Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component in treatment. To date, there are three medications that are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. All brand name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolv. In addition to these FDA-approved MOUDs, there are several other medications that are used off-label to assist in recovery. Clonidine is a medication that is particularly helpful in treating the uncomfortable symptoms of opioid withdrawal.
The FDA approved clonidine to treat a variety of conditions, including hypertension (high blood pressure), attention deficit disorder (ADHD) in children, symptoms of Tourette syndrome, and cancer-related pain. Clonidine is also prescribed “off-label” to treat several other diagnoses. “Off-label” prescriptions are FDA-approved medications that doctors prescribe to treat other conditions than it was originally approved for. Prescribing off-label is a common medical practice. For example, clonidine is prescribed off-label to treat anxiety, insomnia, post-traumatic stress syndrome, and withdrawal symptoms from opioids, benzodiazepines, and alcohol.
Clonidine has been used off-label for over 25 years to relieve the symptoms of opioid withdrawal syndrome. Clonidine is typically prescribed specifically to relieve the symptoms of acute withdrawal and not as a long-term maintenance medication. Unlike other FDA-approved MOUDs, like methadone and buprenorphine, clonidine is not an opioid agonist. This means clonidine does not activate the opioid receptors at all. Not only does clonidine relieve the symptoms of withdrawal, but it also has an anti-craving effect on opioids. Additionally, clonidine is especially useful to individuals preparing for Naltrexone treatment. Naltrexone is an FDA-approved MOUD. Naltrexone is also an opioid antagonist. This means that patients cannot have any opioids in their system for 7-14 days before starting Naltrexone. This includes FDA-approved MOUDs containing opioids that are typically used to facilitate recovery. Clonidine can help ease the discomfort of withdrawal during the 7-14 days prior to Naltrexone treatment.
Clonidine is categorized as an antihypertensive medication. Antihypertensive medications are typically used to treat high blood pressure. Many of the uncomfortable and painful symptoms experienced during opioid withdrawal result from a hyperactive sympathetic nervous system. Clonidine helps to reduce this hyperactivity, thereby minimizing various withdrawal symptoms, including hot flashes, sweating, muscle aches, runny nose, anxiety, and irritability. Clonidine comes in two forms, a tablet, and a body patch. Dosage amounts vary depending on the patient, the intensity of the withdrawal symptoms, and the type of opioid a patient was previously taking.
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.
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