All the things you have never asked me about Kratom

Whenever I talk to myself, I get a of people who will ask, "why you are talking to yourself? Are you trying to have an intelligent conversation?" My reply is always, "Yes, I am forever choosing poorly."

Which makes it funny because I get asked a lot of things about Kratom, and I feel like the same self assessment works in this area too. Most of the time it is simply questions like, "what color should I choose?" Well, being the expert that I am not, I would like to tell you that until yesterday I was not aware there was a yellow strain.

So, if you came to this blog looking for expert advice, once again, you probably chose poorly. But I do have some experience personally with the plant and I would also have some profession thoughts about Kratom, its potential benefit, and how you should manage it with other medications.

1. Kratom or opiods - but never both. Most people in the US who use Kratom use it as a means to manage pain. Many people have asked me about supplementing their opiod regimen with Kratom and I tell them they should manage their pain with Kratom, with opiods but never both. There are several reasons why - but the first one comes down to basic honestly. I think that Kratom effects your pain enough that if you use Kratom with pain medication you are essentially medicating yourself and declaring your pain plan unsuccessfiul but without your provider getting a vote.

   Something you should also consider is that most pain clinics will consider it a violation of your pain agreement so disciplinary action is possible if they find out you are using it and not telling them. Most drug panels do not yet search for Kratom metabolites but as they are very clearly identified, I expect that to change.

   But the BIGGEST reason not to use Kratom and opioids together is this - except for methadone and buprenorphine, the affinity for Kratom is higher than your opioids and so if you take too close to an opioid dose, it could remove the opioid from your pain receptor with a weaker molecule causing you to have a pain crisis. Not withdrawal, simply sudden increased pain. (For comparison, Naltrexone or Narcan causes withdrawal).

2. Kratom plays nice with most of your other medications, so it CAN conceivably be used as a adjunct therapy for some mental health needs like anxiety and depression. Again, do I think you should be doing this without your doctor getting a vote - of course not. But in reference to most questions I have been asked, I don't anticipate your medications interacting with the Kratom any more than your opioids do.

3. If you are going to come off traditional opioids to Kratom and want to know how to do it the safest for a trial of Kratom, then let me give you the advice I give most of my patients who ask. Wait after your last dose of Kratom until you begin to notice early withdrawal, things like rapid heart rate, perspiration, anxiety and headaches. This should mean that enough of your MU receptors are open enough for the Kratom to come in and only be a balm for these exposed receptors to quit reacting to the absence of the opioid. Its affinity for the MU receptor is why many people have prevented acute opioid withdrawal because even if you are not a responder to Kratom (that is, it doesn't seem to work for your pain) I still fully expect it to occupy your receptors and increase your sense of well being should you find yourself suddenly and abruptly opioid free.

4. Kratom is not harmless. It has abuse potential. It does not have the same overdose potential but anything that plays as well as Kratom does with the pain receptors is also going to have an indirect effect on dopamine which is the devil's playground for all things the addicted brain wants. Be wary and respectful.