In an open label pilot study, five opiate-dependent patients underwent baclofen-assisted opiate detoxification after abrupt discontinuation of methadone. Patients received baclofen in oral doses up to 80 mg/day, and all patients subjectively reported some reduction in discomfort. However, 3 of 5 (60%) patients could not complete detoxification with baclofen, primarily because of insufficient suppression of vomiting, myalgias, and headache. These patients successfully completed their detoxification with clonidine. These findings suggest that, in the dose range studied, baclofen is of limited use as a primary treatment for opiate dependence, although adjunctive roles for this medication in detoxification should be explored.