Evaluation of clonidine suppression of opiate withdrawal reactions: a multidisciplinary approach

The purpose of this open, uncontrolled study in a group of confirmed heroin addicts of both sexes was to determine whether clonidine by itself suppresses opiate withdrawal reactions, its maximal effective dosage range, the time of maximal effect, duration of its effectiveness and the extent of cardiovascular side effects. After a washout phase of opium residues, clonidine was administered for eight days and its effects were closely monitored and recorded. Even during the first 24 hour period, when clonidine was administered alone in a high dosage, it suppressed the signs and symptoms of opiate withdrawal reactions. The maximum effect was attained within three days. Thereafter, it maintained improvement until natural resolution of the reactions. Side effects were limited to some small but statistically significant cardiovascular changes. Illicit drug use during the treatment period indicated that drug related behaviour is only slightly affected by clonidine. The drug is thus effective in the acute withdrawal phase but does not replace the important psychosocial management needed to achieve long term drug abstinence.