Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component in treatment. To date, there are three medications that are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. All brand name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolv.
There are other non-FDA-approved substances that individuals use to self-treat OUD. These substances are not evidence-based, nor are they prescribed by physicians. These alternative self-treatment substances are often herbal remedies. This article discusses the herbal supplement kratom and its uses in the context of OUD.
Kratom extract is derived from the leaves of a tropical tree (Mitragyna speciosa) native to Southeast Asia. The kratom tree (Mitragyna speciosa) belongs to the coffee tree family. Kratom is also known by the following names: Biak, Ketum, Kakuam, Ithang, and Thom. Kratom has been used as an herbal remedy for centuries. Historically, kratom has been used to treat an array of health conditions. It has been used to relieve pain, decrease fatigue, increase energy and focus, treat depression and anxiety, and alleviate the symptoms of opioid withdrawal.
Kratom comes in various forms, including chopped or whole leaves, powder extracts, liquid extracts, pills, or capsules. Kratom leaves can be chewed. Additional routes of administration include smoking or brewing dried kratom leaves.
There are two active ingredients in Kratom: mitragynine and 7-α-hydroxymitragynine. Both of these compounds have psychotropic effects on the brain. Depending on the dosage, kratom can either produce opioid-like effects or stimulant-like effects. Taken in large amounts, the opioid properties of kratom can produce feelings of sedation, pleasure, and decreased pain. In small amounts, the mitragynine in kratom produces stimulant-like effects, including feelings of boosted energy, increased sociability, and heightened focus and alertness.
Kratom has been used to self-treat the symptoms of opioid withdrawal and act as an opioid substitute. While kratom is not FDA-approved in the United States, it is not illegal to purchase and consume kratom. It is critical to note that there is no scientific evidence to suggest that kratom is safe or effective in mitigating opioid withdrawal symptoms. Moreover, this lack of research into the safety profile of kratom has led the FDA to issue a warning discouraging the public from consuming kratom.
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.