Several months ago a 26-year-old man named Jim from Northern Virginia came to the office for an Accelerated Opioid Detox. Two years ago he had a surgery, which involved treating his pain with oxycodone. Now he was using heroin.
Jim had a good life. He worked in HVAC and was a reliable employee. He loved working with his hands. He was just blowing all his money on heroin. Jim was using 2 grams of heroin daily so he was scheduled for a three day rapid detox.
Kratom Derails a Heroin Detox
The first day of a patient’s detox off heroin at Coleman Addiction Medicine is usually pretty comfortable. We provide patients with a very small dose of naltrexone with several other medications to minimize any symptoms they may experience. So it was unusual when Rene, Jim’s girlfriend and support person, called us saying that Jim was having strong symptoms of withdrawal.
“He’s having diarrhea and has vomited a couple times. He has really bad body aches and says he feels like he needs to beat on his legs to stop the pain.”
Those are the classic signs of acute opiate withdrawal. But why was Jim having such a violent reaction when most people generally sleep through their first day with Coleman Addiction Medicine’s detoxification protocol?
We asked Rene to bring Jim back to the office. We quickly learned that Jim had neglected to mention that —and we had neglected to ask if—he had been using kratom to help withdraw from opiates. He had purchased the kratom about a week prior to coming to our facility. He told us it really seemed to help his withdrawal symptoms all last week.
The Truth About Taking Kratom for Withdrawal Symptoms
There is a reason for that Jim felt like kratom was helping his withdrawal symptoms. Kratom has similar effects to opioids, according to the FDA, and carries similar risks of abuse, addiction and—in some cases—death. In fact, the FDA has issued a public health advisory related to mounting concerns regarding risks associated with the use of kratom.
“Kratom is a plant that grows naturally in Thailand, Malaysia, Indonesia and Papua New Guinea. It has gained popularity in the U.S., with some marketers touting it as a “safe” treatment with broad healing properties. Proponents argue that it’s a safe substance largely because it’s a plant-based product. The FDA knows people are using kratom to treat conditions like pain, anxiety and depression, which are serious medical conditions that require proper diagnosis and oversight from a licensed health care provider.”
-U.S. Food and Drug Administration
So because Jim had been using the kratom as well as heroin, we were basically detoxing him from two substances. Jim’s ultimate goal was to go on long acting naltrexone, which is an opiate blocker and does not cause any physical dependency. Providing Medically Assisted Treatment (MAT) with naltrexone has been our specialty at TCI for close to 20 years. However, all the opiates must be out of the system before a person starts on the naltrexone.
We were able to give Jim more comfort medications and we extended his detox for another day. He ultimately did very well, and we have learned to question people about whether they are using kratom.
More Questions About Using Kratom to Detox off Heroin?
It can be very confusing to know the ins and outs of various treatments and what substances should and shouldn’t be used to help a patient detox off opiates like Percocet®, Vicodin® or off of street drugs. If you have any questions or concerns about kratom or other opiates, please call us.
Joan R. Shepherd, FNP