Table of Contents
Clonidine Addiction, Abuse, and Symptoms

TABLE OF CONTENTS

I. The Basics

This guide explains the effects, trends, and dangers of clonidine use and provides an unbiased analysis of the medicinal and behavioral treatment methods for clonidine addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription sedative use, which includes barbiturates, benzodiazepines, and certain sleep medications.

Primary Clonidine Dangers

  • Addictiveness: Nutt et al. assessed 20 substances to determine their addictive potential. Substances included in the study ranged from illicit drugs like cocaine and heroin to legal substances like alcohol and solvents. Although Nutt et al. did not analyze clonidine specifically, they did include barbiturates and benzodiazepines — the two most common types of sedatives — in the study. After assessing each substance based on factors such as social harm, risk of physical addiction, and risk of psychological dependence, Nutt et al. ranked all 20 substances from most to least addictive. Barbiturates ranked third, just behind cocaine and heroin, and benzodiazepines ranked seventh. Thus, Nutt et al. concluded that barbiturates and benzodiazepines have a higher addictive potential than LSD, GHB, and ecstasy, which are typically considered to be much more dangerous than prescription sedatives.
  • Risk of Overdose: Clonidine and other sedatives have been implicated in thousands of overdose deaths. Public health officials are especially concerned about the use of sedatives with synthetic opioids. According to 2016 data published by the Centers for Disease Control and Prevention, nearly 80% of overdose deaths involving a synthetic opioid also involved alcohol or another drug; in some cases, the other drug was a benzodiazepine.
  • Unintended side effects: Clonidine has been known to produce serious side effects, some of which can be life-threatening. Possible side effects of clonidine include difficulty breathing, swelling of the throat and face, low blood pressure, and slower heart rate.
  • Legal risks: Clonidine is not a controlled substance in the United States; however, state and federal laws still make it illegal for anyone without a valid medical license to sell or give prescription medications to others. Thus, selling clonidine can result in criminal charges, with the penalties for a conviction ranging from fines to jail time.

Clonidine Background Information

Derived FromSynthetically derived from imidazole
Ways UsedIngested, topical or transdermal use, intravenous administration, epidural administration, snorting
Scientific NameClonidine hydrochloride
Slang/Street Names for Sedatives and TranquilizersChill pills, downers, candy, sleeping pills, tranks
How Long in Bodily SystemHalf-life: 12-16 hours

Elimination in 48 to 72 hours but up to a week in chronic users and those with impaired kidney function

Punitive Legal Measures: Using/PossessionAlthough clonidine isn’t a controlled substance, each state still has laws prohibiting the possession of a prescription medication without a valid prescription. Depending on the state, possession without a valid prescription may be charged as a misdemeanor or felony, with penalties ranging from fines and probation to jail or prison time.
Punitive Legal Measures: Selling/DistributingSelling clonidine and other prescription medications is illegal without a valid medical license. This includes trading medications or giving away clonidine without asking for money in return. Laws vary by state, but selling a prescription medication without a valid medical license is usually charged as a felony, with penalties ranging from steep fines to several years in prison.
DEA Drug RatingClonidine is not a controlled substance, so it doesn’t have a DEA drug rating.

II. Signs of Clonidine Abuse

Behavioral Symptoms of Clonidine Usage and Abuse

How clonidine affects the brain

Clonidine is classified as a centrally acting alpha-agonist, which means it blocks sympathetic activity in the brain. In humans, the sympathetic nervous system is responsible for controlling the fight-or-flight response. This response triggers physical changes that prepare an individual to either flee from a threat or stay and face the threat; for example, heart rate increases, muscles tense, and the individual starts sweating. Its effects on the brain give clonidine the ability to reduce anxiety, produce a mild sense of euphoria, and relieve pain, all of which are desirable effects for non-medical users.

Behavioral signs of clonidine usage and abuse

When taken according to the prescription instructions, clonidine may not cause any behavioral changes; however, non-medical users are likely to display behavioral changes because they take more clonidine than prescribed or because they combine clonidine with alcohol or other drugs. Some users even meet the criteria for substance abuse disorder.

