Botanical agent called Kratom (mitragyna speciosa) being used to treat opiate withdrawal.

[Msmith1986na]

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Anyone heard of pts using a substance called Kratom? It's a plant that is indigenous to Thailand (where it is illegal). The leaves are dried and crushed into a powder. Its ingested orally and is being used to relieve symptoms of opiate withdrawal, and in some cases to manage pain. I've read some of the pharmacologic info and it's main activity on μ receptors. Most of the psych docs I've asked have never heard of it. Anyone?

 

[WisNeuro]

Heard of it, haven't had a pt report having used it yet, though.

 

[affectiveH3art]

I have. I am seeing use at the UCC... It's on FDAs radar for abuse potential. It's illegal in some states. What's your question in regards to use? I'm wondering what setting you have seen it in.


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[Msmith1986na]

A pt at DMH told us he was using it. Concerned about his psych RXs it could have negative interactions with. Does it have any effect on seizure threshold?

 

[Ollie123]

As far as I know its a mu opioid agonist. So seizures aren't likely to be the primary concern. More likely respiratory depression and the like...basically the same profile you'd see with other opioids. Its all theory at this point though, its too new and abuse (at least in the US) is too rare right now for it to have been thoroughly studied. Don't think much is known beyond it impacting the opioid system somehow.

Haven't had a patient report use yet.

 

[WisNeuro]

Curious, so started lit searching. No great human studies, looks like they've tested the hell out of rats and guinea pigs, though. Some case studies of seizures and coma.

For my practice, something I would advise against. Despite the lack of human trials, as an opioid, I would imagine it wouldn't be helping cognition much at all. Something all of my patients are worried about. Well, most of my patients.

 

[PsychBoxe]

We had a few patients using this drug. The staff were new to this drug and we are still doing our research. A patient described it having the effects of both an opiate and stimulant.

 

[DrMikeP]

It has become a problem in Florida as abusers have been using it in higher and higher doses.

www.erowid.org discusses it.