Detoxification from
opiate addiction has been a medical problem for as long as
opiate drugs have been available. Treatment before the discovery of
clonidine involved giving another
opioid drug with less dangerous consequences of chronic use, such as the long-acting and orally administered once a day
methadone, for another
opioid mu agonist like
heroin, which must be taken intravenously many times a day, thus making rehabilitation, work, and avoidance of
hepatitis, HIV, and other illnesses difficult. Although
methadone has proved to be very beneficial, it still has significant abuse potential.
Naltrexone, because it blocks the effects of all
opiates, has facilitated the transformation from addiction to a
drug-free state for many recovering addicts. By alleviating
withdrawal symptoms and by lessening the detoxification period,
clonidine similarly has improved the prospect of recovery from
opiate addiction. Relapse, whether withdrawal is treated with
clonidine or other new agents or not, occurs with great regularity because repeated
opiate use can induce a new acquired drive state--the drive for
opiates. In addition, with powerful
withdrawal symptoms during abstinence,
opiate relapse is difficult to prevent without an adequate treatment program. The efficacy of
clonidine and other medical magic bullets for withdrawal distress needs to be given as part of a long-term recovery program which not only allows the brain to re-establish normal homeostatic changes in the
drug-free state but also provides sufficient motivation for new approaches to achieving and sustaining pleasurable existence.