Klonopin for Opiate Withdrawal Symptoms

Benzodiazepines like Klonopin are not generally used in opiate withdrawal as they can be risky for those who struggle with opioid use.

People who are experiencing opiate withdrawal symptoms may consider taking Klonopin (clonazepam) to sleep or reduce their symptoms. However, Klonopin is addictive and has additional overdose risk when used in someone recovering from opioid addiction. For this reason, doctors don’t recommend them for opiate withdrawal.

Is Klonopin Used for Opiate Withdrawal?

Klonopin is a brand-name version of clonazepam, a benzodiazepine. Klonopin is prescribed to help with symptoms of seizure and panic disorders. This drug is believed to increase the amount of GABA in the brain, which can calm anxiety during withdrawal.

Benzodiazepines depress the central nervous system, as do opiates and opioids. People who are experiencing withdrawal symptoms may choose to take Klonopin to promote sleep and reduce psychological withdrawal symptoms, like anxiety.

Taking Klonopin for opiate withdrawal isn’t necessarily a good option, however. Klonopin is highly addictive, and it also can lead to physical dependence. Non-addictive options like clonidine are often preferred. If someone is given Klonopin during opiate withdrawal, that person could end up replacing one addiction with another. When Klonopin is combined with opioids, it can cause fatal respiratory depression since both of these drugs slow the central nervous system. If someone were to use Klonopin for opiate withdrawal and then relapsed, the results could be deadly.

For this reason, experts recommend that people who take Klonopin during opioid withdrawal undergo detox in a medical facility. Trying to self-medicate by using drugs like Klonopin for opiate withdrawal can lead to relapse or death.

What Happens During Opiate Withdrawal?

Opiates are a class of drugs derived from opium, found in the poppy plant. In specific terms, “opiate” refers to naturally-derived drugs and pain medications, but it’s often used interchangeably with “opioids”. Opioids are synthetic or semi-synthetic and are structurally similar to opiates. Morphine is an opiate, while prescription pain relievers like oxycodone and hydrocodone are opioids. These drugs have medicinal uses, but they are also highly addictive. The opioid class of drugs also includes heroin, which has no medical uses approved in the U.S.

When someone takes an opioid, whether it is a pain medication or heroin, the drug binds to specific receptors in the central nervous system. This triggers dopamine to flood the brain, creating a sense of euphoria, also known as a high. This high activates reward pathways in the brain and can contribute to addiction.

Because opioids are highly addictive, there has been a push in the U.S. for doctors to stop prescribing opioids as first-line pain management treatments. However, despite these efforts, there is an ongoing opioid epidemic in the U.S., and many opioid abuse and addiction cases began with prescription pain medications.

Addiction is a psychological disease in which someone feels compelled to keep using opioids in a way that is out of their control. There’s also physical dependence to consider. When someone uses opioids, the brain and body develop a tolerance, meaning people who take these drugs need increasingly larger doses to feel the same effects.

With tolerance often comes dependence. Someone who is dependent on opioids will likely experience withdrawal symptoms if they try to stop using suddenly. Withdrawal from opiates and opioids isn’t typically life-threatening, but it is highly uncomfortable.

Symptoms of opiate withdrawal can be physical and psychological. They can begin within hours of the last dose and could last for days or weeks. Withdrawal symptoms include:

• Nausea and vomiting
• Anxiety
• Insomnia
• Hot and cold flashes
• Sweating
• Muscle cramps
• Watery eyes and nose
• Diarrhea

Medications for Opiate Withdrawal

There are a few options for opiate withdrawal. Some people may try to stop using “cold turkey”, meaning they stop suddenly. This is one of the most ineffective options because it is highly uncomfortable and because many people who do this will relapse. Another option is to do an at-home tapering and detox program, but this is also very challenging and often results in failure. The best option is a medically-supervised detox program. During medically-supervised detox, patients are kept safer and more comfortable than they would be otherwise.

Certain medications can be given during medically-supervised detox. These include:

• Methadone: a long-term opioid maintenance medication that can reduce the severity of withdrawal symptoms
• Buprenorphine or buprenorphine/naloxone: an alternative medication to methadone
• Clonidine: administered to reduce anxiety and agitation as well as some physical symptoms, like cramping
• Naltrexone: helps prevent relapse after detox is complete
• Benzodiazepines like Klonopin (clonazepam): helps reduce anxiety
• Hypnotics, like Ambien (zolpidem): helps induce sleep
• Non-steroidal anti-inflammatory drugs, like ibuprofen: helps treat muscle cramps
• Bismuth subsalicylate: administered to treat diarrhea
• Anti-nausea drugs, like ondansetron or prochlorperazine: helps prevent nausea and vomiting

If you or a loved one is struggling with opiates or opioids, contact The Recovery Village. We offer specialized detox programs and treatment options that give you the tools you need for a successful, life-long recovery.

Editor – Erica Weiman

Erica Weiman graduated from Pace University in 2014 with a master's in Publishing and has been writing and editing ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more