The current maintenance treatment for opiate withdrawal usually includes using a different, controlled, opiate, either methadone or buprenorphine. Alpha-2 receptor agonists, such as lofexidine, can be used to manage the acute symptoms during withdrawal. Lofexidine is effective and safe and is FDA approved for the management of withdrawal symptoms. It does carry warnings for side effects that relate to its alpha-2 blocking activity-hypotension, bradycardia, syncope, and Q.T. prolongation. It acts directly on the locus coeruleus and reduces the symptoms that would otherwise be associated with opiate withdrawal.
Numerous clinical trials have found lofexidine effective in counter- acting withdrawal symptoms. While it does carry appropriate warnings, it potentially can facilitate withdrawal from chronic opiate use and contribute to the recovery from chronic opiate use and opioid use disorder.
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