Kratom (Mitragyna speciosa) is an herb that is sold over the counter in both pill and liquid forms. It contains opioid and stimulant properties and is used for relaxation as well as for weaning off opioid addictions. While a few adverse effects of kratom have been already reported, mainly with concerns around its toxicity, very little is known about it. We report a case of a female in her 40s presenting with signs of hypoxia reversed with naloxone administration, initially suspected to be a case of opioid overdose. Her urine toxicology was noted to be negative for opioids or any other substance use. The patient survived this accidental overdose due to the quick action of her husband, who rushed her to the emergency department (ED) upon realizing she appeared altered and very ill.
There are also numerous natural pain relievers that people could try. However, doctors do not recommend their use in people with moderate to severe pain. If someone takes small can you overdose on kratom amounts of kratom, they may feel energized, sociable and alert, rather than sedated.
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Kratom is widely used and seen as a safe alternative to opioids, but it’s not without risks like overdose. If you use kratom and are struggling with drug abuse or addiction, seek help as soon as possible to avoid adverse effects and complications. Kratom’s effects and withdrawal symptoms aren’t as well understood or established as other substances.
Kratom Overdose Treatment
There are 12-step programs and recovery programs that can help people in their journey to stay sober. This is the first step in treatment and helps to rid the body of the drug through a detox. Facilities can offer inpatient and outpatient detoxification programs. However, in 2014, the FDA made importing or manufacturing kratom for dietary purposes illegal, and a handful of states have banned the substance altogether.
Aside from case reports, currently, there are no active clinical trials supporting these findings. As such, many ED practitioners are unaware that kratom toxicity is an increasing issue or that it can present similarly to opioid toxicity. Kratom (Mitragyna speciosa) is an herbal substance that is native to Southeast Asia and has both opioid-like and stimulant properties.
It is consumed orally by chewing the leaves, ingesting the powdered leaf in a pill or capsule form, smoking it, or drinking it with the powdered leaf dissolved in a beverage 1. The average amount of the active compound (mitragynine) in one serving of “kratom juice” is 79 milligrams, and the average daily intake recommendation from brands is 276.5 milligrams 2. Recently, it has become popular in the United States and is available over the counter 3. At low doses (1-5 grams), kratom acts like a stimulant with the effects of increased alertness, social behavior, and physical energy. At high doses (5-15 grams), it brings on euphoria and has opioid-like properties such as decreased pain stimulation 4. Kratom is promoted as a treatment to ease withdrawal symptoms from opioid medicines.
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Since kratom acts on opioid receptors, preliminary data suggests that extreme overdoses may respond well to naloxone. A review of the literature demonstrated that Mitragyna speciosa (kratom) is an opioid receptor agonist, activating the mu and delta receptors. In the United States, it is becoming increasingly popular, especially by patients for self-treatment of opioid withdrawal 8.
Sustained Recovery
- In the US, kratom is available on the market as a natural remedy and recreational drug.
- It is crucial for clinicians to be aware of rebound hypoxia when deciding on safe disposition for patients from the ED.
- Unlike smoke shops or gas stations advertising kratom-derived concentrates, these coffee shop-style retailers serve drinks often in the form of tea brewed from the kratom plant5.
- Federal health regulators recently announced plans to control a highly potent kratom byproduct called 7-hydroxymitragynine (7-OH).
- Addiction treatment is individualized, but inpatient and outpatient treatment with behavioral therapies and traditional therapies like individual and group counseling can be effective.
Kratom is not classified as an opioid, but it contains compounds that act on the same receptors in the brain. At smaller amounts, users often report stimulant-like effects such as increased energy, alertness and elevated heart rate. At higher amounts, the same plant can produce sedative and opioid-like effects, including relaxation, pain relief and confusion.
Statewide, the Health Department recorded 38 unintentional and undetermined drug overdose deaths where kratom/7-OH was a contributing factor in Pennsylvania in 2024. Substance abuse or drug addiction can be challenging to overcome on one’s own. If you think someone you know may be struggling with a kratom use disorder, encourage them to get help.
- Opioid overdose presents with altered mental status, decreased respiratory drive, rate, and tidal volume, constricted pupils, and decreased bowel sounds 7.
- “7-OH is more potent than products that contain mitragynine in general, so it makes sense as we’re seeing more of these products in the area; we’re getting more calls about it,” Shulman said.
- The department warns residents to avoid using the compound and, above all, to avoid mixing it with other drugs.
Kratom Overdose: What You Need to Know
The NIDA state that people may take kratom as a pill, capsule, or extract. Others may chew kratom leaves or brew them as tea, while individuals can also smoke the leaves or add them to food. Some people use kratom socially or for pleasure, while others may use it to self-treat certain health conditions.
A compound known as 7-Hydroxymitragynine, or 7-OH, was ruled a contributing cause of death in three otherwise healthy adults between the ages 18 and 40, according to the L.A. Join 40,000+ People Who Receive Our Newsletter Get valuable resources on addiction, recovery, wellness, and our treatments delivered directly to your inbox. When someone is taking a low dosage of kratom, you can expect similar effects to other stimulants such as caffeine.
It also discusses the drug’s legal status and the risks of taking it. This article also offers alternatives to the drug that someone could consider. With higher abuse potential, it does become threatening to tolerance and withdrawing, causing addiction,” Ceretto said.