Wednesday, April 10, 2013

Clonidine for Opiate Withdrawal

Introduction

Hi Folks and welcome to my blog about opiate addiction. This is now my 18th post and I am proud to say my blog, number of followers, and topics are growing each day. This really provides a sense of success for myself and I am so happy I have the opportunity to help others while sharing my own experiences, thoughts, and stories while being to able to express myself. I can't say it enough, thank you guys!

I must admit, the ideas regarding what to write about on my blog are getting more and more challenging. I want to provide you guys with solid information, fresh topics, and things that many opiate addicts search for in their quest for sobriety. After doing some thinking, I came up with the idea to dedicate a few posts to specific drugs that may aid in opiate detox or recovery.

For this particular post, I would like to discuss the drug Clonidine. This drug is a high blood pressure medication that also has several off label uses, one being helping opiate withdrawal.  The drug is supposed to help with symptoms such as high blood pressure, sweats, cold chills, restlessness, insomnia, and anxiety.

This drug is often considered one of the top medications to prescribe for patients undergoing opiate withdrawal and has been used in the addiction community for quite some time. As far as reviews go, they're pretty mixed. Some people swear by this drug when experiencing opiate withdrawal while others say it provides little to no relief. Then of course, there are many who feel somewhere in between. I am currently on the drug myself (more on that later) and would have to say that I'm one of those people who are somewhere in the middle when it comes to judging the effectiveness of Clonidine.
 
What is Clonidine and What is it Used For?
 
According to the RX list, Clonidine is described as:
 
A centrally acting alpha-agonist hypotensive agent available as tablets for oral administration in three dosage strengths: 0.1 mg, 0.2 mg and 0.3 mg. The 0.1 mg tablet is equivalent to 0.087 mg of the free base.

The inactive ingredients are colloidal silicon dioxide, corn starch, dibasic calcium phosphate, FD&C Yellow No. 6, gelatin, glycerin, lactose, and magnesium stearate. The Catapres (clonidine) 0.1 mg tablet also contains FD&C Blue No.1 and FD&C Red No.3.

Clonidine .1 mg Pill

Clonidine is a sympatholytic medication used to treat high blood pressure, anxiety/panic disorder, ADHD, migraines, drug withdrawal, sleep disorders, and certain pain conditions. The drug is commonly used for patients experiencing opiate withdrawal as it helps with many of the common symptoms that accompany withdrawal.

Clonidine can be administered in three ways; orally, injection, and transdermal. For those of you who don't know, transdermal is when the medication is prescribed as a patch, which is worn by the patient throughout the day or night. The patch then provides dosing throughout the day. This method of administration is usually only received under doctor supervision such as in the hospital or in a rehab facility so you'll be likely be dealing with the pills if you are partaking in a rehab or detox center program. Based on what I have read, injection of Clonidine is rarely used, especially for the treatment of opiate addiction.

Possible Side Effects of Clonidine
 
Possible side effects (courtesy of drugs.com) of Clonidine include any of the following:
 
  • Fast or pounding heartbeats

  • A very slow heart rate (fewer than 60 beats per minute)

  • Feeling short of breath, even with mild exertion

  • Swelling, rapid weight gain

  • Confusion, hallucinations

  • Fever, pale skin

  • Urinating less than usual or not at all

  • Numbness or cold feeling in your hands or feet

  • Feeling like you might pass out

  • Severe skin irritation, redness, swelling, burning, or blistering where the patch is worn.

Less serious clonidine side effects may include:
  • feeling dizzy, drowsy, tired, or nervous
  • dry mouth
  • dry or burning eyes, blurred vision
  • headache, muscle or joint pain
  • nausea, vomiting, constipation, loss of appetite
  • sleep problems (insomnia)
  • urinating more at night
  • mild skin rash or itching
  • decreased sex drive, impotence
  • skin rash, discoloration, or mild irritation where the patch is worn


"Clonidine is classed by the FDA as pregnancy category C. It is not known whether clonidine is harmful to an unborn baby. Additionally, clonidine can pass into breast milk and may harm a nursing baby. Therefore, caution is warranted in women who are pregnant, planning to become pregnant, or are breastfeeding." -Physicians Total Care, Inc.

