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Clonidine Found To Improve Buprenorphine Treatment For Opiate Addiction

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

January 23, 2019

Clonidine is a drug used to treat high blood pressure by relaxing blood vessels and reducing excessive beats per minute. Qualities in the drug also have an anti-anxiety effect and are being used to reduce the severity of withdrawal symptoms associated with opiate addiction. While the drug doesn’t specifically treat opiate addiction, research is showing promising results for reducing early relapse for those who are opiate-dependent.

Some commonly abused opiate drugs include opium, heroin, OxyContin, morphine, fentanyl, and codeine. The severity of withdrawal symptoms a person experiences during initial detox vary but can include strong cravings, flu-like symptoms including nausea and vomiting, diarrhea, stomach cramping, headache, shakiness, bone pain, chills, runny nose, excessive sweating, anxiety, insomnia, and muscle tension and cramping. The onset of the severity of these symptoms is an easy avenue to relapse in early treatment.

Common Opiate Withdrawal Symptoms Include:

  • Nausea and vomiting
  • Diarrhea
  • Stomach cramps
  • A headache
  • Shakiness
  • Bone pain
  • Chills
  • A runny Nose
  • Excessive sweating
  • Anxiety
  • Insomnia
  • Muscle tension and cramping

Effectively treating opiate addiction means addressing these early symptoms. Clonidine addresses a number of these symptoms and its use in conjunction with evidence-based treatment is showing success in helping people overcome opiate addiction.

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How Does Clonidine Work in Treating Opiate Withdrawal Symptoms?

Clonidine is one of the most commonly used drugs to treat opiate withdrawal. It works by reducing anxiety, muscle tension and cramping, insomnia, and prevents some of the flu-like symptoms like excessive sweating and runny nose. Used in conjunction with other medications that treat the gastrointestinal discomforts associated with opiate withdrawals, Clonidine creates a smoother transition from active use of opiates to active participation in treatment.

Clonidine works by blocking the body’s alpha receptors, or those control signals that normally cause vasoconstriction. When this happens, the body is unable to constrict the arterial walls, causing a lowering of blood pressure and reduction in heart rate. The reduction of these symptoms leads to a more general relaxation of the body and smooth muscle tissue and more restful sleep.

Research Supports The Effectiveness of Pharmacological Treatment of Opiate Withdrawals

Several studies have demonstrated the effectiveness of clonidine in treating opiate withdrawal symptoms, however, clonidine is just one drug used to treat opiate withdrawals. One study examined the effectiveness of clonidine compared with a combination of buprenorphine and naloxone in a computer randomized trial.

Following the 10-day detoxification period, both groups showed a significant reduction in cravings and associated withdrawal symptoms, however, the buprenorphine/naloxone control group demonstrated an advantage over the clonidine group in providing more comprehensive relief.

However, a person is more likely to become addicted to the combination buprenorphine and naloxone, also known as Suboxone, a synthetic opioid medication, than to clonidine. Clonidine may also be more appropriate medically for someone already suffering from hypertension or related complaints. Likewise, someone suffering from chronic pain will benefit from a long-term pain management strategy that includes appropriate pharmacology, including the use of Suboxone. Both clonidine and use of Suboxone are more effective at reducing overall overdose risk overuse of methadone, the traditional choice in treating heroin addiction.

Pharmacology produces significant results compared with drug tapering. One study compared the use of Suboxone to tapering and found 70 percent of those applying the pharmacological treatment of symptoms relating to withdrawals and cravings remained in treatment, compared to only 21 percent of the taper group.

Harm Reduction With Use of Clonidine

In addition to higher program participation among individuals who apply the use of medications like clonidine to treat early withdrawal symptoms, overall potential for harm including exposure to pathogens like HIV from used needles and crime relating to drug use are also diminished. There is a collaborative effect of the use of the drugs on the overall health and success of an individual participating in these programs.

Potential Health Risks Associated With Use of Clonidine

Clonidine works to reduce hypertension, but the sudden cessation of the drug can result in a rebound effect, with a significant spike in blood pressure. The drug is normally tapered to reduce the potential for side effects relating to this effect. Clonidine may also increase the effects of other drugs or alcohol, and can lead to depression of the central nervous system if not properly monitored.

Some people report feeling drowsy or not as an alert on the medication and a common side effect of the drug is dry mouth and dizziness. Fainting is also possible, if blood pressure drops significantly due to the effects of the medication, especially where an individual had lower blood pressure at the start of treatment.

Overall, clonidine is considered safe in the treatment of opiate addiction.

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