The goal of this clinical trial is to develop an pharmacist-led preoperative opioid taper intervention for patients undergoing total knee or hip replacement who are on chronic opioids before their surgery. The main questions it aims to answer are:

• Is the intervention feasible and acceptable to patients?
• Does the intervention result in a decrease in opioid dose during the preoperative period?

Participants will meet with a clinical pharmacist, who will provide some basic education on pain and opioids, and will propose an opioid taper schedule. The pharmacist will then follow-up with the participant by phone each week until surgery to assess progress and adjust the taper as necessary.

Inclusion Criteria:

• decided to pursue primary, unilateral total knee or hip arthroplasty with planned surgery date in 4-8 weeks
• currently taking between 20 and 90 MME of oral opioids, and that dose has been stable for at least 3 months
• have a reliable telephone number for contact
• speaks English

Exclusion Criteria:

• Taking opioid medications that include:

  • Buprenorphine
  • Methadone
  • Long-acting formulations of opioid pain medications (e.g., extended-release oxycodone and extended-release morphine)
  • Transdermal formations of opioid pain medications (e.g., fentanyl patches)