Clonidine, a medication used for blood pressure, ADHD, anxiety and withdrawal symptoms, may be abused to enhance a drug’s high, typically opioids.
Clonidine is a drug first FDA-approved in the 1970s. Previously best known as a blood pressure medication, it has been used to treat multiple conditions over the past few decades. These include high blood pressure, attention-deficit/hyperactivity disorder (ADHD) and even alcohol and opioid withdrawal. However, in some cases, people may turn to clonidine as a drug of abuse, especially alongside opioids.
What Is Clonidine?
Clonidine is a type of medication called an alpha agonist. It works by blocking alpha receptors in the central nervous system. This prevents the release of norepinephrine (noradrenaline), which causes a variety of effects, including lowered blood pressure and sedation.
What Is Clonidine Used For?
Although originally approved as a blood pressure medication, clonidine is now more commonly used as an auxiliary agent for various conditions. These include not only its original purpose of lowering blood pressure but also treating ADHD and even substance abuse.
Clonidine for Blood Pressure
Clonidine is FDA-approved for high blood pressure. However, experts consider clonidine a last-line drug for blood pressure control, partly because it can be tricky to stop the drug without causing a dramatic increase in blood pressure.
Clonidine for ADHD
Clonidine comes in several different dosage forms. The dosage form sold under the brand name Kapvay is an FDA-approved medication for ADHD. Although the drug can be useful to treat ADHD in children who do not tolerate stimulants, there is less evidence supporting its effectiveness in ADHD compared to stimulants.
Clonidine for Alcohol Withdrawal Syndrome and Opioid Withdrawal Syndrome
Clonidine is not a first-line medication to treat alcohol and opioid withdrawal, but it may be helpful in some people. This is especially true if the person cannot use first-line agents to treat withdrawal symptoms, like methadone or buprenorphine for opioid withdrawal syndrome.
Clonidine for Anxiety
Although clonidine has sedative side effects that some people may think are useful for anxiety, it is not among the expert-recommended anxiety treatments. It is unlikely to be prescribed for this reason.
Clonidine for Sleep
Although clonidine has a side effect of sedation and may help with sleep, it is considered an expert-recommended treatment for insomnia, and doctors are likely to choose other alternatives.
Side Effects of Clonidine
Like any drug, clonidine has some side effects, which are more common and more pronounced with the oral tablet version of this drug and include:
- Dry mouth
Clonidine Life-Threatening Side Effects
Clonidine has few dangerous side effects when prescribed at the recommended doses. However, when taken in excessive doses or abused in combination with central nervous system depressants like opiids, clonidine can cause dangerous side effects in overdose. These are similar to opioid overdose symptoms and include:
- Slowed breathing
- Low blood pressure
- Slow heart rate
- Pinpoint pupils
A clonidine overdose is a medical emergency. If you suspect someone has taken too much clonidine, call 911.
Is Clonidine Addictive?
Although some people think clonidine is addictive, this is not the case. Clonidine is not considered to be an addictive drug and is not a controlled substance. However, it is often abused alongside illicit drugs, mainly opioids like heroin. This is for several reasons:
- To decrease the amount of opioid necessary to get high
- To make an opioid high last longer
- To prevent opioid withdrawal symptoms
- To cause sedation
Signs of Clonidine Addiction
Although clonidine is not addictive, that does not mean people do not abuse it. It may be abused by people wanting to make their opioid high last longer, for example. Some signs that a person is abusing clonidine include:
- Seeking out doctors or pharmacies to obtain clonidine (“doctor-shopping” or “pharmacy-shopping”)
- Exaggerating symptoms in order to get clonidine
- Buying, borrowing or stealing clonidine
- Spending an excessive amount of time trying to get or use clonidine
Withdrawal from clonidine can be dangerous. Because clonidine works by suppressing a type of neurotransmitter called catecholamines like norepinephrine, suddenly stopping the drug can cause rebound effects as norepinephrine surges within the body. Withdrawal effects can start within a few hours of stopping the drug, and you are more at risk if you have been taking clonidine at a high dose (greater than 1.2 mg per day) for more than a month.
