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Settle JR, Smith A, Rausch P. A social media analysis of kratom use to discontinue stimulants. J Addict Dis 2023:1-7. [PMID: 38105430 DOI: 10.1080/10550887.2023.2292304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND While FDA-approved treatments exist for opioid use disorder, none are available for stimulant use disorder. Kratom (Mitragyna speciosa), an unregulated plant-derived substance with known opioid- and stimulant-like effects, has been used to self-treat opioid use disorder; however, its use in relation to stimulant use disorder has not been described. OBJECTIVE To understand whether and how individuals use kratom to self-treat stimulant use disorder. METHODS Using a commercially available social listening platform, 3,820 publicly available social media posts published between January 1, 2020, and June 21, 2021, were reviewed for relevance to kratom and stimulant discontinuation. Manual qualitative thematic analysis was conducted on relevant data. RESULTS Among the 398 relevant posts that discussed using kratom to discontinue stimulants, motivations and methods varied considerably. Posts predominantly identified benefits but also negative outcomes of kratom use. Some justified it as necessary despite consequences, while others reported a desire to quit. CONCLUSIONS Although there is some awareness that kratom is used to self-treat opioid use disorder, its use to treat stimulant use disorder is more novel. In the absence of approved treatments, kratom was viewed as a natural and safe way to quit stimulants. Despite some reported success, this study shows self-treatment may pose significant risks, including kratom addiction and physical dependence. Healthcare practitioners, researchers, and public health professionals may benefit from understanding motivations for kratom use, associated benefits and risks, and the importance of discussing kratom use with patients/clients who have stimulant use disorder.
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Affiliation(s)
- Jill R Settle
- U.S. Food & Drug Administration Center for Drug Evaluation and Research Office of Communications, Silver Spring, MD, USA
| | - Alexandria Smith
- U.S. Food & Drug Administration Center for Drug Evaluation and Research Office of Communications, Silver Spring, MD, USA
| | - Paula Rausch
- U.S. Food & Drug Administration Center for Drug Evaluation and Research Office of Communications, Silver Spring, MD, USA
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Bachu AK, Singal P, Griffin B, Harbaugh L, Prasad S, Jain L, Mohiuddin S, Papudesi BN, Nagi T, Youssef NA, Chopra A, Ahmed S. Kratom use and mental health: A systematic literature review and case example. J Addict Dis 2023:1-12. [PMID: 37942896 DOI: 10.1080/10550887.2023.2273192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE This review aims to synthesize and critically evaluate the existing literature on kratom use and its possible association with induction of psychotic and manic symptoms, in order to identify potential areas for future research that would improve our understanding of the risks of kratom consumption. METHODS An electronic search was performed using five major databases: including PubMed, Scopus, Google Scholar, Web of Science, and PsycINFO. keywords such as kratom, Mitragyna speciosa, mania, psychosis, bipolar disorder, schizophrenia, schizoaffective, case report, and case series. The retrieved articles on initial search were screened based on predefined inclusion and exclusion criteria for this study, and then data synthesis was performed to analyze relevant information from the included studies. RESULTS Six prior papers were found using (1 case series and 5 case reports). These included 10 cases, involving kratom use association with mania and psychosis. The ages of patients ranged from 28 to 55 years mean age was 38, and (SD 13.74), the majority were males (8 out of 11). Patients had durations of kratom use ranging from 2 wk to 15 years. Significant association was found between kratom use and the worsening of psychotic and manic symptoms in individuals with psychiatric conditions. CONCLUSIONS Our research highlights the possibility of worsening preexisting psychiatric conditions in the context of kratom use. This study emphasizes the need for clinical evaluation of patients for kratom use. Additional research is required to gain a deeper understanding of the potential mental health implications of kratom use, especially among vulnerable populations.
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Affiliation(s)
- Anil K Bachu
- Baptist Health - UAMS Psychiatry Residency Program, North Little Rock, AR, USA
- AHN Psychiatry and Behavioral Health Institute, Pittsburgh, PA, USA
| | - Prakamya Singal
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Brittany Griffin
- Baptist Health - UAMS Psychiatry Residency Program, North Little Rock, AR, USA
| | - Lauren Harbaugh
- Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA
| | - Sakshi Prasad
- National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Lakshit Jain
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
| | - Syed Mohiuddin
- Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA
| | | | - Tarika Nagi
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, NY, USA
| | - Nagy A Youssef
- Department of Psychiatry & Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Amit Chopra
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Saeed Ahmed
- Rutland Regional Medical Center, Rutland, VT, USA
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Arhin M, Mobley J, Hamad H, Remick P. Successful Management of Kratom Use Disorder With Buprenorphine and Naloxone. Cureus 2023; 15:e41146. [PMID: 37519540 PMCID: PMC10386870 DOI: 10.7759/cureus.41146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Kratom is an unregulated herbal supplement that is growing in popularity in the United States. Its primary active ingredients, mitragynine, and 7-hydroxymitragynine, are partial agonists that act on mu- and delta-opioid receptors in the central nervous system, producing analgesia and a sense of euphoria. Kratom use can lead to addiction and adverse side effects, such as seizures, hallucinations, and coma. This case report presents a male in his 40s with a history of kratom use, who presented to the clinic seeking help for his addiction. The patient had been using kratom for several years to self-medicate for his anxiety and depression and gradually developed a kratom addiction. The patient was successfully treated with buprenorphine/naloxone, which helped alleviate his withdrawal symptoms and allowed him to abstain from kratom. This case underscores the growing issue of kratom addiction in the United States and the critical need for physician awareness in treating withdrawal.
