The Most Common Medications Used in Treatment of Opioid Addiction

A look at how antidepressants, benzos, and opioid medications are used in the treatment of substance use disorders. More on their uses and application here.

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STAGE 1: Medications During Detox

Addiction treatment begins in earnest during detox. During drug withdrawal and the subsequent stages in recovery, the body needs to remove the substance remaining in the body, to get back to normal. The earliest symptoms of withdrawal can occur within the first few hours of the last dose taken and may last for a week or more, depending on the history of use.  So, what symptoms are common?

During the early stage of opioid or opiates withdrawal, symptoms may include anxiety, sweating, restlessness, runny nose, rapid heartbeat, insomnia, muscle aches, and more. The later symptoms – which normally appear after a day, or so – may include vomiting, nausea, seizures, rapid heart, diarrhoea, high blood pressure, and more.

Although an unassisted withdrawal process may not be life threatening, the challenge in  bearing the discomfort, and other symptoms, often lead the person to relapse. To help them in getting through the withdrawal process, supervised medical detox is sometimes required.

Medications Can Reduce the Effect of Withdrawal

There are many kinds of drug used to reduce the effect of the withdrawal. Here are some of the most common medications used in treatment of opioid addiction:


Benzodiazephine – commonly referred to as “benzos” are well-known as tranquilizers.  These medications slow the communication between nerve cells in the central nervous system, and are used for the treatment of anxiety, muscle relaxation, nervousness, panic attacks, and help people with sleep disorders.

Benzodiazepines are considered very effective when used in the short term, but often lose their effectiveness if used continuously for months.


Brand names: Catapres, Nexiclon, Kapyav, Clophelin, etc.

Clonidine is a medication used in treatment of high blood pressure. In the opioid withdrawal process, Clonidine helps to relieve anxiety, depression, insomnia and help the blood vessels to relax. As an anti-depressant, Clonidine also helps controlling physical withdrawal symptoms such as a runny nose, watery eyes, sweating, etc.

NOTE HERE: Before taking this medication, it is advisable to seek medical advice, particularly if you have any history of heart disease or stroke, kidney disease, or low blood pressure.


Brand names: Atarax, Vistaril, etc

Hydroxyzine reduces activity in the central nervous system, and so is taken for its calming effect, treating anxiety and tension caused by the opioid withdrawal effect in the body.

NOTE HERE: To make sure you can take Hydroxyzine safely, please make sure to inform your doctor if you have experienced conditions such as epilepsy, heart disease, thyroid disorder, liver or kidney disease and other relevant history.


Brand names: Dolophine, Methadose, Methadose Disket, Methadose Sugar-free.

Methadone is usually given to ease the withdrawal symptoms of people addicted to heroin. As a painkiller, Methadone is available in the form of a syrup and in tablet form. Considered a powerful medication, Methadone is not typically offered to people with asthma or other breathing problems or gastric obstructions.


Brand names: Vivitrol, Revia.

Naltrexone lowers the desire to take opiates, reverses the effect of opioid use in the body (pain relief and feeling of well-being) and thus is usually used to prevent relapse. Naltrexone can be taken orally or injected in the muscles.


Brand names: Suboxone, Zubsolv.

Suboxone is a prescription drug containing 2 ingredients; Buprenorphine and Naloxone.  Generally used as painkiller to ease withdrawal symptoms, Buprenorphine, relieves drug cravings and dependence, while Naloxone counters the effects of use and is sometime used in cases of overdose.  Suboxone works in a similar fashion to Methadone but is considered less strong.

NOTE HERE: To make sure you can use Buprenorphine and Naloxone safely, keep your doctor informed if you have problems with asthma, gall bladder and urination problems, liver or kidney disease, seizures or other relevant history.


Brand names: Ultram, ConZip, Rybix ODT, etc.

Tramadol is a prescription drug used as a pain reliever.

NOTE HERE: You should not take tramadol if you have breathing problems, Asthma, liver or kidney disease. In long-term use situations, Tramadol may become habit forming with mental and physical dependence as a possible outcome.

Possible Side Effects of Medications

Although these drugs are useful to help during withdrawal treatment, they can also cause dependency (physical), addiction or other serious impacts. Each of these medications need to be accompanied by proper supervision from a medical practitioner/doctor.

Apart from allergic reaction, side effects of consuming such medications can also include:

  • Drowsiness
  • Confusion
  • Blurred vision
  • Trouble concentrating
  • Headaches or mild dizziness
  • Mild fever
  • Sneezing
  • Feeling tired
  • Dry mouth

The long-term side effects can include:

  • Memory problems
  • Feeling slow and dulled
  • Difficulty concentrating
  • Irritability
  • Less confidence

Everyone reacts to medication differently, you may or may not experience the side effects above.  Misusing these medications, including mixing or consuming the wrong dosage can cause serious effects in our body system, and if you think you may have problem with prescription drug use, you should contact your doctor or other medical professionals.

STAGE 2: Medication Assisted Treatment of Addiction

Substitution therapy is also used to treat opioid addiction. The main idea is that substitution therapy is useful for people who have been  long-term or high-dose dependent on fast-acting opioids (such as heroin). During treatment, they receive slow-acting opioids instead (such as methadone and buprenorphine). This treatment does not necessarily have “substitutive effects” for opioids, but has been proven to reduce cravings and support the control of addictive behavior so that people can pay attention to recovery rather than drug-dependence issues.

Medication assisted treatment usually begins during medical detox where supervised administration of these drugs is used to manage withdrawal symptoms in early recovery, may also require other forms of support, including:

  • supervision by mental health professionals
  • participation in group therapy
  • attending twelve step program meetings

…and others.

With proper replacement/substitution therapy, the risk of death or serious injury caused by withdrawal from drugs can be reduced. It is important to be aware that prescribed drugs used for this type of therapy are typically recommended for temporary use only, the dosage should be reduced over time strictly according your doctor’s recommendation.

The reduction in recommended dosage early in the detox process may be significant, but as the administered doses get closer to none, reduction must be carefully managed as total removal of detox medications too soon in the process, can result in significant recurrence of a persons withdrawal related symptoms.

Seeking help is crucial, and make sure you have qualified healthcare professionals assisting throughout the process.

About the author
Pip Baddock is Operations Director at Bali Beginnings Drug & Alcohol Rehab based in Bali in Indonesia. With his own history of addiction and recovery, and being strong 12 step recovery advocate, Pip works with addicts from varied backgrounds in supporting them in building a life of sobriety. Bali Beginning Rehab Centre treats people with a range of disorders including addiction to Alcohol, Drugs, Ice Addiction Treatment and Sex and Gambling.
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