Lofexidine is a structural analogue of clonidine and reduces withdrawal symptoms for opiate dependent patients. The activity of lofexidine is not prevented by naloxone. This review evaluates the usefulness of lofexidine as a treatment option in the management of opiate dependency. All the available data in the field was consulted and experts in Ireland were contacted. Clinical trials for lofexidine showed that it appeared to be at least as effective as clonidine and reducing doses of methadone for use in the treatment of opiate withdrawal. The evaluation also showed that lofexidine was as effective as clonidine for managed withdrawal without risks of hypertension. Workers in the field have suggested that lofexidine is more effective in younger patients and those who have a shorter, less entrenched history of opiate use. The review suggests that lofexidine may be useful as an additional treatment for managed opiate withdrawal.