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Treatment of Kratom Dependence With Buprenorphine-Naloxone Maintenance

Buresh, Megan MD

doi: 10.1097/ADM.0000000000000428
Case Reports

Introduction: Use of the unregulated herbal supplement kratom is on the rise in the United States. We present a case series of 2 patients who developed kratom dependence and withdrawal who were successfully transitioned to buprenorphine-naloxone maintenance.

Case Summary: Two patients using kratom to self-treat chronic pain after prescription opioids were discontinued presenting to our clinic with evidence of kratom dependence and withdrawal. On examination, both patients showed signs of mild opioid withdrawal. Both patients were successfully transitioned to buprenorphine-naloxone maintenance via home initiation with control of both their opioid withdrawal and chronic pain.

Conclusions: Kratom use is on the rise and with increasing evidence of developing opioid-type dependence due to chronic kratom use. This case series shows that buprenorphine can be used to treat kratom dependence and underlying chronic pain that drives it use.

Division of Chemical Dependence, Johns Hopkins University School of Medicine, Baltimore, MD.

Send correspondence to Megan Buresh, MD, Division of Chemical Dependence, Johns Hopkins Bayview, 5200 Eastern Avenue, Mason F. Lord Building, West Tower, 5th Floor, Baltimore, MD. E-mail:

Received 20 April, 2018

Accepted 26 May, 2018

There are no outside sources of support requiring acknowledgement.

The authors declare no conflicts of interest.

© 2018 American Society of Addiction Medicine