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Affiliation(s)
- Martin Arhin
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Julian Mobley
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Hamad Hamad
- Family Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Paul Remick
- Family Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
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Mukhopadhyay S, Gupta S, Wilkerson JL, Sharma A, McMahon LR, McCurdy CR. Receptor Selectivity and Therapeutic Potential of Kratom in Substance Use Disorders. CURRENT ADDICTION REPORTS 2023. [DOI: 10.1007/s40429-023-00472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Iqbal M, Yan Y, Zhao N, Mubarik S, Shrestha S, Imran MH, Jamshaid S, Abbasi NUH. A Mediation Moderation Model between Self-Evaluative Emotions and Relapse Rate among Polysubstance Users: A Comparative Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3164. [PMID: 36833854 PMCID: PMC9959136 DOI: 10.3390/ijerph20043164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/21/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
A substantial portion of drug abuse research has concentrated on people with a single-substance-use disorder (SSUD), but many people abuse more than one drug. Studies have yet to examine how those with polysubstance-use disorder (PSUD) differ from those with an SSUD on the risk of relapse, self-evaluative emotions (e.g., shame and guilt), and personality factors (e.g., self-efficacy). Eleven rehab facilities in Lahore city, Pakistan were randomly chosen to provide a sample of 402 males with PSUD. For comparison, 410 age-matched males with SSUD were enlisted using a demographic form with eight questions, the State Shame and Guilt Scale, and the General Self-Efficacy Scale. Mediated moderation analysis was performed using Hayes' process macro. The results demonstrate that shame-proneness is positively associated with relapse rate. Guilt-proneness mediates the relationship between shame-proneness and relapse rate. Self-efficacy buffers the influence of shame-proneness on relapse rate. Although the mediation and moderation effects were found in both study groups, these effects were significantly stronger among people with PSUD than those with SSUD. To be more specific, people with PSUD reported a higher overall score on shame, guilt, and relapse rate. Additionally, people with SSUD indicated a higher score on self-efficacy than those with PSUD. The findings of this study suggest that drug rehab facilities should implement a variety of strategies to raise drug users' levels of self-efficacy, which will help to reduce their risk of relapse.
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Affiliation(s)
- Mujahid Iqbal
- Department of Psychology, School of Philosophy, Wuhan University, 185 Donghu Road, Wuhan 430072, China
| | - Yu Yan
- Department of Psychology, School of Philosophy, Wuhan University, 185 Donghu Road, Wuhan 430072, China
| | - Na Zhao
- State Key Laboratory of Resources and Environmental Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan 430072, China
| | - Silu Shrestha
- Department of Psychology, School of Philosophy, Wuhan University, 185 Donghu Road, Wuhan 430072, China
| | - Muzzamel Hussain Imran
- Department of Religious Studies, School of Philosophy, Wuhan University, 185 Donghu Road, Wuhan 430072, China
| | - Samrah Jamshaid
- School of Psychology, Northeast Normal University, Changchun 130024, China
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Falise AM, Hoeflich CC, Nutley SK, Lopez-Quintero C, Striley CW. Polysubstance use profiles among US adults using Kratom (Mitragyna speciosa): A latent class analysis using The National Survey on Drug Use and Health (NSDUH). Am J Addict 2023; 32:76-80. [PMID: 36222599 PMCID: PMC9790024 DOI: 10.1111/ajad.13345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/26/2022] [Accepted: 09/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Kratom (Mitragyna speciosa) use is associated with polysubstance use (PSU) and use disorders. However, additional research on PSU heterogeneity in populations using this novel psychoactive substance is necessary. The authors investigated patterns of past 12-month PSU among US adults reporting past 12-month use of kratom and at least one additional substance. METHODS Latent class models were fit using 2019 National Survey on Drug Use and Health (NSDUH) data which was collected from 412 US adults reporting past 12-month use of kratom and at least one of 11 additional substances. RESULTS Three distinct profiles were identified: "marijuana/alcohol/tobacco" (63.3%), "marijuana/alcohol/tobacco + psychedelics" (19.3%), and "marijuana/alcohol/tobacco + psychedelics/heroin/prescriptions" (17.4%). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This is the first epidemiological study in which a latent class analysis was used to identify unique PSU profiles among US adults using kratom and other substances. Understanding the profiles of people using kratom in relation to the use of other drugs might help guide screening interventions, treatment needs, and policy.
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Affiliation(s)
- Alyssa M. Falise
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Carolin C. Hoeflich
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sara K. Nutley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Catalina Lopez-Quintero
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Catherine W. Striley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
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