This document provides recommendations for medications to help alleviate symptoms of acute opioid withdrawal or withdrawal as part of a planned taper. For acute withdrawal it recommends clonidine to reduce anxiety and check blood pressure, loperamide for diarrhea, ibuprofen or acetaminophen for muscle aches, hydroxyzine for anxiety, trazodone for insomnia, and ondansetron for nausea while checking electrocardiograms. For anticipated withdrawal as part of a taper it recommends the same medications plus starting gabapentin one month prior to reduce anxiety during the taper.