Common Hypertension Drug Could Help Prevent Opioid Relapse

Clonidine, a drug commonly used to treat hypertension, could extend abstinence in patients dependent on opioids, according to a recent study.

For their randomized double-blind placebo-controlled clinical trial, researchers evaluated 208 opioid-dependent patients at an outpatient buprenorphine clinic.

The participants who were able to remain abstinent during weeks 5 to 6 during the trial were continued on buprenorphine and administered either clonidine (N=64) or a placebo (N=57) for a 14-week duration and their urine was tested 3 times a week.
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Researchers used cox regression models to examine time to lapses and relapse—with lapse defined as a missed or opioid-positive urine test and relapse characterized by 2 or more consecutive lapses.

The study showed that clonidine produced the longest abstinence duration (based on consecutive days) from opioid use (34.8 days) compared to 25.5 days with placebo.

Further, the researchers did not observe any difference in time to relapse among the groups, though patients taking clonidine did take more time to lapse (hazard ratio, 0.67).

“Clonidine, a readily available medication, is useful in opioid dependence not just for reduction of withdrawal signs, but also as an adjunctive maintenance treatment that increases duration of abstinence,” explained the researchers of the study.

“Even in the absence of physical withdrawal, it decouples stress from craving in everyday life,” they said.

The complete study published in the August issue of the American Journal of Psychiatry.

-Michelle Canales Butcher

Reference:

Kowalczyk WJ, Phillips KA, Jobes ML. Clonidine maintenance prolongs opioid abstinence and decouples stress from craving in daily life: a randomized controlled trial with ecological momentary assessment. Am J Psychiatry. 2015 August [epub ahead of print] doi: http://dx.doi.org/10.1176/appi.ajp.2014.14081014.