Suddenly stopping Clonidine after continued use can lead to rebound hypertension, meaning that your blood pressure may spike if you stop taking the Clonidine. Therefore, you should taper off of the Clonidine to avoid rebound hypertension. The following is from Wikipedia:

"Clonidine suppresses sympathetic outflow resulting in lower blood pressure, but sudden discontinuation can cause rebound hypertension due to a rebound in sympathetic outflow.
Clonidine therapy should generally be gradually tapered off when discontinuing therapy to avoid rebound effects from occurring. Treatment of clonidine withdrawal hypertension depends on the severity of the condition."

Clonidine for Opiate Withdrawal
 
Most of you reading this post about Clonidine are probably here because you currently are taking Clonidine for opiate withdrawal or are considering it. Therefore, lets start talking about how the drug is used in opiate withdrawal.
 
Everyone here probably has experienced or are aware of the symptoms that accompany opiate withdrawal and how they can make quitting opiates seem impossible. Drugs like Methadone and Suboxone are great in that they help you avoid opiate withdrawal for the time being, allowing one to get his or her life together and decide their plan for recovery but they also come with their disadvantages as well. Unfortunately, these drugs do result in a dependence for the user and one will most likely experience some withdrawal when they come off of a drug like Suboxone or Methadone. The good thing about Clonidine is that it is not as addicting as drugs such as Methadone or Suboxone and withdrawal, if any, will be relatively painless compared to the withdrawal from most opiates.
 
Clonidine isn't a drug you would want to abuse to get high as it has little recreational value so that's a plus for addicts really looking to get clean and turn their lives around. The drug also doesn't have the withdrawal symptoms that come with opiate withdrawal besides rebound hypertension. In other words, when you stop taking Clonidine, you won't be sitting there experiencing the cold sweats, aches, restless legs, the runs, and an overall feeling of crap. Once again, a plus.
 
In a study conducted by PubMed involving 30 patients, the following information was found regarding the effectiveness of Clonidine for opiate withdrawal:
 
"In a placebo-controlled, double-blind crossover trial, clonidine caused a marked and significant reduction of objective signs and subjective symptoms of opiate withdrawal in thirty hospitalized opiate addicts. In an open trial of clonidine in opiate withdrawal, clonidine was found to suppress opiate withdrawal signs and symptoms, allowing all of the patients to detoxify successfully from chronic opiate addiction. Clonidine was demonstrated to reverse and suppress the signs, symptoms, and effects associated with opiate withdrawal."
 
To obtain Clonidine, you will need a doctor's prescription. Based on my experiences and what I have read, there are a few ways to do this. The first is going to your primary care doctor and explaining to him or her your situation. Tell them about your addiction and how you are looking to get clean but feel as through you need something to help get you over the hump and keep withdrawals at bay. Most doctors will be willing to prescribe Clonidine as it is often highly recommended and well known for its ability to aid with opiate withdrawal. This technique also works if you go to the ER and explain to them your situation. The final way that I know of to obtain a prescription for Clonidine concerns those of you who are currently in a Suboxone or Methadone treatment program. I have been able to obtain a prescription by telling my Suboxone doctor during my taper that I am having trouble sleeping at night and experience random chills and restlessness throughout the day and night. Without hesitation, my Suboxone doctor prescribed me Clonidine. Overall, it shouldn't be too difficult to get a prescription for Clonidine. However, everyone's doctor is different and has different views/methods so take a careful look at your options.
 
 
Clonidine typically comes in pills that contain .1 mg each. Please note that this is .1 mg not 1 mg. There is a big difference right there so it is important you are careful with your dosing and are aware of what and how much you are putting in your body. The typical dosing protocol is usually .1-.3 mg 2-3 times per day or as needed. Higher doses are also prescribed depending upon the patient and situation at hand but these doses are usually the most common. I currently take .2 mg once at night and find this dose to be sufficient but again, everyone is different.
 
The use of Clonidine for opiate withdrawal is quite common in rehab facilities and outpatient detox as the drug is seen as both an effective and relatively safe drug in combating opiate withdrawal. The following link provides a typical protocol when it comes to dealing with opiate withdrawal and medications that can help provide relief for patients.
 
 
 
Some Good Links Regarding Clonidine for Opiate Withdrawal
 
Like most of my previous posts, I'll leave you guys with some links to websites that discuss the use of Clonidine for opiate withdrawal. These links are found below this paragraph.
 
This link provides experiences and thoughts about Clonidine for opiate withdrawal by several people who have used the drug.
 
