While clonidine addiction isn’t necessarily the most common type of addiction today, its effects on the body, mind, and on an individual’s life can be just as destructive as many other drugs.
In this article, we’ll be taking a deep look into what exactly clonidine is, what it’s used for, and how addiction begins. We’ll also be looking at what clonidine addiction looks like and what to expect from rehab treatment.
All general drug information including side effects and dosages for clonidine are provided by the Mayo Clinic.
Also known by the brand names Catapres, Kapvay, and Nexiclon XR, clonidine belongs to the antihypertensive class of medications, more specifically to the alpha-2 adrenergic receptor agonists. This class of drugs is frequently used to treat high blood pressure (hypertension) in patients.
It works by altering the brain’s nerve impulses to relax the blood vessels of the body, letting blood easily pass through them and thereby lowering blood pressure. Lower blood pressure takes some of the stress off of many internal organs like the heart, brain, and kidneys and lowers the risk of heart failure, stroke, or kidney failure.
Clonidine can also be used to treat attention deficit hyperactivity disorder (ADHD). Though the more common treatment method for ADHD is typically a stimulant like Ritalin, clonidine might be the best choice for patients with any sleep disorders or a condition that may conflict with a stimulant. As such, clonidine is considered a “third-line agent” (as opposed to first- and second-line) for treating this disorder.
Precautions Before Taking Clonidine
Clonidine has been shown to have negative interactions with other drugs so anyone using clonidine should be aware of possible conflicts with antidepressants, beta blockers, calcium channel blockers, anxiety medications, sedatives, and antidepressants.
Also, alcohol can increase the potency of side effects from clonidine so ask your doctor before using them together.
Clonidine Side Effects
Some of the side effects of taking clonidine that usually clear up on their own may include constipation, darkening of the skin, decreased sexual ability, dry or itching eyes, loss of appetite, and nausea or vomiting.
If any of the following side effects occur, check with your doctor immediately: mental depression, swelling of the feet and lower legs, confusion, hyperventilation
Irregular heartbeat, skin rash, trouble breathing, tightness in the chest.
Symptoms of clonidine overdose are:
- Extreme dizziness or faintness
- Feeling cold
- Pinpoint pupils
- Unusual tiredness or extreme weakness
Such signs and symptoms of a clonidine overdose can occur within half an hour to 2 hours after the initial exposure. Once the dosage is taken, the overdose may result in hypertension that is then followed by hypotension, weakened breathing, irritability, or coma.
Clonidine comes in a couple different forms. It can be taken orally with immediate-release tablets or extended-release tablets. It’s important to note that switching from extended-release to immediate-release tablets should only be done under the guidance of a doctor. Clonidine can also come in the form of an oral suspension.
Patients taking extended-release tablets to treat ADHD will have varied dosages determined by their doctor. As such, the following dosages are provided only as a guideline. Children over 6 and teenagers will typically be prescribed 0.1 mg once a day at bedtime and increased as necessary according to your doctor. Children under 6 must have dosage determined by their doctor.
For a suspension used for blood pressure regulation, adults will receive 0.17 mg or 2 mL a day at bedtime and may be increased up to 6 mL a day. Extended release tablets follow the same guidelines and will usually be from 0.17 to 0.52 mg per day. Immediate release tablets will typically be prescribed at 0.1 mg doses twice a day at first and may move up to 0.2 mg to 0.6 mg a day.
Dosage for children taking clonidine for high blood pressure is varied and is determined by a doctor.
Clonidine for Sleep and Other Uses
Clonidine has also been shown to be effective in treating the sleep disorders typically associated with children that have ADHD. This population is particularly prone to suffering sleep disturbances. Though not much testing has been done in adult populations, it is accepted as a good remedy for general insomnia in younger patients.
Throughout the drug’s history that dates back to the 1960s, clonidine has also been used to treat:
- Dysmenorrhea (extremely painful menstrual cramps)
- Hypertensive crisis
- Tourette’s syndrome
- Menopausal hot flashes
Clonidine Use for Addiction Withdrawal
One of the primary uses of clonidine is in the treatment of substance withdrawal. It has been shown to be effective in aiding tobacco cessation and even plays a major role in modern alcohol and opiate withdrawal treatment as well. Here’s why.
The use of clonidine in treating tobacco, alcohol, and opiate withdrawal all boils down to the same basic principles: it acts as a way to inhibit the brain’s responses to withdrawal.
The main benefit of using this drug during rehabilitation treatments is the effect it has on the sympathetic nervous system. This area is responsible for the body’s response to danger or stress and is the origin for our “fight-or-flight” responses.
