We used three different studies involving patients undergoing detoxification to evaluate the worth of propranolol hydrochloride in withdrawal of opiates. If propranolol acts as a narcotic antagonist, the patient's condition should become worse and require increased methadone hydrochloride; if it were to afford symptomatic relief by blocking autonomic responses, methadone requirements might be decreased. None of the studies indicated that propranolol hydrochloride in doses of 160 mg/day or less aggravated withdrawal symptoms. Patients treated with the drug consistently required a somewhat smaller methadone dose for detoxification. Patients who responded favorably had mild withdrawal symptoms. The small benefit from the drug hardly merits its consideration as an adjunct to the treatment of withdrawal from opiates.
Hollister LE, Prusmack JJ. Propranolol in Withdrawal From Opiates. Arch Gen Psychiatry. 1974;31(5):695-698. doi:10.1001/archpsyc.1974.01760170083013