Kratom use disorder: a primer for primary care physicians

Groff, Destin; Stuckey, Heather L.; Philpott, Carolyn; Dyke, Erika Van; Silvis, Matthew; Leong, Shou Ling; Bone, Curtis

doi:10.1080/10550887.2021.1950263

Cited by 3 publications

(3 citation statements)

References 41 publications

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“…We assume a DSM diagnosis of KUD uses a modified DSM-5-based checklist. To our knowledge, that method has been undertaken by two groups, 5 , 6 though Groff and colleagues also provided a framework for it 7 . Broyan and colleagues cited a paper 8 with an estimated “KUD prevalence” of 0.8%, which was derived from a different assessment method (the Drug Abuse Screening Test-10), meaning KUD was not evaluated; interpretations of those findings are debated 9 , 10 .…”

Section: We Advocate For Operationalized Clinical Definitions Of Kud ...mentioning

confidence: 99%

“…Finally, we suggest that all authors undertaking kratom research in humans consider what “advantageous” entails within a broader context of KUD or other SUD treatment. Buprenorphine/naloxone may be the best treatment for patients with moderate-severe KUD who are not opioid-naïve (especially if they have a history of OUD) and who wish to begin pharmacotherapy, but this should be carefully determined on a case-by-case basis in light of the patient's history and treatment goals 7 , 42 . Given our limited understanding of the mechanisms of action for kratom alkaloids and the lack of standardization of kratom products, pharmacotherapies for KUD should be approached with caution and with patients’ full informed consent regarding treatment options.…”

Section: We Advocate For Caution and Remind Readers Of The Need For E...mentioning

confidence: 99%

“…To our knowledge, that method has been undertaken by two groups, 5,6 though Groff and colleagues also provided a framework for it. 7 Broyan and colleagues cited a paper 8 with an estimated "KUD prevalence" of 0.8%, which was derived from a different assessment method (the Drug Abuse Screening Test-10), meaning KUD was not evaluated; interpretations of those findings are debated. 9,10 Our own surveys of kratom-using adults using modified DSM checklists showed higher rates of past-year KUD (12.0% and 29.5%, respectively).…”

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confidence: 99%

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Need for Clarity and Context in Case Reports on Kratom Use, Assessment, and Intervention

et al. 2022

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This Letter to the Editor is a response to Broyan and colleagues who recently published a Case Report presenting data on 28 patients in the United States who identified kratom as their primary substance of use and who were subsequently induced on buprenorphine/naloxone for a reported diagnosis of kratom use disorder. We applaud the authors for helping to advance the science on kratom and recognize the difficulties in conducting kratom-related clinical assessment and research. However, a number of inconsistences and generalizations were identified in this Case Report, which also lacked some critical context. Importantly, such inconsistencies and generalizations can be observed throughout kratom-specific case reports. We feel this is now an important opportunity to highlight these issues that are present in the Broyan and colleagues Case report but emphasize that they are not unique to it. We do this with the hope that by acknowledging these issues it can help inform editors, clinicians, and researchers who may not be familiar with kratom and, as a result of this unfamiliarity, may inadvertently present findings in a manner that could confuse readers and even misinform clinical researchers and practitioners.

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