Opioid withdrawal management typically includes which medication to alleviate autonomic symptoms?

• A. Methadone
• B. Buprenorphine
• C. Clonidine
• D. Naltrexone

Answer: (C)

Withdrawal from opioids drives a surge of sympathetic nervous system activity, leading to autonomic symptoms like sweating, runny nose, gooseflesh, tachycardia, and hypertension. A medication that directly dampens sympathetic outflow from the brain helps relieve these autonomic signs. Clonidine, an alpha-2 adrenergic agonist, reduces central noradrenergic firing, which blunts these autonomic manifestations and often makes withdrawal more tolerable.

Methadone or buprenorphine provide opioid receptor activity that can ease overall withdrawal and cravings, but they don’t specifically target the autonomic hyperactivity as clonidine does. Naltrexone, an opioid antagonist, would block opioid effects and can precipitate withdrawal if given during active withdrawal, so it isn’t used to treat autonomic symptoms.