Toxicity of agents used for opioid withdrawal: a case-based approach

Watson, C. James; Whitledge, James D.; Barbuto, Alexander F.; Boyle, Katherine L.; Ganetsky, Michael

doi:10.1097/aia.0000000000000265

Cited by 2 publications

(2 citation statements)

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“…Clinical reports detailed patients who presented with kratom-associated, adverse cardiovascular effects, such as cardiac arrest, cardiac palpitations, elevated blood pressure, prolonged QT interval, or tachycardia. 25 - 35 Abdullah et al 25 described a patient who experienced cardiac arrest and had a history of ingesting kratom tea several times per day to self-treat opioid dependency. Further, Nacca et al 28 presented a case of intracerebral hemorrhage when a kratom-based product was adulterated with phenylethylamine.…”

Section: Reviewmentioning

confidence: 99%

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Health Effects Associated With Kratom (Mitragyna speciosa) and Polysubstance Use: A Narrative Review

et al. 2022

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Background: Kratom ( Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices. Methods: The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described. Results: Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate’s risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions. Conclusions: Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.

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Section: Reviewmentioning

confidence: 99%

“… 39 Vomiting and/or nausea associated with kratom use or withdrawal were also documented in clinical reports. 26 , 27 , 30 , 31 , 33 , 40 - 42 Some patients with a history of kratom use were observed to have symptoms of liver 31 , 34 , 42 - 48 or kidney 47 , 49 injury.…”

Section: Reviewmentioning

confidence: 99%