April 1985

Clonidine in Outpatient Detoxification From Methadone Maintenance

Author Affiliations

From the Department of Psychiatry, Yale University School of Medicine, and the Connecticut Mental Health Center, New Haven.

Arch Gen Psychiatry. 1985;42(4):391-394. doi:10.1001/archpsyc.1985.01790270081009

• Inpatient narcotic detoxification with clonidine hydrochloride has been used since 1978. Outpatient withdrawal, potentially more useful, has not been adequately studied. This report describes a double-blind random assignment of 49 methadone hydrochloride—maintained patients whose dose had been lowered to 20 mg. Twenty-five were detoxified using methadone at 1-mg decrements, 24 by abrupt substitution with clonidine. Approximately 40% of both groups achieved successful detoxification, with one third maintaining abstinence over the subsequent six months. The groups were also largely equivalent on withdrawal symptoms, but the clonidine group experienced symptoms in the first half of the study and the methadone group in the second half. Clonidine appears to be a safe and efficacious outpatient treatment for opiate withdrawal, although the results were less favorable than those obtained in open or inpatient studies.