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Kratom, an Emerging Drug of Abuse: A Case Report of Overdose and Management of Withdrawal

Diep, Jack, MD*; Chin, David, Tian, BS; Gupta, Somdatta, MD; Syed, Faraz, DO§; Xiong, Ming, MD, PhD; Cheng, Jianguo, MD, PhD*

doi: 10.1213/XAA.0000000000000658
Case Reports

Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens.

From the *Department of Pain Management, Cleveland Clinic, Cleveland, Ohio; Rutgers New Jersey Medical School, Newark, New Jersey; Department of Anesthesiology and Perioperative Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; and §Department of Critical Care Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey.

Accepted for publication September 12, 2017.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Jack Diep, MD, Department of Pain Management, Cleveland Clinic, 9500 Euclid Ave, C-25, Cleveland, OH 44195. Address e-mail to

© 2018 International Anesthesia Research Society
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