Clonidine for Alcohol and Opioid Withdrawal

Clonidine is a common medication for opioid withdrawal treatment, but carries some of its own risks and side effects. Understanding how it works can help.

Clonidine is an FDA-approved prescription medication used to treat blood pressure or attention-deficit/hyperactivity disorder (ADHD). It has also been studied and used off-label to treat symptoms of opioid withdrawal or alcohol withdrawal.

While clonidine is not a controlled substance, some people may be concerned about whether the medication can be habit-forming. Learning more about clonidine and how it works can help you determine the potential risks and benefits of taking clonidine for withdrawal.

Related Topic: Opioid Rehab

What Is Clonidine?

Clonidine is a common prescription medication available as tablets or patches that are worn on the skin. The patches and short-acting tablets are FDA-approved for treating high blood pressure, but the long-acting clonidine tablets are only FDA-approved for treating attention-deficit/hyperactivity disorder.

The short-acting form of clonidine is often prescribed off-label to treat opioid withdrawal symptoms, and the drug can also be used to help treat alcohol withdrawal syndrome. Unlike other medications used for medication-assisted treatment (MAT) during opioid detox, clonidine is not a controlled substance.

Clonidine for Opioid Withdrawal

Some researchers believe clonidine’s mechanism of action in the brain is what makes it able to treat withdrawal symptoms. During opioid withdrawal, there is often an increase in the noradrenergic neurotransmitters that excite the brain. This increase can cause withdrawal symptoms to occur.

Clonidine belongs to a class of drugs known as alpha-2 adrenergic agonists, which work on brain neurons that produce noradrenergic neurotransmitters. More specifically, these drugs prevent the neurons from releasing noradrenergic chemicals into the brain. By blocking these chemicals that would otherwise cause withdrawal symptoms, clonidine helps to prevent and treat withdrawal..

Clonidine for Alcohol Withdrawal

Clonidine can also be helpful in treating alcohol withdrawal symptoms. This is because alcohol withdrawal and opioid withdrawal cause similar changes in the brain. Similar to how it’s used for opioid withdrawal, clonidine prevents neurotransmitters from releasing noradrenergic chemicals into the brain, helping prevent or treat alcohol withdrawal symptoms. Specifically, clonidine can help to control pulse, blood pressure and overall alcohol withdrawal.

Clonidine Administration and Dosage for Withdrawal

While clonidine is not FDA-approved for withdrawal, it has been studied and is often used for this purpose. However, since there is no FDA approval, the dosage used for withdrawal treatment can vary.

For opioid withdrawal, 0.1 mg to 0.3 mg of clonidine every six to eight hours has been reported. The dose may be adjusted based on how well it controls symptoms. Patients are eventually weaned off of the drug as withdrawal symptoms gradually lessen. For alcohol withdrawal, 0.5 mg of clonidine two or three times daily may help with tremors, heart rate and blood pressure control.

Clonidine Side Effects

Clonidine’s side effects are generally mild. The most common side effects are:

• Dry mouth
• Drowsiness
• Dizziness
• Constipation
• Fatigue

Other side effects include:

• Dry throat
• Headache
• Insomnia
• Sexual dysfunction
• Nausea
• Change in taste
• Anxiety

Notably, when clonidine is used for opioid withdrawal, low blood pressure is an additional side effect that often limits the dose a person can take.

Clonidine Interactions

Like all drugs, clonidine has some drug interactions. Medicines that should be used cautiously or avoided with clonidine include:

• Central nervous system depressants: Clonidine may intensify the side effects of sedating drugs like alcohol, opioids, benzodiazepines and barbiturates.
• Antipsychotics: Clonidine shares side effects with antipsychotic drugs, including low blood pressure, dizziness and fatigue. Combining the medications may exacerbate these side effects.
• Some cardiac medications: Heart and blood pressure medications that impact heart rate may dangerously slow the heart when combined with clonidine. Examples include digitalis, beta blockers like metoprolol and calcium channel blockers like verapamil and diltiazem.

Risks of Clonidine Treatment

Clonidine can be used safely in many people. However, one of the most significant risks of clonidine is that it should not be suddenly discontinued. Stopping the drug cold turkey can have serious health consequences, including a rapid rise in blood pressure that can cause a stroke or even death. You may also experience symptoms like agitation, tremor or confusion.

If you need to stop taking clonidine, you should only do so while being closely monitored by your health care provider. Generally, your provider will reduce your dose over several days to safely wean you off the drug.

Abuse Potential

Although clonidine is not a controlled substance, experts believe it has the potential for abuse. For example, some may begin to psychologically rely on clonidine while getting treatment for opioid addiction. This psychological dependence may occur if a person begins associating clonidine with the relief of opioid withdrawal symptoms. Other times, people who struggle with opioids or other depressants may intentionally take clonidine to enhance their high.

Find a Medical Detox Program Near You

If you or someone you love is struggling with alcohol or opioid abuse, help is available. The Recovery Village at Baptist Health can provide evidence-based treatment at any stage of your recovery.

The Recovery Village at Baptist Health offers a range of addiction rehab treatment programs in multiple South Florida locations. The Recovery Village Miami specializes in outpatient treatment services, while The Recovery Village Palm Beach offers a full continuum of care that includes medical detox and inpatient rehab. Contact us today to learn how our qualified medical professionals can help begin the path to a healthier, substance-free life in recovery.