- Addiction & recovery
Kratom and Suboxone – Treatment for Opioid Use Disorder
David Schwartz, MD
December 13, 2021
Opioid addiction is a long-standing health concern in the United States. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), of the 2.1 million Americans diagnosed with an opioid use disorder (OUD), only 20% received comprehensive addiction treatment. Although medications for opioid use disorder (MOUD), such as Suboxone, is an evidence-based solution, many are wary of using them, especially when the medication itself contains opioids.
Amidst all the speculations, a new herbal alternative known as kratom is growing in popularity as a treatment for managing opioid withdrawals. Although kratom has no FDA approval to treat any medical condition, it hasn’t stopped many from using it. So let’s find out how kratom, an unproven medication, compares to a proven medication such as Suboxone. And how they differ from one another.
What Is Kratom and How Does It Work?
For generations, people in Asian countries have used kratom for medicinal and ceremonial purposes. Kratom leaves are traditionally consumed raw or brewed into a tea to help relieve fatigue. But they are now available in various forms, including dried or crushed leaves, capsules, tablets, liquids, and resin to treat chronic pain, digestive ailments, and opioid withdrawals.
Kratom can generate stimulant-like effects in lower doses and sedative effects in higher doses. This reaction is caused by the two main chemicals found in kratom leaves: mitragynine and 7-α-hydroxymitra-gynine. Because these compounds interact with opioid receptors in the brain in the same way that opioid pain medications do, the FDA classifies kratom as an opioid.
There are currently insufficient clinical trials and studies to help understand the long-term health implications of kratom use. However, several states in the United States have prohibited kratom products due to their potential to cause serious side effects and dependence.
What Is Suboxone and How Does It Work?
Suboxone, a medication containing buprenorphine and naloxone in a 4:1 combination, is one of the most widely prescribed medications for treating OUD. Suboxone works by attaching to the same brain receptors as other opioids like heroin, morphine, and oxycodone. This function helps blunt intoxication, reduce cravings and the risk of relapse.
Buprenorphine, the primary active ingredient, is a partial, long-acting opioid that blocks opioid receptors and reduces cravings. The second component, naloxone, works to counteract the effects of other opioids and prevent misuse. Both ingredients work together to aid in the safe and effective management of opioid withdrawal syndrome.
Suboxone Side Effects
Side effects caused by Suboxone can range from mild to severe. Most of these side effects usually subside in a matter of days or weeks. However, if the side effects persist or worsen with time, consult your healthcare provider before stopping Suboxone treatment.
Common side effects of Suboxone include:
- Stomach pain
- Mouth pain
- Mouth redness
- Mouth numbness
- Inability to concentrate or focus
Severe side effects of Suboxone include:
- Allergic reaction
- Increased tolerance
- Breathing problems
- Hormone issues (adrenal insufficiency)
- Liver damage
- Severe withdrawal symptoms
Prolonged use of Suboxone can lead to tolerance and dependence. For this reason, individuals on Suboxone treatment are gradually weaned off the medication towards the end of their treatment to mitigate the risk of withdrawals.
Kratom Side Effects
Kratom use is accompanied by an array of side effects that range in severity. The side effects vary depending on the dose consumed, method of consumption, and the type of kratom strain used.
Common side effects of kratom use may include:
- Dry mouth
- Increased urination
- Loss of appetite
- Feelings of agitation, irritability, or uneasiness
- Abnormally fast heartbeat
- Muscle spasms
- Liver damage
Several cases of psychosis have also been reported as a result of long-term kratom use. Individuals are advised to contact their healthcare provider immediately if they experience negative side effects after using kratom.
Suboxone’s built-in “ceiling effect” makes it difficult to overdose on Suboxone alone. However, overdose is a possibility if the medication is administered incorrectly or combined with other substances that slow down breathing.
Symptoms of a Suboxone overdose may include:
- Abdominal pain
- Nausea and vomiting
- Loss of physical coordination
- Slowed heartbeat
- Depressed breathing
- Irritability, anxiety, and mood swings
Individuals who exhibit symptoms of an overdose after using Suboxone must seek medical attention immediately.
According to the Centers for Disease Control and Prevention (CDC), around 91 fatal overdoses were associated with kratom use between 2016 and 2017. However, most of these cases also involved other substances, including benzodiazepines, illicit opioids, and alcohol in conjunction with kratom.
Overdosing on kratom may not be as noticeable as overdosing on other substances. Because kratom works in the brain as both a stimulant and a sedative, it can create various overdose symptoms, many of which are difficult to detect.
Symptoms of a kratom overdose may include:
- Severe nausea
- Respiratory depression
- Aggressive or combative behavior
Seek immediate medical attention if you experience any of the following symptoms.
Kratom vs. Suboxone – The Benefits
There are many advantages to Suboxone maintenance treatment, and a significant reduction in opioid withdrawal symptoms is its primary advantage. One of the biggest hurdles of addiction is overcoming withdrawal symptoms. Suboxone helps reduce psychological cravings and helps individuals in recovery focus on other aspects of a treatment program without the hindrance of withdrawals.
Other advantages of Suboxone include:
- Lower risk of misuse – Suboxone is difficult to misuse when taken as directed. The naloxone in the medication reduces the risk of misuse and overdose.
- Accessibility – Rather than going in for treatment daily or residing in a residential facility, Suboxone doctors can prescribe the medication, which you can then fill at your local pharmacy.
- FDA approved – Suboxone is a controlled medication with a proven track record. There are no unknown risks because the medication has been evaluated, and there is no possibility of dilution or contamination during the manufacturing process. There are also clear guidelines available on dosing and safe use.
Kratom has also been associated with various health benefits such as:
- Chronic pain relief
- Mood enhancement
- Increased energy
Many people stand by their claims that kratom is a safe alternative to opioids. However, there is currently very little scientific evidence to prove the effectiveness of kratom as a medication for opioid addiction or any other health condition.
Kratom vs. Suboxone – The Risks
Although Suboxone is an effective treatment for opioid use disorder, it does possess a few drawbacks.
Suboxone has certain disadvantages such as:
- Suboxone may cause uncomfortable physical and psychological side effects.
- Potential for overdose when used in conjunction with other medications.
- Missing Suboxone doses can make the medication less effective.
- Suboxone may not be a viable medication for people with certain health conditions.
- Sudden discontinuation of Suboxone can cause withdrawal symptoms.
It’s important to keep in mind that, contrary to the common misconception, Suboxone isn’t used to “replace one addiction with another,” but rather to aid individuals in staying sober throughout the early stages of rehabilitation.
On the other hand, kratom use can paradoxically lead to physical dependence and thus replace one addiction with another. Other disadvantages of kratom include:
- Lack of regulation and guidelines on dosing and safe use.
- Higher risk of contamination.
- The risks and side effects of long-term use are unknown.
- High risk of misuse, dependence, and addiction.
- Severe withdrawal symptoms during abrupt discontinuation.
There is currently inadequate information to confirm or refute the safety of kratom use. However, there are signs that kratom products may be contaminated with other chemicals that aren’t safe in and of themselves.
Addiction is difficult to overcome, and overcoming opioid addiction is no easy task. Although MOUD treatments can be beneficial, you must carefully assess the benefits and drawbacks of each treatment option and consult with a trusted and reliable medical practitioner who can assist in choosing the appropriate treatment option for you.
If you are seeking help with your loved one’s addiction, contact us today or complete our quick contact form below, to speak with an addiction treatment specialist.
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