How the Prescriby Health tapering program works
Medication matters. Let's talk about it.
What we taper, what happens at each visit, how long it takes, what it costs, and who the program is — and is not — right for.
Every prescription had a reason. Not every prescription still does.
Medications are prescribed for a reason, and usually a good one. What often does not happen is the review. A prescription written to cover two weeks after surgery, or to get someone through a difficult year, quietly continues for years because nobody stops to ask whether it is still needed.
Some of these medications carry effects that accumulate — on sleep, memory, balance, mood, sexual function, bone health or the gut. And some of them cannot simply be stopped. The body adapts to them, and coming off too fast can make you feel considerably worse than the medication ever did.
That is the gap this clinic exists to close: a structured, provider-led review and reduction, at a pace your body can actually manage.
Dependence is not addiction
Physical dependence means your body has adapted to a medication. Two things follow. You may need more of it for the same effect, which is tolerance. And if you stop abruptly, you get withdrawal symptoms. Dependence is an expected, predictable consequence of taking certain medications as prescribed for long enough. It is not a moral failing and it is not something you did wrong.
Addiction — clinically, a substance use disorder — is a different thing. It describes a pattern of use that has become compulsive: craving, loss of control, and continuing despite clear harm.
Most people who come to us are dependent, not addicted. They took the medication exactly as it was prescribed. The reason stopping is hard is physiological rather than behavioral — and that is a medical problem with a medical solution.
Medications we taper
Each class has its own page with generic and brand names, long-term effects, withdrawal symptoms and how the taper is run.
What the program looks like
From first contact to your last dose.
First contact
You contact us directly, or your provider refers you. We check insurance or self-pay and book your intake. No referral is required.
Intake visit — about an hour
A full review of your medication history, your health, any previous attempts to stop, and what you want the outcome to be. In person in South Portland, or by telehealth.
Your taper schedule
Your provider writes a dose-by-dose schedule for your medication, and we take over prescribing it for the duration of the taper. The schedule goes into the Prescriby app so you can see the next step and log how you feel.
Follow-ups every one to four weeks
Telehealth or in person, at whatever interval your taper needs. If a step is too hard we hold it or make the next one smaller. The schedule serves you, not the other way round.
Completion
The program ends when you reach your goal — off the medication, or at the lower dose you set out to reach. You leave with a written summary for whoever manages the rest of your care.
What the program achieved in Iceland
These figures come from Prescriby's dedicated tapering clinic in Iceland, run in 2024–2025 in partnership with Iceland's Ministry of Health. The US clinic in Maine uses the same care model; its own outcome data is not yet published.
Iceland clinic cohort, 2024–2025.
Iceland clinic cohort, 2024–2025.
Iceland clinic cohort, 2024–2025.
Fit
Is Prescriby Health right for you?
We would rather tell you now than three visits in.
- Long-term useYou are on a medication long-term and want to reduce it or stop it.
- A previous attemptYou have tried to stop before and the withdrawal symptoms sent you back.
- Around surgeryYou are about to have surgery, or have just had one, and want a plan for getting off the opioid afterwards.
- The prescribingYou want someone to take over prescribing the medication while you taper, so refills are not a monthly negotiation.
- Getting to usYou can attend an intake in South Portland, Maine, or by telehealth.
- Starting a medicationYou want to start or increase a medication. We reduce; we do not initiate.
- Acute withdrawal or crisisContact your prescriber or urgent care today rather than waiting for us. Call 911 if you feel unsafe, or call or text 988 for crisis support.
- Substance use disorderIf you are seeking treatment for a substance use disorder involving illicit drugs or alcohol, that needs a different specialty — and we will help you find it.
- Active treatmentYou want to stop a medication your treating provider considers essential. We will review it with you, but we will not override active treatment for a condition that needs treating.
What it costs
Self-pay is $400 per month for as long as your taper runs.
We also bill insurance, and several plans are accepted. Which plans, and how billing works, is set out on the plans page.
Referring a patient
We take on the taper, including the prescription for the medication being reduced, and send you progress updates. The patient stays yours.
For the duration of the taper we assume prescribing responsibility for the medication being reduced, along with the day-to-day patient contact and symptom monitoring.
You receive progress updates through the taper and a written summary at completion, so the reduction is documented in the patient's wider care.
Fax, secure email, phone, or the secure referral form — whichever fits your workflow.
Refer by fax (207) 417-4185, email referrals@prescribyhealth.com, or call (207) 417-4182.
Frequently asked questions
Because for a lot of people the original reason has gone and the medication has not. Long-term use of the medications we work with can carry costs that build quietly over years — on memory, balance, sleep, mood, sexual function, bone health or the gut — and those costs are worth paying only if the medication is still doing a job.
Tapering is how you find out. It is not a judgement about the prescription and it is not all-or-nothing: some patients come off entirely, others settle at a lower dose that works better than the one they were on. What tapering is not is a reason to stop on your own. Several of these medications are dangerous to stop abruptly, and the whole value of a planned reduction is that it is supervised and reversible.
Almost certainly not, in the clinical sense — and the distinction matters more than almost anything else on this page.
Physical dependence means your body has adapted to the medication. You may need more of it for the same effect, and stopping abruptly causes withdrawal. That is an expected, predictable consequence of taking certain medications as prescribed for long enough. It happens to people who have followed every instruction perfectly.
Addiction — a substance use disorder — is a behavioral pattern: craving, loss of control, taking more than intended, and continuing despite clear harm to your life. It is a different problem with different treatment.
The overwhelming majority of the people we see are dependent, not addicted. If both are present, that is worth telling us at intake: not because it disqualifies you, but because it changes what the right care is, and we would rather point you to the right service than run the wrong program.
It depends on which medication, what dose, and how long you have been taking it — and your provider will give you a realistic estimate at intake rather than a number off a website.
As a rough guide: a post-surgical opioid taper is often measured in weeks. A step-down off a stomach-acid medication is usually a few weeks to a couple of months. Antidepressants, sleep medications and gabapentinoids typically take a few months. Benzodiazepines after long-term use take the longest, and rushing them is the most common way a taper fails.
The schedule is not fixed. If a step is hard we hold it, and holding is part of a successful taper rather than a setback.
No. Many of our patients contact us directly. Providers can also refer, and either way we coordinate with whoever manages the rest of your care.
The point of the schedule is to keep withdrawal to a minimum, and most patients report feeling well for most of the process. Some steps are harder than others, particularly at low doses. You log symptoms between visits, and when a step is difficult we slow down rather than push through.
That is a perfectly good goal. Plenty of patients want a lower, more sustainable dose rather than zero. You define what success looks like at intake, and the schedule is written to it.
We do, for the medication being reduced, for the duration of the taper. That is deliberate: having the prescriber and the taper plan in the same place removes the refill anxiety that makes tapering harder than it needs to be. Your other medications stay with your usual prescriber.
Follow-up visits are routinely done by telehealth. Whether your intake can be is something to confirm when you contact us, since it depends on the medication and on where you are.
You get a written summary of the taper — what was reduced, over what period, and where you finished — to give to whoever manages the rest of your care, along with what to watch for afterwards.
Yes. All communication and record-keeping is HIPAA compliant. Please do not include protected health information in the general contact form — use the secure intake or referral forms instead.
Ready to talk about your medication?
Tell us what you are taking and how long you have been taking it. We will tell you what a taper would involve, roughly how long it would take, and what it would cost.
Providers: refer directly by fax, email, phone or the secure form.