According to the DSM-V, one of the criteria for substance abuse disorder is the continued use of a substance even when it interferes with the ability to meet obligations related to work or school. People who misuse clonidine may receive poor performance ratings or lose their jobs due to issues such as absenteeism, tardiness, or an inability to fulfill their basic duties. Adolescents who misuse clonidine may receive poor grades, skip school, or stop doing their homework.

Some people who misuse clonidine also give up their hobbies and other recreational activities because they spend so much of their time obtaining clonidine, using it, and hiding their addiction from others. Adolescents may give up activities such as school sports and after-school clubs, and adult users may stop participating in social clubs or attending community events.

Financial and legal problems are also a potential sign of clonidine abuse. Users may stop paying their bills or start asking friends and family members to borrow money because they’ve spent all their money on clonidine. People with a substance use disorder may also engage in risky behaviors, making it more likely that they’ll receive traffic tickets or be charged with crimes like reckless driving or driving under the influence.

Physical Symptoms of Clonidine Abuse

How clonidine affects the body

When clonidine activates alpha-2 receptors in the brain and other parts of the nervous system, it triggers a series of physical changes. The heart rate slows down, reducing the amount of blood pumped with each heartbeat. Clonidine also causes the blood vessels to dilate, reducing the workload of the heart. As a result of these changes, blood pressure decreases.

Early physical effects of clonidine

Although it may take two to four weeks for clonidine to start reducing an individual’s blood pressure, some side effects appear within as little as 30 to 60 minutes of the first dose. Some of these side effects are unpleasant; if clonidine isn’t taken according to the prescription instructions, certain side effects can even be life-threatening.

This table illustrates the possible short-term physical effects associated with clonidine.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.)Drowsiness
Sedation
Lingering (within an hour of taking the drug)Fatigue
Headache
Weakness
Post-Use (several hours to days after use)Constipation
Nausea
Hallucinations
Anxiety
Difficulty falling asleep or staying asleep
Depression

Severe and long-term physical effects of clonidine

Non-medical users of clonidine often take more of the drug than prescribed to heighten its euphoric effects. Therefore, long-term use of clonidine can cause several physical effects, some of which are undesirable. In people who have pre-existing health conditions or use clonidine along with other substances, these effects can even be life-threatening.

People who stop using clonidine suddenly can also experience rebound hypertension, a condition characterized by a significant increase in blood pressure. In one study, three patients experienced such a significant spike in blood pressure while withdrawing from clonidine that they had to take antihypertensive medication — medication used to reduce blood pressure — within 12 to 60 hours after taking their last dose of clonidine.

Combining clonidine with alcohol or drugs can be dangerous, especially in people who have high blood pressure and other chronic medical conditions. Combining clonidine with other substances can produce a strong sedative effect and reduce the effectiveness of the clonidine itself, resulting in elevated blood pressure and other serious problems.

In some people, clonidine causes a significant drop in blood pressure, which can result in lightheadedness or fainting. Although fainting itself doesn’t cause any harm, fainting while driving or using heavy machinery can result in serious injuries. It’s also possible to sustain a head injury or broken bone while fainting.

This table illustrates the possible long-term physical effects associated with clonidine.
Long-Term Physical Symptoms
CasualConstipation
Nausea
Vomiting
Headache
Weakness
Chronic

Including all of the above effects for casual use

Agitation
Anxiety
Hallucinations
Insomnia
Depression
Lack of coordination
Slurred speech
WithdrawalDangerous increases in blood pressure (rebound hypertension)
Increased heart rate
Nervousness
Lack of sleep
Headache
Nausea
Heart palpitations

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription sedative addiction.

III. Clonidine Usage

Non-medical use of sedatives is a growing concern, especially among women

According to the 2019 World Drug Report, approximately 10 tons of sedatives were seized by law-enforcement officials in 2017. Although the amount of sedatives seized in 2017 was much lower than the amount seized during the previous year, sedative misuse is still a serious problem in all regions of the world. Officials are especially concerned about polydrug use, which is the use of sedatives with other substances. For example, some users combine sedatives with alcohol, increasing the risk of serious side effects.

