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Suboxone Treatment for Kratom Dependence: Is It Safe and Should You Do It?

By Karen Vieira, PhD
Nov 29, 2021

Kratom is a substance that people may use to feel more alert and to fight pain. However, some people who use this drug experience kratom withdrawal symptoms or kratom dependence. 

Suboxone is a drug that is used to treat opioid use disorder (OUD), which occurs when a person misuses opioids. The medication blocks the effects that opioids have within the brain.

Since kratom works in a similar way as opioid drugs, some people try to use Suboxone to help treat kratom dependence. However, there is limited evidence that this treatment works.

Kratom vs. Suboxone

Kratom, or Mitragyna speciosa, is a tree found in Southeast Asia. Historically, people brewed kratom leaves into a tea, or chewed the leaves. Currently, kratom may come in the form of a powder, tablet, capsule, or extract.[1]

Within the brain, kratom acts like an opioid drug

Mitragynine and 7-hydroxymitragynine, two chemicals found in kratom leaves, attach to opioid receptors, affecting the way the brain perceives pain, pleasure, and tiredness.[1] 

Kratom is legal in the US and Canada, although some states have banned the drug. 

The Food and Drug Administration (FDA) has issued a warning encouraging people not to ingest it. The warning states that:[2]

  • The FDA has not approved kratom for any medical purposes.
  • Kratom may lead to abuse or dependence.
  • There are safety concerns surrounding the substance.

On the other hand, Suboxone is a medication that is approved by the FDA for the treatment of OUD. It is used by people who are undergoing Medication for Addiction Treatment (MAT). 

Suboxone comes as a film or tablet that is placed under the tongue. It contains two different medications: buprenorphine and naloxone.[3] These medications interact with opioid receptors in the brain, blocking opioid drugs from activating the receptors. 

The drug doesn’t lead to an opioid high, but it does help reduce opioid cravings. Suboxone can also lessen symptoms of opioid withdrawal such as muscle pain, diarrhea, and nausea.[3]

When prescribed by a healthcare provider, Suboxone is legal and safe to consume. 

People should follow their doctor’s instructions when using Suboxone, and should not stop taking the medication without first discussing it with their doctor.

Kratom Side Effects

Low doses of kratom can make people feel more energetic, talkative, and less tired. However, higher doses can increase fatigue.[4]

Some people try to use kratom as a way to help control opioid dependence. 

They believe that kratom helps reduce cravings or manage opioid withdrawal symptoms. However, there is currently no data that suggests kratom is effective when used in this way.[5]

Kratom use may lead to several unpleasant side effects which include:[5]

  • Nausea or vomiting
  • Loss of appetite
  • Constipation
  • Itchiness
  • Sweating or chills
  • Dry mouth
  • Needing to urinate more than usual
  • Difficulty breathing
  • Depression
  • Hallucinations
  • Seizures

Because kratom products are not regulated, there is no guarantee that they are safe. 

The FDA has reported finding potentially dangerous substances, including heavy metals and salmonella, in kratom products sold by a variety of different companies.[6,7] 

Heavy metal poisoning could lead to additional side effects, including high blood pressure, kidney damage, and increased cancer risk. 

A salmonella infection can cause fever, abdominal pain, and diarrhea.

In some cases, kratom can cause overdoses and the drug has been linked to multiple deaths in recent years. 

In one study, researchers from the U.S. Centers for Disease Control and Prevention (CDC) analyzed data from 11 states between July 2016 and December 2017. They found that kratom was involved in 91 overdose deaths.[8]

Most of the time, these deaths occurred when a person had ingested other substances in addition to kratom. Many people who overdosed had also used fentanyl or other opioids, heroin, benzodiazepines, or cocaine. 

Kratom-related deaths have also been reported in people who used other substances, such as caffeine, alcohol, and diphenhydramine (an allergy medication).[5]

Kratom Withdrawal Symptoms

People who take kratom may experience physical dependence.[5] 

Over time, their body becomes used to the drug and they may need more of it to feel an effect. When they stop using it, they experience symptoms of withdrawal.

Kratom withdrawal may lead to:[9]

  • Insomnia and tiredness
  • Muscle aches and pains
  • Twitchy or shaky movements
  • Dilated pupils
  • Nausea
  • Diarrhea
  • Sweating or chills
  • Runny nose
  • Panic
  • Emotional changes, including feeling more restless, irritable, or aggressive than usual

These kratom withdrawal symptoms typically disappear within four days.