This is another forum that provides stories and experiences by people who have used Clonidine.
 
This link provides an in depth look the drug Clonidine including dosing protocol.
 
This link also provides a brief description of Clonidine as well as commonly asked questions about the medication.
 
How Effective Is Clonidine for Opiate Withdrawal?
 
I don't know about you guys, but whenever I come across a new drug that can help minimize, avoid, or aid withdrawals from opiates, I instantly become extremely interested and curious about the drug. I begin to hope and pray that I have finally found something that will make opiate withdrawal a hell of a lot easier. Sometimes the drug ends up being a great tool while others don't quite seem to live up to expectations. Well, Clonidine is one that falls somewhere in between.
 
The following excerpt is from the book, Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy regarding the effectiveness of Clonidine in opiate withdrawal:
 
"Studies in animals and humans have demonstrated that clonidine hydrochloride, an alpha-2-nor-adrenergic agonist, significantly attenuates the opiate withdrawal syndrome. Inpatient and outpatient clinical studies have shown that clonidine is a reasonably safe, specific, and effective agent for detoxifying opiate addicts. Clonidine seems best suited for use as a transitional treatment between opiate dependence and induction onto the opiate antagonist naltrexone. Dosage regimens of clonidine must be individualized according to symptoms and side effects and closely supervised because of varying sensitivity to clonidine's sedative, hypotensive, and withdrawal-suppressing effects. Clonidine is an important new treatment option for selected opiate addicts and may be the treatment of choice when detoxification using methadone is inappropriate, unsuccessful, or unavailable. Lofexidine, a structural analogue of clonidine, may be safer and more effective as an opiate detoxification treatment. It has similar withdrawal-suppressing actions but causes little hypotension and sedation. Although clonidine and lofexidine may be highly effective in helping opiate addicts achieve initial abstinence, a multi-modality aftercare treatment approach including naltrexone and psychotherapy may be necessary to maintain an abstinent state."
 
Study on 21 people on the effectiveness of Clonidine
 
 
Dr. Janaburson writes about Clonidine in her blog (I highly recommend checking it out) stating: 
 
Since clonidine works by calming the locus ceruleus, clonidine reduces many of these unpleasant opioid withdrawal symptoms. So how effective is clonidine? Most patients say that it helps somewhat, but they still feel withdrawal symptoms. My impression from what patients have described is that clonidine is mildly to moderately effective.


The following link provides several cases of patients who were prescribed Clonidine for opiate withdrawal. These cases are interesting as they deal with a variety of patients ranging from what the researchers describe as hardcore addicts, casual users, and everyone in between. When you click on the link, you will see three little pages near the top of the website. Each page comes from a study provided by PubMed. Simply click on any of these pages to read these cases about Clonidine. The link is below.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1862300/

So, exactly how effective is Clonidine when it comes to going head to head with opiate withdrawal. There is no universal and definite answer to this question and it appears that the effectiveness of the drug varies based upon several factors such as the patient involved, his or her tolerance, their general health, the dose they are taking, the length of time they have been taking the medication, and more. I have read probably close to a hundred forums about the effectiveness of Clonidine and have talked to some addicts who have used Clonidine and still have no clear-cut answer for you guys. Some people swear by it while others find it little help. At the end of the day, I think it comes down to what does and doesn't work for the person using the medication. Some people may find this medication to do wonders for their withdrawals while others may notice little to no difference.

Conclusion
 
I am currently prescribed and am taking Clonidine once a day at night. My dose is .2 mg (2 .1 mg pills) and I have found this dose to be quite helpful. I have been on Suboxone for just under a year now and am currently going through a taper regime. I recently went from 2 mg to 1 mg of Suboxone per day and have experienced some withdrawal since my drop in dose. These withdrawals usually start to arise right before bedtime (around 8 p.m.), which I believe is a result of my morning dose wearing off. This is where the Clonidine has come in handy as it really has helped me with sleep, restless legs, and minor anxiety.
 
As I mentioned earlier in this post, getting a prescription was easy and painless and it was actually something that both my Suboxone and primary care doctor recommended. I haven't had any negative side effects from taking the mediation either which is always a good sign in my book. However, please be careful with taking this medication and to talk honestly and openly with your support network. Some people say they get dizzy on the medication or feel as if they are about to fall over when they get up after sitting for a long period of time. Make sure you are cautious if you must drive or work on this medication.
 
