Considering the Opiate epidemic, the efforts of the government and the doctors have increased to deal with this crisis.
In such a scenario, new drugs and herbs are popping up in the market on a daily basis, which claims to have fruitful results for Opiate withdrawal.
Clonidine is also considered as a drug of choice for Opiate withdrawal, and research studies prove its efficacy.
In comparison to the standard Opiate withdrawal regimen, how efficient is Clonidine? Can you entirely withdraw from Opiates just by using Clonidine? Do you need supplementation with clonidine to treat Opiate addiction? These are some of the questions that will be answered in this article.
What is Clonidine and how is it useful for Opiate withdrawal?
Clonidine is an alpha2 adrenergic agonist that stimulates the alpha2 receptors and decreases the blood pressure by lowering the peripheral vascular resistance. It’s usually incorporated in the management of hypertensive patients.
However, it is also useful in treating hyperactive states like ADHD. Clonidine also acts on the imidazoline receptor agonist.
It primarily functions by inhibiting the release of norepinephrine which is a sympathetic neurotransmitter and results in hyperactivity and vasoconstriction of blood vessels leading to elevation of blood pressure.
The use of Clonidine for Opiate withdrawal has been studied for years. The results of various studies prove its efficacy and potency for the treatment of Opiate withdrawal.
Opiate withdrawal is not an easy process. It is like dealing with a multitude of severe crippling symptoms that can hamper the day to day activities. Therefore, treatment for Opiate withdrawal symptoms is required.
This is where clonidine comes into action. Unlike other drugs used for Opiate withdrawal, clonidine is not a narcotic. It just alleviates the symptoms by its activity on the alpha2 receptors.
It won’t reduce your craving for Opiates, but yes, it will reduce your muscle cramps, your physical symptoms like sweating and runny nose, your psychological symptoms like anxiety and agitation. Clonidine doesn’t relieve insomnia associated with Opiate withdrawal.
Research studies in favor of use of Clonidine for Opiate withdrawal
A study ‘Clonidine blocks acute Opiate withdrawal symptoms’ by Mark S Gold, Eugene Redmond and colleagues were conducted in the year 1978.
It was a double-blind, placebo-controlled study which proved that Clonidine alleviated the objective signs and the subjective symptoms of 11 patients in a hospital.
The same patients were observed for six weeks, and out of 11 patients seven were off of all opiates, four were using methadone, and 1 of these was also taking tricyclic antidepressants. Overall, all 11 patients were doing well after being observed for six weeks.
The study confirmed that the Opiate withdrawal symptoms appear due to excessive neuronal activity in the locus coeruleus which is regulated by alpha2 adrenergic receptors as well as Opiate receptors. Therefore, clonidine is an active drug for Opiate withdrawal.
Another study by the same group of researchers as stated above was ‘Noradrenergic hyperactivity in Opiate withdrawal supported by clonidine reversal of Opiate withdrawal.’
In this study, five μg/kg of clonidine was administered to 6 male Opiate addicts after the discontinuation of previous medicine (methadone).
The results of the study suggested that clonidine is a more effective treatment option as it led to alleviation of Opiate withdrawal symptoms quickly as compared to methadone.
Another study by Mark S Gold and colleagues are known as ‘Opiate withdrawal using clonidine: A safe, effective and rapid non-opiate treatment’ was carried out in an inpatient setting on ten patients after they abruptly discontinued the use of methadone hydrochloride.
Clonidine was given to these patients for 14 days, and the results showed that all ten patients were detoxified from the chronic opiate administration.
Clonidine was proven to be safe and effective that suppressed the Opiate withdrawal symptoms. The data suggest that clonidine has anti-withdrawal effect by inhibiting the release of noradrenergic activity.
How to take Clonidine for Opiate withdrawal?
Clonidine is taken in the form of pills, skin patches and injections. In the pill form, it is available in a dose of 0.1mg, 0.2mg, and 0.3mg. Initially, a dose of 0.1mg of clonidine must be administered every 4 hours.
The dose should be increased 3rd day onwards to 0.2mg clonidine every 4 hours. Day 5 onwards the dose should be gradually tapered.
Clonidine patch comes in three varieties which are labeled as #1, #2 and #3. #1 patch delivers 0.1mg, #2 delivers 0.2mg and #3 delivers 0.3mg in 4 hours. The patch can be used for one week only and then it needs replacement.
On the first day of application of the patch, an oral dose of 0.2mg clonidine must be taken after every 6 hours and then on the next day a dose of 0.1mg of clonidine after every 6 hours.
The number of patches to be placed should be decided by the weight of the patient. More patches are required in obese patients.
Contraindications of Clonidine for Opiate withdrawal
Do not take clonidine for Opiate withdrawal if you are pregnant or a lactating mother. Avoid taking clonidine if you are taking medications for any other ailment, specifically for hypertension of renal and cardiac disorders. Clonidine is also contraindicated in adrenal gland cancer.
Always perform a skin patch test before taking clonidine.
As you must have read the studies mentioned above, we can safely say that Clonidine for Opiate withdrawal is an effective medication. It doesn’t cause addiction or development of tolerance like other Opiate medication.
Though it prolongs the Opiate withdrawal period, its side effects are fewer if the right doses are taken at appropriate timings.
Frequently asked questions
What are the side effects of clonidine?
The side effects of clonidine include dry mouth, headache, weakness, fatigue, tiredness, nausea, and vomiting, nervousness and constipation.
Along with this swelling of the lips, tongue, throat, face including eyes, lower legs, ankle, and feet may occur.
I am taking clonidine for hypertension; will it help me in withdrawal from Opiates?
The dose of clonidine that you are taking for hypertension differs from that of the Opiate withdrawal.
It is necessary that you follow the proper dosage regimen to have Opiate withdrawal. Therefore, antihypertensive treatment with clonidine is not sufficient for Opiate withdrawal.
Can I develop an addiction to clonidine?
No, clonidine is not a narcotic, and you won’t develop an addiction to it. However, the dose of clonidine should be tapered gradually as sudden quitting of clonidine can lead to adverse effects.