As with most substance abuse problems, the body tends to get used to substances that regulate pleasure-giving chemicals in the brain like dopamine. When the body is recovering from substance abuse during the detoxification phase and is no longer exposed to an addictive substance, it sends signals to the rest of the body that say, “something is wrong!”
These signals then trigger a host of withdrawal symptoms that vary from substance to substance. They could be anxiety, sweating, nausea, or a range of other ailments. For many drugs, these signals are communicated through the sending and receiving of epinephrine and norepinephrine.
Where clonidine comes into the withdrawal treatment process is that it tends to partially block the transmission of epinephrine and norepinephrine, thereby lessening the painful effects of the substance withdrawal.
For alcohol dependency that could mean anxiety, irritability, agitation, sweating, and nausea. Opiate addicts going through rehab aided by clonidine will see some of the same symptom relief as well and tobacco users may see similar changes to a lesser degree.
Clonidine Addiction: How Does It Start?
Although clonidine is typically not as addictive as many narcotics, it is still possible to become addicted this drug.
As mentioned above, clonidine is typically used in cases of hypertension, ADHD, anxiety, or insomnia. As with most other prescription drug addictions, the onset of the addictive behaviors can be traced back to an original prescription for the drug. It could be initially for a personal problem or it could be taken from a friend or family member.
In many cases though, a prescription pill abuser doesn’t typically fit the “druggy” stereotype. Part of this misconception is due to the fact that many abusers don’t actually feel like they are doing anything wrong. They do have a doctor-written prescription after all. In fact, CDC estimates put the percentage of illegally obtained prescription medication at only about 15% of total prescription drug misuse.
And that doesn’t come as much of a surprise either as many drug prescriptions are increasing at an alarming rate, especially when it comes to opioids. In 2012, for example, there were more than 259 million opioid pain medication prescriptions written. That’s more than a bottle of pills for every adult in the U.S.
To add to the easy availability of clonidine, it is also not currently a scheduled drug meaning it is not categorized as having a high potential for abuse by the United States government. As such, clonidine is not considered to be a controlled substance. As a result, there are much looser regulations for writing a prescription for clonidine. Punishments for possession are also less strict, making it less of a risky drug to take.
Clonidine Addiction Arising from Addiction Treatment
As mentioned earlier, clonidine is also used to help ease the withdrawal symptoms of alcohol and opiates. For many alcohol and opiate abusers, the withdrawal symptoms can be especially difficult to handle. Consequently, significant effort has been placed on finding ways to make the process easier and thus facilitate a greater degree of full rehabilitation success.
The supplemental use of clonidine to lessen the severity of these symptoms is one such way treatment centers are making detox less of a struggle. Its ability to partially block chemical signals from the sympathetic nervous system can cut down on many of the intolerable withdrawal symptoms of these drugs like nervousness, sweating, insomnia, and even depression.
The drawback of using clonidine in this way, however, is the possible trading of addictions. The idea of switching one addiction for another is somewhat controversial. Proponents will say that becoming addicted to something like cigarettes after recovery is a small price to pay for a life without, say, heroin. Others, however, claim that by simply latching on to another substance, an addict isn’t truly facing what’s causing the addiction in the first place.
Whatever side of the fence you land on, the truth is that many people would have never had access to clonidine had they not been given it as treatment for another addiction.
Beyond the simple issue of access to the drug is the additional problem that some people find mixing clonidine with other drugs such as opiates or alcohol can intensify the effects of the drugs. In the case of alcohol, for example, taking both drugs at the same time might make an individual feel even drowsier and might detach them from reality even further. In this way, both the alcohol and clonidine high are bolstered.
While not much research has been done on this relationship, such mixing of substances could become particularly troublesome for individuals looking to overcome their addictions. The possibility of experiencing an even greater high because of the drugs a detox clinic provided could make the notion of relapsing even more appealing than before.
Signs of Being Addicted to Clonidine
The following is a list of symptoms of drug addiction provided by the Mayo Clinic. If several of these behaviors sound familiar, you may be addicted to clonidine.
- You feel that you have to use clonidine on a regular basis, ranging anywhere from daily to more than once a day
- You experience intense urges for clonidine
- You find yourself taking more clonidine to achieve the same affect
- You always ensure you have a back supply of clonidine
- You spend more on clonidine than you can afford
- Your work, social, or recreational responsibilities suffer due to clonidine use
- You compromise personal integrity or act differently in order to obtain clonidine, even committing illegal acts to get it
- You engage in risky behaviors when you’re under clonidine’s influence
- You spend increasing amounts of time and energy on both getting and using clonidine
- You can’t ever seem to successfully quit using clonidine
- You feel the effects of withdrawal when you try to stop taking clonidine
Noticing the signs of clonidine addiction in others can be the first step towards getting them the help they need. Some of these signs could include difficulties at work or at school, a degraded personal appearance or grooming, failing health, erratic and drastic changes in behavior, and money problems.
