| Medication | Initial dose (adult) | Indication |
| Opioid | ||
| Methadone | 10 mg intramuscularly or 20 mg orally. | Acute opioid withdrawal. Not recommended for management of acute withdrawal triggered by an antagonist (naloxone, naltrexone). |
| Buprenorphine | 4 to 8 mg sublingually. If withdrawal persists 30 to 60 minutes later, can give additional doses up to 24 mg total in 24 hours. [Alternative dosing: 0.3 to 0.9 mg intravenously (given over 20 to 30 minutes) or intramuscularly]. | Acute opioid withdrawal. Not recommended for management of acute withdrawal triggered by an antagonist (naloxone, naltrexone). |
| Non-opioid adjunctive medications* | ||
| Clonidine | 0.1 to 0.3 mg orally every hour with monitoring of blood pressure and heart rate (0.7 mg maximum total daily dose); check blood pressure prior to each dose and hold the dose if hypotension is present. | Anxiety, restlessness, dysphoria with elevated or normal blood pressure and heart rate. |
| Diazepam | 1 to 10 mg orally, intravenously, or intramuscularly. Alternative benzodiazepines if diazepam not available:
| Anxiety, restlessness, dysphoria, insomnia, muscle cramping. |
| Promethazine | 25 mg intramuscularly (preferred) or intravenously (vesicant). | Nausea, vomiting, restlessness, insomnia. |
| Diphenhydramine | 50 mg intravenously, intramuscularly or orally. | |
| Hydroxyzine | 50 to 100 mg intramuscularly or orally. | |
| Loperamide | 4 mg orally, followed by 2 mg every loose stool. | Diarrhea, stomach cramps. |
| Octreotide | 50 micrograms subcutaneously every 6 hours. | |
| Bismuth subsalicylate | 524 mg orally. | |
| Acetaminophen | 650 mg orally. | Pain, myalgia. |
| Ibuprofen | 600 mg orally. | |
| Baclofen | 5 to 10 mg orally. | Muscle cramping. |
