There has been a lot of talk lately about using kratom much like an opioid-based drug – either for pain management or for reducing withdrawals from opioid drugs. Since there isn’t a lot of good information about kratom, or its uses, we wanted to research this even more.
What is Kratom?
Kratom – as it is commonly known – comes from mitragyna speciasa, and evergreen tree related to the coffee family. The plant is indigenous to Southeast Asia – specifically the nations of Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea.
Kratom for Opioid Withdrawals
Even though the FDA doesn’t see much potential for the use of kratom to relieve withdrawals from heroin and other opioids, there are many people that stand by their claims that kratom is a safe alternative to opioids.
In fact, the use of kratom as a substitute for opioids (simply “opium,” at the time) can be traced back to Malaysia in 1836. It was also used as an opium substitute in Thailand throughout the 1800s. So why is it not widely recognized as a substitute today, when so many are struggling with chronic pain and dependency to opioid prescription painkillers?
There are a lot of opinions as to why the FDA seemingly has a grudge against this plan, but the fact remains that there have been no clinical trials for kratom at all in the United States. Even though no clinical trials are on the records, there are many that have decided to try it for themselves. The results are that many who have tried using kratom as a substitute for opioids and heroin have found it to help them immensely.
Does Kratom Work When You Are On Suboxone?
Kratom users that utilize the plant for opioid withdrawals have clearly stated that it does help to relieve the symptoms of withdrawal from drugs like heroin, OxyContin, and other prescription opioids, but what about using it to get off of strong opioid replacement drugs like Suboxone or methadone?
A cursory web search on this subject only yielded warnings from the FDA about kratom use and its possible dangers, but some further digging led to more conversations from people who have used kratom and Suboxone. First, many wondered if kratom would even have any effect on a person using Suboxone due to the naloxone being an opioid antagonist – meaning negates the effects of opioids on the receptors.
The opioid antagonist concern was quickly dismissed because the naloxone in Suboxone is not activated when taken orally. The naloxone is added to buprenorphine in Suboxone as a safety measure to prevent misuse of the drug – primarily, crushing it up and shooting it intravenously. So, theoretically, kratom should work (or at least will have some effect) even if you have Suboxone in your system.
Buprenorphine MU Receptor Affinity and Kratom
The second concern that arose, was that buprenorphine – the active opioid in Suboxone – has an extremely high affinity for MU receptors in the brain. This means that that buprenorphine has a strong pull to the MU receptors, sticking to them tightly. Many felt that the affinity was so high, that the receptors would collect only the buprenorphine first, and not leave room for the kratom to attach to the receptors.
The high affinity of buprenorphine, it seems, is what led to so many mixed reviews and opinions as to whether kratom would have any effect on a person who was already on buprenorphine. In short, most “low grade” forms of kratom had virtually no effect, as the buprenorphine had the stronger of receptor affinity.
The kratom and Suboxone experiences related by individuals who used incredibly potent and high-grade strains of kratom, however, show that the kratom did have an effect. Without a clinical study, it would be difficult to give a definitive answer, but it seems that some strains of kratom have compounds with a high enough affinity to bind to receptors alongside buprenorphine.
Does Kratom Help with Suboxone Withdrawal?
From the opinion of those who have tried kratom when having Suboxone withdrawals, yes kratom does reduce symptoms of withdrawal from opioids, even Suboxone. However, kratom too can be addictive, and cause withdrawals as well. So, it would seem that kratom may stave off withdrawal symptoms in the short term, but you are still physically dependent on opioids. Even with kratom, you are still left with the same 2 options as with suboxone or methadone – use the drug for opioid replacement, or use it to taper down to eventually quit completely.
The Dangers of Taking Suboxone and Kratom at the Same Time
Now that we have figured out how Suboxone and kratom can both actively work on brain receptors, we need to go over the standard “be smart, be careful” verbiage. Drugs are bad… and very dangerous. Not recognizing the risks and dangers of using drugs is what led to addiction and dependency in the first place – so don’t mess around with chemicals and your brain lightly.
Second, the FDA has made their stance on kratom very clear. There not any current FDA-approved kratom-based treatments for opioid use disorders and dependency. If you are looking to get off opioids, use an addiction treatment program that utilizes MAT (Medications Assisted Treatment) with the goal of tapering you off the opioid replacement drugs as soon and as safely as possible.
Beware of opioid maintenance programs that only have the goal of giving you high doses of buprenorphine or methadone for long-term periods, with no intention of tapering doses or getting 100% clean in the end.
Have you had experiences with kratom? Do you have an opinion on the FDA’s stance toward kratom and kratom users? Share your opinions with others in the Fight Addiction Now community either on our forum, Facebook group, or the other platforms for our growing community.