The Rise in Kratom Addiction (an RN’s Perspective)
“Stan” and his buddies believed that kratom is harmless because it is sold over-the-counter at gas stations and head shops.
The Sanford Behavioral Health (Sanford) nursing team (of which I am a part) all had concerned looks on their faces. It was early Monday morning, and the unit was quiet. “Just make sure you don’t say the ‘q’ word,” admonished one of the therapists as he walked by the nurse’s station. Then, just as the charge nurse thought she could get away with grabbing a morning coffee, the quiet was shattered by an incoming call on the 24/7 EZ Admissions hotline. “It looks like that coffee will have to wait,” she announced as she reached for the phone.
The Rise in Kratom Addiction
Two years ago, Stan N.(a composite of multiple individuals) ruptured a disc in his back and became dependent on opiates prescribed to him after surgery. When his prescription ran out, he looked to his friends for help. One of his buddies took him to a local head shop and introduced him to kratom. His friend said it would be just as effective as pain medication, easy to obtain without a prescription, and “legal.” (Kratom is not federally regulated in the U.S.). Today, Stan is calling Sanford because he is in bad shape and needs help with what has become a kratom addiction. He’s been spending $2000 a month on kratom pills and gummies.
There has been a rise in calls like this over the past six months and we are prepared to receive Stan. When he arrives at Sanford for an assessment, Stan tries to get comfortable in his seat. He appears anxious and agitated, looking pale and sweating profusely. Stan says he hasn’t eaten in days. He wants to stop kratom, but the withdrawals are hitting him harder than any he’s ever experienced. We assure him that the detoxification process at Sanford will be safe and comfortable.
The author, Michelle Koets, RN, works with colleagues at the Sanford Detox Center.
What is Kratom?
The culprit is the leaf of a tropical evergreen tree native to Southeast Asia, known as Mitragyna speciosa, commonly referred to as kratom. Manufacturers grind the leaves and distribute the powder in capsules, pills, drinks, and edibles. You can even get them in the flavor of your choice – cherry, mint, or fruity chews. In the United States, kratom is an increasingly popular feel-good way to get relief from chronic pain or for its relaxing, euphoric effects. It is also used as a home remedy for opioid withdrawal. Kratom is sold as a dietary supplement in some states in the U.S. However, it is not approved by the Food and Drug Administration (FDA) for any medical use.
Kratom is not an opioid, but it contains alkaloids responsible for its opioid-like properties. The two components of kratom are mitragynine and 7-hydroxymitragynine. Kratom compounds bind to and partially activate opioid receptors in the brain, producing some of the effects that opioids do. The positive effects include pain relief, relaxation, and a sense of euphoria. But negative effects also exist, including appetite loss, nausea, constipation, and erectile dysfunction. Even more serious side effects can occur, including respiratory depression, seizures, psychosis, elevated blood pressure, and liver damage.
Kratom and Dopamine
Kratom, like its opioid cousins, increases the availability of the reward chemical dopamine in the brain. Dopamine is necessary for motivation, physical energy, and mental stamina. When the brain is flooded with chemicals that produce high levels of dopamine, the brain’s dopamine-making machinery shuts down (as the external substances are doing all the work). And when the body stops receiving those external, feel-good chemicals, it takes a while for the brain to get its dopamine-making machinery back in full operation. The process can take months, and in the meantime, the dopamine deficit sends the body into a tailspin.
The Sanford Behavioral Health Detox Center – Kratom Withdrawal
We call them “withdrawal symptoms” – a smorgasbord of indications that include insomnia, restlessness, profuse sweating, aches, muscle spasms, seizures, and even death. But the symptoms aren’t all physical. Our patients also experience psychological impacts that can last for months. Specifically, kratom withdrawal symptoms include muscle aches, joint pain, sweating, chills, nausea, vomiting, diarrhea, fatigue, and tremors. Kratom withdrawal can also cause anxiety, depression, irritability, insomnia, mood swings, and intense cravings.
The goal at the Sanford Detox Center is to get our patients’ body and brain chemistry back in balance and keep them from using any addictive substances that undermine that process. Overcoming challenges like cravings, depression, and dysphoria isn’t easy. That’s why places like Sanford Behavioral Health Detox Center are crucial. They create supportive environments, guide patients through recovery, and provide 24/7 nursing and continuous medical monitoring.
Stan’s Detox Regimen
Most patients who come to Sanford with a kratom addiction stay in detox between five and seven days. We prescribe Stan benzodiazepine, along with other medications to help control his symptoms and make him more comfortable. After a few days, we might prescribe a Suboxone regimen, with a scheduled taper or a maintenance dose, as appropriate for his individual needs. Stan knows he is in good hands at Sanford. Even though his week in detox is challenging, he starts to feel better and more confident that he can beat the addiction. After detox, he can decide in coordination with his support team whether he should continue with residential treatment or receive treatment using outpatient services. Virtual options are also available.
Stan and his buddies believed that kratom is harmless because it is sold at gas stations and head shops. Packaging and colorful labels conceal or downplay its addictive properties. We must, therefore, take every opportunity to educate ourselves and our loved ones about the dangers of substances like kratom. Over the past six months at Sanford Behavioral Health, we have observed a substantial increase in patients struggling with kratom addiction. Some start using kratom as a way of weaning off addictions to heroin, fentanyl, alcohol, and other addictive substances, only to find themselves cross-addicted and worse off than before.
If you or a loved one is struggling with addiction, eating disorders, co-occurring mental health conditions, or daily functioning, please don’t wait to change your life for the better– click the link below to speak with an admissions specialist today. With Sanford Behavioral Health’s 24/7 EZ Admissions, you talk to a real person and start treatment now.
