Is Clonidine a Controlled Substance?

What you will learn

• Clonidine is not classified as a Schedule I-V controlled substance by the DEA.
• Clonidine is only approved as a prescription medication that can be obtained from a pharmacy with a prescription.
• A person who stops taking clonidine suddenly may experience significant withdrawal symptoms, including increased blood pressure (also called "rebound hypertension").
• Clonidine can be prescribed during supervised withdrawal treatment to assist with certain withdrawal-related symptoms, but it does not treat the addiction.

Is Clonidine Controlled? Quick Answer

No, clonidine (including clonidine HCl) is not classified as a controlled substance [1] under the U.S. Controlled Substances Act.

However, clonidine is a prescription drug, so it is not available without a doctor’s order and should only be used under the supervision of a medical professional. Understanding the difference between controlled and non-controlled medications [2] is critical for those navigating addiction recovery or treatment for mental health disorders.

What Is Clonidine?

Clonidine is a medication that acts on the central nervous system (CNS) [2] and affects both the brain and spinal cord. Clonidine’s mechanism of action involves the stimulation of alpha-2 adrenergic receptors. Stimulation of these receptors reduces the transmission of nerve impulses [3] in the body, leading to a decrease in heart rate and blood pressure.

Due to its effects on the CNS, clonidine has been used as an effective medication for many years, and clinical studies and experiences [4] support its use as an evidence-based medication.

Uses for Clonidine

Clonidine is primarily prescribed to treat [3] elevated blood pressure. Its mechanism of action works to relax the blood vessels, thereby allowing the heart to pump blood more easily. In addition to being used to lower blood pressure, the extended-release formulations [5] of clonidine have been approved by the FDA to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents.

Some clinicians also prescribe clonidine for “off-label” purposes. “Off-label” means that clonidine is used to treat symptoms that are not indicated by the manufacturer’s FDA approval but are prescribed by a medical doctor because the managing physician believes it is needed in a monitored setting (e.g., in patients going through withdrawal from substances, clonidine may be given to reduce anxiety and sweating [4], and increased heart rate, etc.).

Is Clonidine a Controlled Substance?

DEA Scheduling (Federal) Status

Controlled substances are drugs controlled by the U.S. federal and state regulations described in the Controlled Substances Act. All controlled substances are placed into one of five different classifications based on their potential for dependence and abuse and their accepted medical uses.

• Schedule I substances are those substances that have no recognized medical uses and have the highest potential for abuse and dependency.
• Schedule II substances have accepted medical uses but have a high level of psychological or physical risk of dependency.
• Schedule III through V substances have progressively lower potential for abuse.

Clonidine is not classified in any [1] of these five classifications. According to the classification listing and FDA labeling provided by DailyMed, clonidine does not fall under the classification of controlled substances. Therefore, clonidine medications do not fall under the restrictions that apply to drugs in the same classes as opioid and stimulant [2] medicines.

Reasons for Misunderstanding Clonidine’s Classification

Clonidine is not classified as a controlled substance. However, it is often discussed in the context of withdrawal and detox. Detoxification in a treatment setting refers to when patients receive medication and supervision to help manage their withdrawal symptoms [4] from substances safely.

Because clonidine is used for withdrawal symptoms such as restlessness or elevated blood pressure, it is not unusual for people to think that clonidine is a narcotic or controlled medication.

The confusion about the classification of clonidine may also stem from the experience that sudden withdrawal from clonidine can cause an intense reaction. This response exemplifies the physical dependence experienced when the body becomes dependent on a medication. Physical dependence occurs [6] when the body has adapted to a medication, and when the medication is no longer used, the body then experiences physical withdrawal symptoms. Although physical withdrawal symptoms can be experienced, in this setting, they are not indicative of addiction.

How Is Clonidine Regulated?

Clonidine is not classified as a “controlled substance” under federal law. The term “not controlled” means that clonidine prescriptions are not subject to scheduling restrictions [1] such as limited refills or requiring special prescription forms under federal law. This does not make clonidine safe to use without supervision; clonidine must not be shared, abused, or stopped without consulting a physician. As with any prescription medication, clonidine may be dangerous if you do not take it as prescribed.

Doctors routinely monitor patients’ blood pressure, heart rate, and their overall response to clonidine while they are taking this medication. When determining if a patient should stop taking clonidine, a doctor typically will recommend the patient gradually taper their usage [6] instead of suddenly stopping, which can increase the risk of withdrawal.

Safety, Dependence, and Withdrawal

Can You Get Addicted to Clonidine?

Although clonidine is not considered “addictive” in the sense that it does not produce the euphoric feelings associated with addiction, it is possible to develop physical dependence on clonidine. With regard to physical dependence on clonidine [2], the body becomes physically dependent upon the medication. As a result, withdrawal symptoms may occur upon a sudden cessation of this medication. However, physical dependence does not necessarily indicate that an individual has a substance use disorder.

Why You Should Not Stop Clonidine Suddenly

Abruptly stopping clonidine can cause “rebound hypertension,” which is characterized by a rapid increase in blood pressure [6] well above the patient’s baseline level. Headaches, heart palpitations, anxiety, agitation, sweating, and tremors may be some of the symptoms associated with rebound hypertension. Tapering clonidine gradually may reduce the risk of rebound [6] hypertension.

Side Effects and Higher-Risk Combinations

Some common side effects of clonidine include drowsiness and dry mouth [5], dizziness, and fatigue. When taken in conjunction with other sedating medications or substances, the sedative effect may be enhanced, resulting in increased safety risks.

Why Clonidine May Be Used During Withdrawal

Clonidine is used in conjunction with other medications and treatments as support for managing various withdrawal symptoms. Clonidine is not a stand-alone treatment for addiction; rather, it is typically used as an adjunct to other forms [2] of treatment or care.

What Supervised Care Typically Includes

Typical treatment programs feature medical supervision to monitor vital signs (blood pressure and heart rate); medication management and adjusting dosages as needed; appropriate mental health screenings for issues such as anxiety, depression, or trauma; and coordination of additional treatment programs (e.g., outpatient or intensive outpatient).

When to Seek Professional Help

If you are using substances and also suffering from mental health issues or trauma, you should seek assistance from a professional. Epiphany Wellness provides evidence-based dual-diagnosis care and a variety of treatment options that will support your long-term recovery.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more