Opioid-like dependence due to chronic kratom use can be successfully treated with buprenorphine, according to a recent case report published in the Journal of Addiction Medicine.

Kratom, an herbal supplement that shares structural similarities with opioid analgesics, has recently grown in popularity as an unapproved opioid replacement therapy. The drug is easily obtained via the Internet (as it does not require a prescription), but oftentimes contains higher than typical doses and may be mixed with adulterants, increasing the risk of toxicity.

In their article, the authors report on two patients who used kratom to self-treat their chronic pain after they could no longer receive opioid analgesics from healthcare providers. Both patients presented to the clinic with evidence of kratom dependence and withdrawal and underwent home initiation of sublingual buprenorphine-naloxone therapy. In each case, transitioning to buprenorphine-naloxone maintenance led to control of both their chronic pain and opioid withdrawal symptoms.

“Although some debate whether kratom is a true opioid or not, this case series shows that opioid agonist treatment with buprenorphine-naloxone is effective for some patients with kratom dependence and demonstrates 2 safe home initiations of buprenorphine,” concluded the authors.

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