Opioids are among the most dangerous substances readily available to abuse. From the damage it does to your body and brain to the far-reaching results of chronic opioid abuse, opioids have been the spotlight in the past years. Research shows that within a span of a decade, opioids alone were already the cause of 15,000 deaths a year in the United States, and that number has more than doubled up to 30,000 and higher. With these numbers in mind, researchers, doctors, and scientists work around-the-clock to combat this wave of opioid abuse and addiction.
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Very recently, the U.S. Food and Drug Administration (FDA) approved the use of a new type of drug to help addicts treat their opioid addiction. Lucemyra (lofexidine hydrochloride) works to lessen the intensity of withdrawal symptoms and, although it is effective, lofexidine should only be used with caution and doctor’s approval/supervision.
How to Treat Opioid Withdrawal
As some of the most chemically-altering drugs for the brain, opioid abuse commonly leads to addiction. In treating opioid addiction, it is more than likely that the patient experiences withdrawal symptoms. Withdrawal symptoms are the result of an addict’s brain, practically relying on a drug for its source of dopamine. In treatment, a patient is denied that drug, and thus the body reacts and readjusts to sobriety.
Common withdrawal symptoms associated with opioids can include, but are not limited to:
- Runny noses
- Muscle aches/cramps
- Sleep irregularities
Opioids themselves are common medications used to treat other opioid addictions. Buprenorphine and methadone are both opioid agonists, binding to opioid receptors and making the user experience the similar, yet much more subtle effects of abusing opioids. This quality makes opioids a valid medication used in treatment for opioid addiction, but it also raises some questions. Isn’t use of other opioids to treat addiction simply replacing the addiction with a different one?
This question is common among those seeking information about drug treatment, and rightfully so. While it is true that medications used in medication-assisted treatment (MAT) can be harmful and addictive, this is rarely the case. Doctors and other medical experts are trained to only administer safe amounts of medication in MAT. Even so, the stigma of MAT for opioid abuse disorder exists.
Fortunately, lofexidine is the first non-opioid drug used in opioid withdrawal. Lofexidine detox removes the stigma surrounding the use of opioids in treating opioid addiction and is very effective in doing so.
What Is Lofexidine?
It’s entirely possible that you’ve never heard of Lofexidine. It has been on the market for several years and was initially used only in a residential treatment basis for opioid detox. It’s becoming increasingly common as a safe and effective method to help people curb their opioid use disorder (OUD) without the addictive properties that methadone possesses.
Lofexidine is a central alpha-2 agonist, which is similar to Clonidine without the risk of hypotension in higher doses. It suppresses the chemicals that produce acute withdrawal symptoms that keep many clients from stopping opioids.
Lofexidine is an FDA approved medication and can cause mild pain relief, sedation, and relaxation. The class of medicine was originally used to treat high blood pressure and anxiety but has also been used in some cases to treat opioid withdrawal. The drug is slightly safer when compared to other drugs, and is highly effective. When it is put up against methadone in a medically supervised withdrawal, the peak withdrawal severity was much worse with Lofexidine.
Safe Use of Lofexidine
As mentioned before, taking lofexidine only as instructed is instrumental in preventing negative side effects. Lofexidine comes in tablets, either coated with a film or as a tan, round tablet. Oral consumption is the safest method of taking lofexidine and should only be used to help treat adults (not enough research has been done yet to determine its safety with youth or elderly.)
According to Medicines.org, safe dosage amounts start at 0.8 mg per day and increase as days go on by 0.4 mg per day. It is important not to exceed 2.4 mg in one day, and single-dose amounts should not exceed 0.8 mg. A high-quality treatment center makes sure that each and every case of opioid addiction is viewed as unique. Your doctor will determine your dose amount depending on your severity and length of addiction.
Adverse Effects of Lofexidine
While a number of medications are used to treat opioid addiction, the ways that they affect the users vary. For example, naltrexone is a medication commonly used in medication-assisted treatment for opioid abuse disorder. It binds to and blocks opioid receptors, speeding up the detoxification process and pretty much sending the user into immediate withdrawal. Some people do not like the way that naltrexone affects them, and lofexidine is a great alternative.
Instead of sending the user into immediate withdrawal and trying to speed up detox, lofexidine mitigates the chills, sweating, cramps, and runny nose symptoms of opioid withdrawal and detox.
Unfortunately, as is the case with every other medication used in addiction treatment, lofexidine and lofexidine detox can inadvertently cause a number of adverse effects, such as:
- Irregularities in heart rate
- QT prolongation (increased risk of an irregular heartbeat)
Irregularities in blood pressure are common when it comes to lofexidine use, as lofexidine was originally used to treat high blood pressure. When using lofexidine, a user may experience low blood pressure. When intake is ceased (after roughly 14 days of use), the user’s blood pressure will “bounce back,” often resulting in high blood pressure.
To best avoid the adverse effects of lofexidine, it should be used as a short-term medication aiding in the tapering off of an opioid. Tapering refers to the substitution of an addicted opioid by a new medication, with the gradual reduction of that new medication until the patient is able to function normally without any substance in his or her system.
Lofexidine Drug Interactions
Lofexidine is known to prolong the QT interval, which results in severe interactions when combined with other drugs that prolong the QT interval. These medications include methadone, citalopram, amiodarone, and fluconazole. These medications can increase the risk of low levels of potassium in the blood. Before using any of these medications, you must consult with a medical professional to determine if this is the right choice for you.
In the event of an overdose, you must call the poison control helpline at 1-800-222-1222. If someone has collapsed, had a seizure, has trouble breathing, or will not wake up, you must immediately call emergency services at 911 and wait for further instruction.
Symptoms of overdose include:
- Slowed breathing
Lofexidine: MedlinePlus Drug Information. (n.d.). Retrieved from from https://medlineplus.gov/druginfo/meds/a618036.html
Commissioner, O. O. (n.d.). FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults. Retrieved from from https://www.fda.gov/news-events/press-announcements/fda-approves-first-non-opioid-treatment-management-opioid-withdrawal-symptoms-adults
BritLofex Tablets 0.2mg. (n.d.). Retrieved from from https://www.medicines.org.uk/emc/product/1483/smpc
Wakeman, S. (2018, August 10). Lofexidine: Another option for withdrawal from opioids, but is it better? Retrieved from from https://www.health.harvard.edu/blog/lofexidine-another-option-for-withdrawal-from-opioids-but-is-it-better-2018060614515
(June, 2018). Medications to Treat Opioid Use Disorder. National Institute on Drug Abuse. Retrieved August, 2019 from from https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work