The opioid epidemic has seen a wide range of people developing a substance use disorder related to opioids. Heroin is one of the most common opioids of abuse, with 626,000 people meeting the criteria for a heroin use disorder, according to the National Institute on Drug Abuse (NIDA). Only a fraction of this population seeks out the treatment they need, and even fewer make it to sobriety. One of the largest barriers to sobriety for heroin users is the inability to make it through withdrawal symptoms.
Opioid withdrawal symptoms are similar to the flu, except that people who have gone through it report that it feels significantly worse than any flu they had ever experienced. Nausea, vomiting, diarrhea, sweating, body aches, and fever are common symptoms. Though it’s not typically deadly, withdrawal can cause dehydration, which can be dangerous without medical help.
Because withdrawal is such a significant barrier, doctors, researchers, and clinicians have worked hard to develop treatment options that alleviate the uncomfortable symptoms to help people through the withdrawal phase. One medicinal treatment option is clonidine, a prescription used for a variety of purposes.
Clonidine is a medication in a class of drugs called antihypertensives that are designed to lower high blood pressure. The drug is traditionally used to treat high blood pressure, attention-deficit hyperactivity disorder (ADHD), anxiety disorders, migraines, and tics. However, it also has been studied and used as a medication to help ease the uncomfortable symptoms of opioid, alcohol, benzodiazepine, and nicotine withdrawal. It’s rare for a medication to be useful in treating withdrawal for a wide variety of drugs, but its wide-reaching efficacy may make it a common medication in addiction treatment centers.
Clonidine is a prescription medication that requires a medical professional or authorized dispensary to administer it. It comes with a few common side effects including dizziness, hypotension (low blood pressure), dry mouth, fatigue, headache, anxiety, constipation, and nausea.
But, is the drug an effective and viable option for the treatment of heroin withdrawal symptoms? Learn more about heroin detox, clonidine, and how it may or may not be an effective option for you.
Clonidine works in the body in several ways. To treat high blood pressure, it activates a specific chemical receptor in the brain that decreases peripheral vascular resistance. In other words, it increases blood flow and lowers blood pressure. This may help to alleviate certain symptoms like headaches and tachycardia that are common in opioid withdrawals. In this way, it’s similar to other blood-thinning pain relievers like aspirin.
When it comes to treating other withdrawal symptoms, clonidine may reduce the sympathetic nervous system responses that cause hypertension, sweating, hot flashes, and restlessness. Opioids work in the body similarly to central nervous system depressants. They suppress excitability in the nervous system and cause sedation and euphoria. When you become dependent, your brain starts to rely on heroin to regulate your nervous system in that way. When you stop using, your brain chemistry will become unbalanced, causing nervous system overactivity that results in these uncomfortable symptoms.
Clonidine may also have sedative effects that can help ease insomnia that comes from discomfort. However, these effects may be mild.
Clonidine has been used in opioid withdrawal treatment for several decades. Its effectiveness for this purpose has been studied scientifically since the 1970s before we knew much about what causes withdrawal symptoms. A 1978 study into the effectiveness of clonidine in treating acute opiate withdrawal symptoms found that the drug postpones the symptoms for a short time in some patients. The study was used to help conclude that opioid withdrawal is caused, at least in part, by increased neuronal activity.
However, clonidine isn’t a miracle cure for addiction withdrawal symptoms, and it may be effective for everyone. A 1985 study reported that clonidine was effective in treating the symptoms caused by autonomic symptoms (like hypertension), but it wasn’t effective in treating other symptoms of discomfort. This means that clonidine won’t be the only treatment you need to get through withdrawal symptom-free. Some symptoms will be difficult to avoid, while others may need other treatment options to address. Clonidine is just one part of an effective, holistic treatment plan. For the best results, it’s important to speak to professionals and explore the full range of detox and addiction treatment options.
A study in 1983 also found that clonidine may not be an effective treatment for insomnia and sleep problems that are associated with opioid withdrawal. In the study, practitioners helped to alleviate insomnia with benzodiazepines, which are common sleep aids used in treatment. They also used doxepin, which may have counteracted the effects of clonidine, making it less effective.
Overall, clonidine has shown to be effective in treating some of the uncomfortable symptoms of opioid withdrawal, but it’s not a cure-all. Clonidine needs to be used as one part of a broader treatment approach.”
Heroin withdrawal is rarely life-threatening, but it can be fatal in rare instances without medical treatment. Heroin withdrawal symptoms are described as a very bad case of the flu, and like the flu, you will need to drink plenty of water. Symptoms like diarrhea, vomiting, and excessive sweating can cause you to lose water quickly.
If you are going through withdrawal on your own, you may not drink enough just because you feel too weak or too distracted by uncomfortable symptoms to do it. In a detox program, even one that’s in a hospital, medical professionals can help make sure that you avoid potentially dangerous dehydration.
In some settings, you can go through what is called rapid detox, in which you are given opioid antagonists, which are drugs that bind to opioid receptors and block them from being activated. This will skip the gradual process of opioids leaving your system and send you straight to acute withdrawal. Your symptoms will be mitigated with other medications. Though this can shorten the time it takes for you to go through detox, it’s a relatively new process. According to the American Society of Addiction Medication, ultra-rapid opioid detox hasn’t been adequately studied enough and needs more scrutiny.
In a medical detox program, opioid addiction can be treated alongside other substance use disorders and medical conditions that need addressing. After the detox process, on-staff clinicians will help you find the next level of care for your needs. Detox is usually not enough to lead to long-lasting recovery, especially if you’ve developed a severe substance use disorder. Addiction is a chronic disease, but it can be treated with the full continuum of care in addiction treatment.
Darke, S., Larney, S., & Farrell, M. (2016, August 11). Yes, people can die from opiate withdrawal. from https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512
National Institute on Drug Abuse. (2018, June). What is the scope of heroin use in the United States? from https://www.drugabuse.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states
Gold, M. S., Redmond, D. E., & Kleber, H. D. (2003, September 26). CLONIDINE BLOCKS ACUTE OPIATE-WITHDRAWAL SYMPTOMS. from https://www.sciencedirect.com/science/article/pii/S0140673678928234
Jasinski, D. R. (1985, November 01). Clonidine in Morphine Withdrawal. from https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493689
Schanda, H., Presslich, O., & Hermann, P. (1983, August 26). [Clonidine for the treatment of heroin withdrawal syndrome]. from https://www.ncbi.nlm.nih.gov/pubmed/6649643