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The 2 adrenergic agonist drug clonidine, marketed as an antihypertensive, has been used to facilitate opioid withdrawal in both inpatient and outpatient settings (Charney et al. 1986; Gold et al. 1978; Kleber et al. 1985). Clonidine at dosages of 0.6–2.0 mg/day reduces many of the autonomic components of the opioid withdrawal syndrome, although craving, lethargy, insomnia, restlessness, and muscle aches are not well suppressed (Charney et al. 1981; Jasinski et al. 1985). Clonidine is believed to exert its ameliorative actions by binding to 2 autoreceptors in the brain (e.g., locus coeruleus) and spinal cord. Both opioids and clonidine can suppress the activity of the locus coeruleus, which is hyperactive during opioid withdrawal.

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Table Reference Number
TABLE 19–4. Clonidine-aided detoxification

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