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"Our study showed 81.5% of patients with chronic noncancer pain reduced their average daily opioid dose immediately prior to or in the 395 days following implantation of an intrathecal drug‐delivery system. Overall, 43% of patients discontinued systemic opioids following implantation of an intrathecal drug‐delivery system, with discontinuation associated with significantly lower costs from a payer perspective in the one‐year postwashout time period. Patients on lower systemic opioid dose levels (morphine milligram equivalents of 1‐50 mg/day) were two times more likely to discontinue systemic opioid therapy relative to patients on high doses prior to start of intrathecal drug‐delivery system therapy (morphine milligram equivalents ≥90 mg/day). However, we observed only minimal dose reduction prior to start of intrathecal drug‐delivery system therapy in this study population. Our results suggest a need for broader adoption of opioid weaning and/or discontinuation protocols prior to start of intrathecal drug‐delivery system therapy to maximize probability of complete systemic opioid discontinuation with intrathecal drug‐delivery system therapy and to maximize cost savings in this patient population. Furthermore, complete systemic opioid discontinuation could decrease diversion, addiction, opioid overdose, and overdose‐related deaths."