Withdrawal from opiates: Realities, misconceptions, and consequences of using Kratom
Kratom, a plant native to Southeast Asia, has gained popularity in the United States as an alternative to opioids. However, its use is not without controversy.
Safety Concerns
The Food and Drug Administration (FDA) has reported numerous deaths associated with kratom, some of which may have resulted from an overdose of kratom alone. CDC data recorded 91 kratom-related fatalities from 2016 to 2017, and the FDA identified 44 deaths since 2011.
The unregulated nature of kratom products poses a significant risk. Unlike FDA-approved opioid use disorder (OUD) treatments such as methadone and buprenorphine, kratom products do not have standardized dosing or medical oversight. The compound 7-hydroxymitragynine, which is much more potent than morphine and highly addictive, is responsible for many of kratom’s opioid-like effects and withdrawal symptoms.
Efficacy and Use for Opioid Withdrawal
While some individuals use kratom as an accessible and affordable alternative for managing pain or easing opioid withdrawal symptoms outside the formal medical system, especially when access to FDA-approved medications is limited, medical experts warn against its use for OUD treatment. The lack of controlled dosing, safety data, and integration into comprehensive treatment plans that include counseling and monitoring make kratom an unsuitable substitute.
Reports from user communities and some researchers mention kratom’s potential to reduce withdrawal symptoms, but these are anecdotal and lack rigorous clinical evidence. Use of kratom extracts, especially those high in 7-OH, raises safety concerns rather than offering a medically sound substitute.
Additional Considerations
Kratom dependence and withdrawal can be severe, necessitating specialized treatment including medical detoxification, behavioral therapies, and support programs akin to treatments for other substance use disorders. Regulatory agencies are increasing oversight on kratom products, especially concentrated extracts, to improve public safety.
Conclusion
While kratom is sometimes used in the U.S. to self-manage opioid withdrawal due to accessibility and affordability, it carries significant safety risks due to lack of regulation, unpredictable dosing, and addiction potential from potent alkaloids like 7-hydroxymitragynine. The FDA and medical experts do not endorse kratom as a substitute for approved OUD treatments, which are medically supervised and standardized for safety and efficacy.
Anyone dealing with kratom withdrawal should ensure they regularly communicate with a family member, loved one, therapist, or counselor for emotional support. Repeated use of kratom can cause liver damage, with early symptoms including fatigue, nausea, itchy skin, and dark urine. It is crucial to seek advice from a doctor and consider strategies such as staying hydrated, having a nutritious diet, exercising regularly, and having a structured sleep schedule.
- The compound 7-hydroxymitragynine, found in kratom, is more potent than morphine and highly addictive, leading to severe dependence and withdrawal that may require specialized treatment.
- Kratom, despite being used by some for managing pain or easing opioid withdrawal symptoms, lacks rigorous clinical evidence and integration into comprehensive treatment plans, making it an unsuitable substitute for FDA-approved medications.
- Regulatory agencies are increasing their oversight on kratom products, especially concentrated extracts, to improve public safety and address concerns about unregulated substance use.
- It is crucial for individuals dealing with kratom withdrawal to engage regularly with a family member, loved one, therapist, or counselor for emotional support, maintain a nutritious diet, exercise regularly, and seek medical advice regarding liver damage symptoms and strategies for detoxification.
