Clonidine for Opiate Withdrawal

The abstinence syndrome which follows withdrawal of opiates is the prototype of drug withdrawal reaction and is one of the several factors promoting addiction. Although management of this syndrome is but a small part of treatment of an addict, it is nonetheless an important one. Recent studies have shown that a single dose of Clonidine hydrochloi ide (ARKAMIN) relieves signs and symptoms of opiate withdrawal and that addicts can be successfully detoxified with Clonidine. The rationale for testing Glonidine's efficacy in opiate withdrawal was based on animal studies showing that increased brain noradrenergic activity associated with opiate withdrawal was markedly reduced by Clonidine (Wash-ton et ah, 1980). Recently, we have successfully treated a case of opiate withdrawal with Clonidine. The case is being reported to demonstrate Clonidine's efficacy in treating opiate abstinence syndrome with particular relevence to our country where Methadone is r.ot available. Mr. V, a 32 year old married Hindu male was brought to our OPD on May 25, 1981, for treaiment of Morphine addiction. He first took Morphine injection seven years ago, when he met with a small accident. The patient reported that he had a very pleasant experience with that injection, and reported for daily injections. physician readily agreed. Within 3 months, he became an addict and without Morphine injections he could not function. His intake of Morphine gradually increased to 5-10 ampules per day. Meanwhile, he started consuming diazepam and alcohol in large quanti'ies. He was unsuccessfully treated at a number of facilities. The patient was admitted and Morphine was completely discontinued from the day of hospitalization. For the first two days, he was put on inj. pethidine 100 mg twice a day, inj. diazepam 10 mg twice daily and a hypnotic at bed time. Patient developed severe withdrawal symptoms in the form of irritability, sleeplessness, lethargy, chills, rhinor-rhoea, restlessness, abdominal cramps, nausea and diarrhoea. From the third day of hospitalization, he was started on tab. Clonidine 0.1 mg 6 hourly (all other drugs were stopped). The dose of Clonidine was increased by one tablet everyday upto a maximum of 0.9 mg per day. Regular checkup of blood pressure was done and the patient did not develop any postural hypotension. Paiicnt showed remarkable improvement on the veiy next day of starling Clonidine, and he became asymptomatic within 5 days. Patient was maintained on a dose of 0.9 mg of Clonidine per day for the next …