What does a blood pressure medication have to do with opiate withdrawal?
The two have more in common than you might think and it has to do with how the brain works.
Interconnected features in the brain often connect two bodily functions that seem to have nothing in common at all. For instance, ibuprofen will alleviate inflammation by suppressing a chemical that causes it. But that same chemical is responsible for fevers.
That’s why over-the-counter pain relievers will also bring down your high temperatures. By understanding brain functions, scientists have found a way to use clonidine for opiate withdrawal, along with a whole host of other uses.
But is it a safe way to get over an addiction?
What Is Clonidine?
As a medication, clonidine has a wide range of uses with seemingly no connection. It’s used to treat high blood pressure, attention deficit disorder, anxiety disorders, migraines, diarrhea, and other pain conditions. The drug was initially introduced in the 1960s as a treatment for hypertension, but it began being used for other purposes. In 2010, it was approved for treating ADHD. It can also be used to treat tics associated with Tourette syndrome. Some doctors prescribe clonidine for off-brand uses including the treatment of stress, PTSD, and sleep disorders.
Clonidine inhibits the release of norepinephrine, which is the main neurotransmitter of the sympathetic nervous system (SNC). The SNC has two main functions: to maintain homeostasis (your body’s process of maintaining your body temperature, blood pressure, and pH level) and it controls the fight-or-flight response. Because clonidine suppresses the neurotransmitter that regulates this, it relaxes blood vessels and lowers the heart rates making it an effective medication for treating high blood pressure.
By facilitating easier blood flow, it can also alleviate pain caused by constricted arteries and blood flow like angina or certain headaches. However, this isn’t the only way clonidine interacts with your body. It has an effect on the brain in the area that controls impulsive behavior in the frontal lobe, making the use of clonidine for opiate withdrawal a viable option.
Clonidine and Impulse Control
Since clonidine affects the SNS, it affects the part of the brain that controls impulses like the fight-or-flight response. Many of these reactions are automatic (they are a part of the autonomic nervous system) but we can train impulsive responses over time.
For instance, when you are a child, you may have trouble sitting still. Your impulse is to get up, run around, and play. Even when you want to sit still it might be difficult, making school work difficult. But over the years, teachers and parents have helped you train your brain to respond differently when it’s time to sit still and focus. Children and adults with ADHD, have an overactive response system and need help managing impulses.
Clonidine is used to curb activity in the SNC by inhibiting norepinephrine, its main neurotransmitter. The drug is approved to treat ADHD in both children and adults and efficiently calms the impulses that would typically have trouble with stillness.
However, we can also negatively train our impulses. If you eat junk food every time you have a craving for hyper-palatable food, you’ll train your brain to seek it automatically. Addictive drugs can do the same thing.
Addiction is a disease of the reward system of the brain in the limbic system, not the frontal lobe. Instead of healthy cravings for food, comfort, and other survival necessities, addiction rewrites your reward-seeking to cause intense cravings for your drug of choice. However, your response to these cravings can become impulsive.
Clonidine for Opiate Withdrawal
Opioids are a powerfully addictive class of drugs that includes heroin and prescription painkillers like Percocet. Heroin users often start by abusing prescription opioids (around 75 percent said they abused scripts first). The addictive power of opioids can turn a prescription for an injury into heroin addiction. When prescriptions run out or become too difficult to obtain illegally, people struggling with opioid addiction may turn to heroin.
Opioid withdrawal symptoms can be painful, uncomfortable, and come with intense cravings. When cravings strike, it may trigger an impulse to alleviate the uncomfortable withdrawal symptoms as quickly as possible. Because of this, it’s difficult to get through withdrawal symptoms without using on your own.
Studies have shown that clonidine blocks some of the symptoms associated with acute opioid withdrawal. In a 1978 study of 21 people in treatment for opioid addiction, nine did not return to the available methadone treatment after completing one week of clonidine treatment. All of the recipients said that they didn’t experience many of the symptoms generally associated with opiate withdrawal. Even physical signs like tearing and yawning were alleviating.
After you detox, you may still feel cravings, especially during times of stress. One 2014 study shows that clonidine may help with stress-induced cravings. Researchers determined that the drug is not just good for alleviating physical withdrawal symptoms, it can also help lengthen the duration of drug abstinence.
Clonidine Side Effects
Clonidine is not without its own adverse reactions. For one, it is, itself, potentially addictive. Patients who take it for the blood pressure may experience a rebound of hypertension if the drug is abruptly discontinued. Common side effects of using clonidine for opiate withdrawal include sedation, dry mouth, and hypertension but, the following symptoms have also been reported:
Because it also lowers blood pressure, it may not be the best option for people with low blood pressure or who are prone to hypotension. Clonidine use should not be stopped suddenly. Gradually weaning off the drug will help to avoid rebounding effects.
Other Addiction Treatment Options
Medications like clonidine for opiate withdrawal may work best in conjunction with other clinically proven treatment options. Behavioral therapies can help you achieve long-term sobriety even after you discontinue clonidine use. Cognitive-behavioral therapy can also address some of the underlying issues that may have initially lead you to addiction.