The non-medical use of sedatives and tranquilizers is especially concerning in Central America and South America. More than 2% of the general population in both regions report engaging in the non-medical use of these substances. Data from school surveys indicates that the non-medical use of sedatives and tranquilizers is a growing problem among adolescents. For example, approximately 1.9% of El Salvadoran students between the ages of 13 and 17 reported non-medical use of these substances in 2017.

Sedative and tranquilizer use has also been increasing throughout Europe, especially in the Western and Central regions. Based on data from the 2019 World Drug Report, Czechia, Italy, Lithuania, and the Netherlands are particular areas of concern. In Czechia, for example, nearly 20% of the population has engaged in the non-medical use of tranquilizers.

The amount of data available for Asia and Africa is limited, but the current data indicate that sedative and tranquilizer use is also a growing problem on these continents. In Asia, non-medical use of these substances is especially prevalent in Hong Kong, Singapore, Malaysia, Brunei, and Indonesia. Non-medical use of tranquilizers, including benzodiazepines, is also prevalent in Morocco, Algeria, and other parts of North Africa.

Prescription Sedative Use Throughout the World
HighestSecondThird
Regions With the Highest Number of Prescription Sedative UsersCentral America/South AmericaWestern/Central EuropeNorth America
European Countries with the Highest Number of Female Sedative/Tranquilizer UsersCzechiaLithuaniaItaly

*This table includes data from users of prescription sedatives and tranquilizers, including benzodiazepines and barbiturates.
Sources: 2019 World Drug Report

Clonidine Usage Demographics in the United States

Prescription sedative and tranquilizer misuse is a serious concern in the United States

Non-medical use of sedatives and tranquilizers is a much bigger problem in the United States than it is in other parts of North America. For example, while only 0.2% of Canadians aged 15 and older reported past-year tranquilizer misuse in 2017, 2.2% of Americans aged 12 and older reported misusing tranquilizers in the same timeframe.

Although sedative and tranquilizer misuse is still a serious problem for Americans, data from the Monitoring the Future Study indicate that the prevalence of tranquilizer use among 10th graders and 12th graders was lower in 2019 than it was in 2017 and 2018. In 2019, 6.10% of 12th graders reported that they had misused tranquilizers, down from 6.1% in 2018. The number of 10th graders reporting lifetime tranquilizer use also decreased, going from 6% in 2018 to 5.7% in 2019.

One particular area of concern is the rising prevalence of tranquilizer use among younger adolescents. In 2018, 3.5% of 8th graders surveyed reported that they had used tranquilizers at some point in their lives; this increased to 4% in 2019. Past-year use of tranquilizers also increased, going from 2% in 2018 to 2.4% in 2019.

Several factors influence the rising rates of sedative and tranquilizer misuse in the United States, but one of the most important is the increased trafficking of these substances. In 2017, nearly half of the barbiturates seized by law-enforcement officials were seized in North America. Increased trafficking makes it easier for Americans to obtain sedatives and tranquilizers, contributing to increased rates of abuse.

Demographics of Prescription Usage
Past Year (2019)Lifetime
8th grade (14-15 yo)2.40%4.00%
10th grade (15-16 yo)3.40%5.70%
12th grade (17-18 yo)3.4%6.10%

IV. How to Find Help

Clonidine reduces anxiety, relieves pain, and produces a mild euphoric effect, increasing the risk of tolerance and dependence. As a result, some users have to take higher doses of clonidine to achieve these desirable effects. Clonidine can also cause severe withdrawal effects, including significant increases in blood pressure and heart rate, making it difficult for users to stop taking the drug.

Treatment for clonidine addiction typically focuses on slowly tapering off the substance, which makes the detoxification process more comfortable and reduces the risk of serious withdrawal symptoms. To learn more about this multi-step process, review our clonidine rehabilitation guide, which provides an overview of the rehabilitation options available to individuals addicted to clonidine.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.