kratom

[tectonic6086]

Hello, all.

I've been working at a subacute detox center for about six months. We've just had a few patients detoxing from kratom and I'm wondering what your experiences are.

The few I've encountered have had a complicated detox--although the few I've seen have had more complex mental health acuity (high anxiety at baseline, few coping mechanisms, etc.). I'm not sure how to separate my limited experiences with patients of a similar mental health profile from the drug itself.

Any experience or ideas?

Cheers.

[BrittPsychNP]

I have extensive experience with Kratom. Generally the detox protocol is the same as for traditional opiates. My preference is Valium or phenobarbital for early detox, and then transition to Suboxone (optional, although recommended) for short or long term maintenance therapy. Although Kratom isn't a traditional opiate like oxycodone or heroin, Kratom does partially activate the opiate receptors in the brain, much like opiates that fully activate the receptors. Kratom detox compared to opiate detox differs in that the physical symptoms are generally less pronounced (although still present) with kratom; however, the mental symptoms can be more severe and extend for a longer period of time. I have had great success with Suboxone therapy for long term kratom users, especially chronic relapsers. I promise I'm not a Suboxone sales rep ;-). The truth is that I just enjoy sharing little known knowledge about the very addictive (and yet somehow still legal) drug called Kratom.

[jirizarry]

Good question, I also have had a patient detoxing off of kratom and it was a very difficult process mental health wise. This patients had a list of co-occurring disorders as well but I still saw more of a bumpy road for that patient compared to my co-occurring patients detoxing off of heroin.

Kratom works on those mu receptors and also has an effect on the receptor that is activated by clonidine so I can see how it can affect anxiety/mental health. This patient also is doing better while on Suboxone. I think Suboxone is very helpful if used properly, theres that chance for diversion. But! With the arrival of Sublocade I am hoping for some better outcomes.