Clonidine Withdrawal Symptoms
Symptoms linked to clonidine withdrawal can start within as few as two hours and may include:
- Rapid increase in blood pressure
- Heart palpitations
- Rapid pulse
- Stomach pains
- Muscle pains
- Increased saliva production
Other FAQs About Clonidine
Can Clonidine Get You High?
Generally, people do not get high on clonidine on its own. However, it is often taken along with other drugs (specifically opioids) to enhance a high and make a high last longer.
Is Clonidine a Controlled Substance?
Clonidine is not a controlled substance. However, it is a prescription medication that can only be obtained with a doctor’s order.
Can You Overdose on Clonidine?
A clonidine overdose can occur and is especially a risk with children or those who ingest their clonidine patch by mouth accidentally or on purpose. Symptoms of a clonidine overdose can start within the first hour and a half after taking the drug and may include:
- Slowed breathing
- Low blood pressure
- Slow heart rate
- Pinpoint pupils
Can Clonidine Cause Depression?
Clonidine might cause or worsen depression and carries a warning about its use in people with depression. Although a person with depression can still take the drug, the package labeling instructs prescribers to more closely monitor for worsening depression.
What Is Clonidine’s Mechanism of Action?
Clonidine is an alpha agonist that works in the central nervous system. By stimulating alpha receptors in the brain, clonidine causes the brain to produce fewer catecholamines like norepinephrine.
Because norepinephrine causes increases in heart rate, blood pressure and excitability (“fight-or-flight symptoms”), blocking norepinephrine causes the opposite effects. For this reason, an alpha agonist like clonidine can cause lower blood pressure and relaxation.
How Long Does Clonidine Last?
Clonidine lasts for about eight hours when taken by mouth. If used as a skin patch, effects start to wear off about eight hours after the skin patch is removed but may take several days to fully resolve.
How Long Does It Take for Clonidine to Work?
Clonidine starts to work within about 30 to 60 minutes if you take the oral tablet dosage form of the drug. However, the skin patch version of clonidine can take a couple of days to start working after being applied to the skin.
Find Help for Clonidine Abuse and Addiction in New Jersey
If you or a loved one struggles with clonidine, help is available. Since clonidine is generally abused alongside other drugs like opioids, a facility like The Recovery Village Cherry Hill at Cooper that specializes in polydrug abuse is the best place to start a new, clonidine-free life. This is especially true since clonidine detox is safest when done in a medically supervised setting. From medical detox, where you can be weaned off clonidine and opioids, to rehab, where you will learn how to live a life without substances, our caring experts are here to help. Don’t wait: contact us today.
Norman, Kenneth & Nappe, Thomas M. “Alpha Receptor Agonist Toxicity.” StatPearls, August 11, 2021. Accessed July 9, 2022.
Manzon, Lauren; Nappe, Thomas M.; DelMaestro, Christopher; & Maguire, Nicole J. “Clonidine Toxicity.” StatPearls, May 2, 2022. Accessed July 9, 2022.
Whelton, Paul K., et al. “2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/[…] Practice Guidelines.” Hypertension, November 13, 2017. Accessed July 9, 2022.
Wolraich, Mark L., et al. “Clinical Practice Guideline for the Diag[…]dren and Adolescents.” American Academy of Pediatrics, October 1, 2019. Accessed July 9, 2022.
Sateia, Michael J., et al. “Clinical Practice Guideline for the Phar[…]l Practice Guideline.” Journal of Clinical Sleep Medicine, February 15, 2017. Accessed July 9, 2022.
Anxiety and Depression Association of America. “Clinical Practice Review for GAD.” July 2, 2015. Accessed July 9, 2022.
Drugs.com. “Clonidine.” October 4, 2021. Accessed July 9, 2022.
Dennison, S. J. “Clonidine abuse among opiate addicts.” The Psychiatric Quarterly, Summer 2001. Accessed July 9, 2022.
Beuger, M.; Tommasello, A.; Schwartz, R.; & Clinton, M. “Clonidine use and abuse among methadone […]licants and patients.” Journal of Substance Abuse Treatment, November–December 1998. Accessed July 9, 2022.
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