Assessment

Patients should be carefully selected as being motivated to come off opiates. Persuading patients to come off opiates if they are reluctant or unwilling is unlikely to be successful.

Patients who wish to detoxify from opiates

Lofexidine blocks the adrenaline/noradrenaline related withdrawal symptoms of opiate withdrawal. These are:

  • abdominal cramps
  • lacrimation
  • dilated pupils
  • pilo-erection
  • diarrhoea
  • restlessness
  • vomiting
  • rhinorrhoea
  • profuse sweating

Lofexidine does not affect other opiate withdrawal symptoms such as muscle aches, insomnia and craving. Non-adrenergic withdrawal symptoms may be severe and may require symptomatic treatment.

Muscle aches may respond to analgesia and insomnia usually responds to a short course of benzodiazepines: up to diazepam 30mg daily for a non-benzodiazepine user or up to 50mg daily for regular benzodiazepine user, for no more than 2 weeks.

Lofexidine can be used to reduce withdrawal symptoms in patients