Symptoms of Clonidine Withdrawal
Though clonidine is not as addictive as many drugs, some of the withdrawal symptoms are similar to that of other narcotics and the intensity of each will depend on the length and severity of clonidine abuse. Some of these symptoms include:
- Nausea or vomiting
- Depression or anxiety
In addition to the greater likelihood of these symptoms presenting when higher doses of the drug were used, the simultaneous use of clonidine with beta-blockers can also make such symptoms more likely. As such, patients that are taken off of clonidine should first be taken off of the beta-blocker several days before clonidine.
Other symptoms caused by clonidine withdrawal can include cerebrovascular accidents, hypertensive encephalopathy, and even death, though such instances are rare. Given the potentially fatal consequences of withdrawal, however, the detoxification process is different than other drugs.
Clonidine Detoxification Process
Treating a clonidine addiction must be handled differently than other instances of substance abuse due to the potentially fatal nature of stopping clonidine use all at once.
The risk of death comes from a condition known as “clonidine rebound” or “rebound hypertension”. Since clonidine suppresses signals sent to the sympathetic nervous system which results in low blood pressure, suddenly stopping the use of it can cause an overreaction in the system. The sympathetic nervous system then produces even higher levels of adrenaline and noradrenaline, causing a rapid increase in blood pressure that may end up being fatal.
Due to this possibly life threatening side effect of withdrawal, clonidine detoxification procedures follow a tapering method rather than immediate cessation. After being admitted to a treatment facility, the patient will likely undergo a medical examination as well as a series of questions and interviews to determine their duration of use and their drug and medical history.
Determining an exact drug history as well as an accurate appraisal of the patient’s clonidine usage is incredibly important for a number of reasons. First, as noted earlier, the use of clonidine at the same time as beta-blockers has been shown to increase the likelihood of adverse side effects once clonidine use has actually ended. As such, the use of these medications must be stopped several days before the clonidine.
Second, determining the proper tapering schedule is based in large part off of the length of clonidine use and the dosage. As the tapering is meant to be a gradual weaning off of clonidine, patients that enter addiction treatment having taken large amounts of the drug will likely have a longer detoxification process, possibly up to several weeks.
During this period, a medical professional will be closely monitoring the patient’s progress. If they exhibit any signs of withdrawal, the treatment facility personnel may determine it necessary to increase the dosage to former levels. As such, a specific timeframe of detoxification is usually quite difficult to determine.
Beyond that, many patients have vastly different physiologies. General health, nervous system peculiarities, and sensitivity to certain withdrawal symptoms all play a major role in determining how your body reacts to the treatment. It should be noted, then, that the recovery process is just that: a process. Patients should learn to trust the system, even in the face of setbacks.
Further Treatment Notes
While one of the main concerns for facilities overseeing the detoxification of clonidine addicts is ensuring they are properly and safely tapered off of the drug, doing so is simply a medical detox and is only the first step towards true rehabilitation.
Overcoming physical addiction paves the way for truly investigating what it is that’s causing the addictive behaviors in the first place. Without the distractions of the physical dependence on the drug, patients are able to better tackle the mental and emotional hurdles in their lives without using a substance as a crutch.
Many treatment centers will feature counseling sessions, talk therapy, behavioral adjustment classes, stress management courses, and even art therapy and meditation. Supplementing the physical detoxification process with these additional programs can help patients reduce their risk of relapse, make meaningful changes in their lives, and give them an outlet to deal with any frustrations or concerns.
In that same vein, it’s worth noting that dealing with an addiction can be an especially difficult task. That’s why anyone addicted to clonidine or any other substance should seek out the help of a qualified medical professional before beginning on their path towards rehabilitation. There are a variety of addiction treatment options to choose from and you’re likely to find at least one that caters to your particular situation.
In addition to the various supplemental programs mentioned above, treatment centers also provide another extremely important quality when it comes to drug rehabilitation: safety. These facilities are manned by medical professionals that are trained to help make your rehabilitation as painless as possible.
This aspect is especially important for clonidine addicts as trying to manage this drug’s withdrawal symptoms not only might result in discomfort, they could even lead to death or other serious side effects like coma or heart problems. A treatment facility has access to both the knowledge and the equipment that might be necessary to keep you safe.
Making the choice to get treated for your clonidine addiction is a hard one. And while the path ahead might be difficult, we can guarantee it’s one you won’t be disappointed you took. Your body, mind, friends, and family will all be happy you did too.