I have no experience taking the drug in full blown withdrawal so I can't say much as to how effective it is in a situation such as this. I have read and can imagine that Clonidine probably only provides minor relief to one who is full blown opiate withdrawal (what drug besides Suboxone or Methadone truly takes away or masks all the withdrawal) but I could be wrong. Again, I think it all depends on the person taking the medication as everyone and their reactions to certain medications is different. At the end of the day, I don't think having a prescription for Clonidine can hurt provided that the patient has talked it over with their doctor and has no health conditions that could interfere with the drug.
 
I would love to hear from you guys about what you think about Clonidine. If you have taken it before for opiate withdrawal, please tell us how effective it was for you and would you recommend it? I will be making the jump off of Suboxone in the near future and see Clonidine as one of a few tools I have in battling the dreaded opiate withdrawals.
 
As always, thanks for reading my blog and remember to continue seeing the light!
 
Take Care Friends,
 
Seeingthelight

8 comments:

  1. When trying to get through opiate withdrawal and stay off once through the physical detox, I did not want to take another prescription drug. I used a product or actually three products from a company called Pure Health Group. This was about a year ago so I do not remember the actually name of the product. I know it worked as I used it and got through it and have been clean for a year now. It was non-addictive and effective. Not as good as Suboxone (tried that but got hooked on it). I don't know but I think a natural ways that works 80% as well as a prescription drug that is addictive is really a much better choice. I just looked up that companies website, the product is called Withdrawal Relief Complex.

    ReplyDelete
    Replies
    1. Hi there,

      Thanks for telling us about your experience with the product Withdrawal Relief Complex. I have always been really curious about products like these but know that good ones can be hard to find. In other words, there are unfortunately a lot of scams or ineffective products out there. That's great you found one to work. Suboxone has been amazing for me and would be the perfect solution if not for its addicting nature so I'm always open to trying something new, especially one that is non habit forming.

      I would like to know a little more about this product if you can help me out. I tried looking it up on the company's website but could only find a limited amount of information. Do you know what the active ingredients are? Is this legal to obtain without prescription? You have opened my eyes to what might be a great tool for surviving opiate withdrawal and I thank you for that.

      Take Care,

      Seeingthelight

      Delete
  2. Opiate drugs often result in addiction and physical dependence on the drugs. opiate withdrawal symptoms

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  3. I'm on clonidine for methadone w/d and it makes me feel FREEZING COLD!!! I was in Florida for vacation last week and it was 70 - 80 but I was still very cold. I told my doctor about this and even looked it up beforehand but he didn't believe me - he said it's the w/d's - whatever... I know it's less than 1% of people that feel this - guess I'm a 1%'er....

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  4. Hi thank you, finally some informed information. I'm currently on 40 methadone when should I start to use clonidine to come off the done? Should I taper down to 20 first? I also have some serapax that I can have to help with. I can only take 4 weeks off work will this be enough time. Thanks for your help.

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  5. Currently tapering of Suboxone and started taking clonidine .2 per day when I dropped to 6MG from 8MG of Suboxone. I am also taking 100MG of Quetiapine at night for insomnia. I am down to 1MG and no WD's effects at all except a few side effects from clonidine. This combination has been amazing since last time I tried to taper with nothing I had insomnia,insane Restless Legs, anxiety/panic, Hot/Cold chills. The clonidine/quetiapine combination has been great and recommend this combination. Another thing I do when going to sleep I turn off the tv and have silence and do not fight sleep and quetiapine will kick in.

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  6. i am getting off suboxone and i am currently on 6mg. i find that the clonodine works well but i was wondering if there was anything else that would help with it. i just want to be done with this suboxone for good. thanks for your link

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  7. I am on heroin and currently have a huge tolerance and have been using it for years. I tried participating in a placebo controlled double blind study for lofexidine and my girlfriend made it through the seven days but I left the study during the second because it didn't help much. It helped a little so I think I got the real drug but the low dose not to mention my habit size.. anyways I have sense obtained 18 orange clonidine pills, fifty fifty mg tramadols, and maybe 20mg of suboxone and was hoping for some advice on how to make this work. Suboxone scares me cuz it usually causes withdrawal so idk what to do... Any advice will help. I also have quite a few trazedones to help for sleep. And plenty of benadryl as well.

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