As clinicians and patients scramble for opioid analgesic alternatives and ways to blunt opioid withdrawal, kratom (also known as mitragynine) use among desperate patients has surged. What should practitioners know?
- Kratom is not part of the usual standard test for urine screens
- At low doses, kratom blocks reuptake of norepinephrine, serotonin, and dopamine, like combinations of contemporary antidepressants do
- It inhibits or induces cytochrome enzymes so there’s a large chance of drug interactions
- As you raise the dose of kratom, it has opioid agonist properties; it’s actually a partial opioid agonist
- It’s not technically an opiate (because by definition, an opiate is a drug that’s derived from a poppy plant) but it does have opioid pharmacology and it does affect the opiate receptors, so it’s basically a naturally occurring nonopium derived opioid narcotic
- Some states have outlawed it; some countries have outlawed it
- In some states you can find it in gas stations, right next to the CBD lollipops