Can You Treat Kratom Dependence With Suboxone?

Currently, a very small amount of data shows that Suboxone may be a possible treatment for kratom dependence. 

Researchers have not yet performed many studies on kratom, so there are no officially approved treatments for people who misuse this substance.[5] 

However, a few doctors have published case reports in which they described successfully using Suboxone to treat a patient with kratom dependence. A recent scientific paper found a total of eight people who had undergone this treatment.[10] 

So far, there are no clinical trials that have analyzed Suboxone treatments in people undergoing kratom withdrawal. Because of this, there are no guidelines that describe how to use this treatment safely or effectively. 

People who are interested in learning more about kratom dependence treatments should talk to a healthcare professional.

What Happens If You Combine Kratom and Suboxone?

The effects of combining kratom and Suboxone are not well understood. 

Although there have been a couple of cases in which a person with kratom dependence was treated with Suboxone, there is not enough information to know how safe or effective the drug combination will be. 

It is important to note that combining kratom with other drugs can have harmful or even fatal health effects.[5] 

Avoid taking multiple substances, unless you are directed to do so by a health care provider. 

Is It Safe to Use Kratom for Suboxone Withdrawal?

No, it is not safe to use kratom for Suboxone withdrawal. Kratom is an addictive substance and should not be used to treat withdrawal from other drugs. 

Suboxone withdrawal can be avoided by slowly tapering off the medication. 

If a person suddenly stops taking Suboxone, they may experience withdrawal symptoms like hot flashes, chills, runny nose, muscle pain, vomiting, and diarrhea. 

Talk to your health care provider to learn how to safely taper off Suboxone.

Learn More About OUD Treatment Options from Bicycle Health

Bicycle Health uses Suboxone as a primary medication for dealing with opioid dependence. To learn more about the benefits and the effects of Suboxone, schedule a time to speak with one of our MAT professionals, or call us today at (844) 943-2514.

Image used under the Creative Commons Attribution-Share Alike 3.0 Unported license.

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Citations

1. Kratom. National Center for Complementary and Integrative Health. Updated November 2018. Accessed November 24, 2021. https://www.nccih.nih.gov/health/kratom 

2. FDA and Kratom. U.S. Food and Drug Administration. September 11, 2019. Accessed November 24, 2021. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom 

3. Buprenorphine. Substance Abuse and Mental Health Services Administration. Updated May 14, 2021. Accessed November 24, 2021. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine 

4. Kratom: Drug Fact Sheet. Department of Justice/Drug Enforcement Administration. April 2020. Accessed November 24, 2021. https://www.dea.gov/sites/default/files/2020-06/Kratom-2020_0.pdf 

5. Kratom DrugFacts. National Institute on Drug Abuse. April 2019. Accessed November 24, 2021. https://www.drugabuse.gov/publications/drugfacts/kratom 

6. Laboratory Analysis of Kratom Products for Heavy Metals. U.S. Food and Drug Administration. April 3, 2019. Accessed November 24, 2021. https://www.fda.gov/news-events/public-health-focus/laboratory-analysis-kratom-products-heavy-metals 

7. Statement from FDA Commissioner Scott Gottlieb, M.D. and FDA Deputy Commissioner for Foods and Veterinary Medicine Stephen Ostroff, M.D., on the Ongoing Risk of Salmonella in Kratom Products. U.S. Food and Drug Administration. July 2, 2018. Accessed November 24, 2021. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-and-fda-deputy-commissioner-foods-and-veterinary 

8. Olsen EO, O’Donnell J, Mattson CL, et al. Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected — 27 States, July 2016-December 2017. Morbidity and Mortality Weekly Report. 2019;68(14):326-327.

9. Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T. Kratom Withdrawal: A Systematic Review with Case Series. J Psychoactive Drugs. 2019;51(1):12-18. doi:10.1080/02791072.2018.1562133

10. Weiss ST, Douglas HE. Treatment of Kratom Withdrawal and Dependence With Buprenorphine/Naloxone: A Case Series and Systematic Literature Review. J Addict Med. 2021;15(2):167-172. doi:10.1097/ADM.0000000000000721

11. Buprenorphine Sublingual and Buccal (Opioid Dependence). MedlinePlus. Updated December 15, 2020. Accessed November 24, 2021. https://medlineplus.gov/druginfo/meds/a605002.html

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