Self‐Treatment of Opioid Withdrawal with a Dietary Supplement, Kratom

Abstract

We examined the use of Kratom (Mitragyna sp.), a dietary supplement with mu-opioid agonist activity, by members of a cybercommunity who self-treat chronic pain with opioid analgesics from Internet pharmacies. Within one year, an increase in the number of mentions on Drugbuyers.com, a Web site that facilitates the online purchase of opioid analgesics, suggested that members began managing opioid withdrawal with Kratom. This study demonstrates the rapidity with which information on psychoactive substances disseminates through online communities and suggests that online surveillance may be important to the generation of effective opioid analgesic abuse prevention strategies.

Self‐treatment of opioid withdrawal using kratom (Mitragynia speciosa korth)

“…Opioid analgesics remain highly effective modalities for the treatment of chronic pain, but their long-term administration is associated with the development of opioid misuse, abuse, dependence and addiction, the incidence of which is increasing [4]. Among individuals with chronic pain who are maintained on opioid analgesic agents, kratom is gaining awareness as a `natural' alternative to physician-supervised opioid replacement therapy [1].…”

“…Initiation of kratom use may reflect increasing interest in alternative therapies for chronic medical problems [9,10]. Alternatively, some patients with chronic pain may perceive that formal drug treatment is reserved for users of illegal substances [1]. Finally, patients' satisfaction with existing systems that treat chronic pain or problematic opioid use -which frequently underprescribe analgesics, require treatment contracts, demand ongoing drug testing or stigmatize those who seek care-may be so poor that some patients shun physician contact [1,11].…”

“…Alternatively, some patients with chronic pain may perceive that formal drug treatment is reserved for users of illegal substances [1]. Finally, patients' satisfaction with existing systems that treat chronic pain or problematic opioid use -which frequently underprescribe analgesics, require treatment contracts, demand ongoing drug testing or stigmatize those who seek care-may be so poor that some patients shun physician contact [1,11]. In this last population, whether self-treatment with kratom can avert problematic opioid analgesic use is uncertain.…”

“…Kratom (Mitragynia speciosa korth) is a medicinal herb indigenous to Southeast Asia whose components mitragynine and 7-hydroxymitragynine agonize the mu-opioid receptor with high affinity [1][2][3]. Recent findings suggest that kratom is purchased from internet sources by some of the 40 million Americans with chronic pain to self-manage opioid withdrawal [1].…”

“…Recent findings suggest that kratom is purchased from internet sources by some of the 40 million Americans with chronic pain to self-manage opioid withdrawal [1]. Unfortunately, the reasons underlying this practice, its efficacy or adverse effects are poorly understood.…”