One hundred and ten patients with preoperative opioid use undergoing elective spine surgery for degenerative disease were randomized to receive an individualised tapering protocol with telephone counselling 1 week post-discharge (n=55) or standard care with no tapering plan or follow-up (n=55). The primary outcome was the proportion of patients who successfully tapered opioids to zero at 1 year. Secondary outcomes included failure to taper to preoperative doses, pain intensity levels, and reasons for continued opioid use. Outcomes were assessed 1 year after discharge. Overall, the results of the study revealed that 81% of patients in the intervention group were opioid-free at 1 year versus 61% in the control group, with no significant difference in pain levels. These findings suggest that an individualised tapering plan combined with telephone counselling can significantly reduce long-term opioid use without worsening pain.