Skip Navigation Links.
Collapse <span class="m110 colortj mt20 fontw700">Volume 12 (2024)</span>Volume 12 (2024)
Collapse <span class="m110 colortj mt20 fontw700">Volume 11 (2023)</span>Volume 11 (2023)
Collapse <span class="m110 colortj mt20 fontw700">Volume 10 (2022)</span>Volume 10 (2022)
Collapse <span class="m110 colortj mt20 fontw700">Volume 9 (2021)</span>Volume 9 (2021)
Collapse <span class="m110 colortj mt20 fontw700">Volume 8 (2020)</span>Volume 8 (2020)
Collapse <span class="m110 colortj mt20 fontw700">Volume 7 (2019)</span>Volume 7 (2019)
Collapse <span class="m110 colortj mt20 fontw700">Volume 6 (2018)</span>Volume 6 (2018)
Collapse <span class="m110 colortj mt20 fontw700">Volume 5 (2017)</span>Volume 5 (2017)
Collapse <span class="m110 colortj mt20 fontw700">Volume 4 (2016)</span>Volume 4 (2016)
Collapse <span class="m110 colortj mt20 fontw700">Volume 3 (2015)</span>Volume 3 (2015)
Collapse <span class="m110 colortj mt20 fontw700">Volume 2 (2014)</span>Volume 2 (2014)
Collapse <span class="m110 colortj mt20 fontw700">Volume 1 (2013)</span>Volume 1 (2013)
American Journal of Medical Case Reports. 2022, 10(9), 214-217
DOI: 10.12691/AJMCR-10-9-1
Original Research

Kratom Associated Withdrawal Symptoms and Naltrexone: A Case Report

Reece Vesperman1, , Shalinee Wayland1, Shemar Crawford1 and Corinne Jackson2

1Pensacola Regional Campus, Florida State University College of Medicine, Pensacola, United States of America

2Department of Emergency Medicine, Baptist Hospital, Pensacola, United States of America

Pub. Date: September 05, 2022
Full Text PDF

Cite this paper

Reece Vesperman, Shalinee Wayland, Shemar Crawford and Corinne Jackson. Kratom Associated Withdrawal Symptoms and Naltrexone: A Case Report. American Journal of Medical Case Reports. 2022; 10(9):214-217. doi: 10.12691/AJMCR-10-9-1

Abstract

Kratom (Mitragyna speciosa Korth), an indigenous herb of Southeast Asia, is popularly used to treat withdrawal symptoms associated with opiate addiction and a myriad of ailments including chronic pain, anxiety and hypertension. Its use has significantly increased in western countries because of its widespread advertisement on the internet as a safe, nonaddictive alternative treatment of pain and opioid dependent disorders. This report describes the first emergency case of toxic encephalopathy, rhabdomyolysis, and liver injury in relation to kratom withdrawal syndrome induced by naltrexone in a 49-year old male. The symptoms were resolved with a regimen of dexmedetomidine, lorazepam, oral lactulose, and a bicarbonate drip. Outpatient treatment with lorazepam and tramadol was recommended for further withdrawal symptoms.

Keywords

kratom, withdrawal, opioid, toxicity, naltrexone

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend. 2014; 139: 132-137.
 
[2]  Prozialeck WC, Jivan JK, Andurkar SV. Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. J Am Osteopath Assoc. 2012; 112(12): 792-799.
 
[3]  Alsarraf E, Myers J, Culbreth S, Fanikos J. Kratom from Head to Toe—Case Reviews of Adverse Events and Toxicities. Current Emergency and Hospital Medicine Reports. 2019; 7(4): 141-168.
 
[4]  White CM. Pharmacologic and clinical assessment of kratom. Am J Health Syst Pharm. 2018; 75(5): 261-267.
 
[5]  Babu KM, McCurdy CR, Boyer EW. Opioid receptors and legal highs: salvia divinorum and kratom. Clin Toxicol (Phila). 2008; 46(2): 146-152.
 
[6]  Olsen EO, O’Donnell J, Mattson CL, Schier JG, Wilson N. Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected — 27 States, July 2016–December 2017. MMWR Morb Mortal Wkly Rep 2019; 68: 326-327.
 
[7]  Kuehn B. Kratom-Related Deaths. JAMA. 2019; 321(20): 1966.
 
[8]  Stanciu CN, Gnanasegaram SA, Ahmed S, et al. Kratom withdrawal: a systematic review with case series. J Psychoactive Drugs. 2019; 51(1): 12-18.
 
[9]  Galbis-Reig D. A case report of kratom addiction and withdrawal. WMJ. 2016; 115(1): 49-52, quiz 53.
 
[10]  Khazaeli A, Jerry JM, Vazirian M. Treatment of kratom withdrawal and addiction with buprenorphine. J Addict Med. 2018; 12(6): 493-495.
 
[11]  Buresh M. Treatment of kratom dependence with buprenorphine-naloxone maintenance. J Addict Med. 2018; 12(6): 481-483.
 
[12]  Galbis-Reig D. A Case Report of Kratom Addiction and Withdrawal. WMJ. 2016; 115(1): 49-53.
 
[13]  Boyer EW, Babu KM, Adkins JE, Mccurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction. 2008; 103(6): 1048-1050.
 
[14]  Lydecker AG, Zuckerman MD, Hack JB, et al. Intravenous Kratom Use in a Patient with Opioid Dependence. J Toxicol Pharmacol 2017; 1: 003.
 
[15]  Sangani V, Sunnoqrot N, Gargis K, Ranabhotu A, Mubasher A, Pokal M. Unusual Presentation of Kratom Overdose With Rhabdomyolysis, Transient Hearing Loss, and Heart Failure. J Investig Med High Impact Case Rep. 2021; 9: 23247096211005069.
 
[16]  Boyce SH. Effect of innappropriate naltrexone use in a heroin misuser. Emergency Medicine Journal. 2003; 20(4): 381-382.
 
[17]  Donroe JH, Fiellin DA. A Case of Kratom Use: Implications for Managing Addiction and Addressing Comorbidity in Overdose Survivors, and for the Education of Clinicians Who Are Not Addiction Specialists. J Addict Med. 2022; 16(2): 138-140.
 
[18]  Swogger MT, Smith KE, Garcia-Romeu A, et al. Understanding Kratom Use: A Guide for Healthcare Providers. Front Pharmacol. 2022; 13: 801855. Published 2022 Mar 2.
 
[19]  Aldyab M, Ells PF, Bui R, Chapman TD, Lee H. Kratom-Induced Cholestatic Liver Injury Mimicking Anti-Mitochondrial Antibody-Negative Primary Biliary Cholangitis: A Case Report and Review of Literature. Gastroenterology Res. 2019; 12(4): 211-215.
 
[20]  McIntyre IM, Trochta A, Stolberg S, Campman SC. Mitragynine 'Kratom' related fatality: a case report with postmortem concentrations. J Anal Toxicol. 2015; 39(2): 152-155.