer more options for her clients.

Understanding the Science Behind Tapering

Watch the video to get a sense of our science-based approach to tapering benzodiazepines and opioids, where our medical director describes the essentials of a successful taper.