Long-Term Buprenorphine Treatment for Kratom Use Disorder
Abstract
Introduction
The US opioid epidemic remains a major contributor of overdose deaths. More recently, there has been an increased use of alternative substances which can also produce central nervous system effects. Kratom (Mitragyna speciosa), a herbal plant capable of causing opioid-like effects due to its chemical composition, has been used to minimize opioid withdrawal symptoms, reduce pain, and produce a euphoric state. There is little literature regarding treatment of kratom use disorder with buprenorphine, thus we wanted to further explore treatment efficacy through a case series.
Methods
Patients were included if they identified kratom as their primary substance of use and were subsequently treated with buprenorphine. Target variables that were analyzed for each patient included: length and dose of past kratom use, duration of ongoing treatment, initial stabilizing buprenorphine dose, current daily buprenorphine dose, current outpatient appointment frequency, urine definitive drug test results, and current treatment status.
Results
This case series presents 28 patients who have identified kratom as their primary substance of use. The patients included in this study used kratom anywhere from 1 month to 25 years before seeking treatment. Ongoing treatment duration range from 4.5 months to 22 months. Out of the 28 patients treated for kratom use disorder, 20 are still receiving ongoing outpatient opioid agonist therapy.
Conclusion
To our knowledge, this is the largest case series to date to explore long-term buprenorphine treatment for kratom use disorder. Our findings suggest that buprenorphine treatment can be used as an effective treatment option for kratom use disorder.
About the Presenters
Jessica Brar
Jessica Brar is currently a second-year medical student at WSU’s Elson S. Floyd College of Medicine. Born and raised in Pullman, WA, Jessica has been a Coug her whole life! She graduated from WSU-Pullman in 2018 with a Bachelor of Science in Biology. Jessica’s long-term career goals include practicing rural medicine in Central or Eastern Washington. She is passionate about serving in underserved areas, as well as addressing the ongoing opioid epidemic. She hopes through her research, volunteering, and engagement with local organizations she will become a better advocate for those with substance use disorders.