Podcast
Questions and Answers
What percentage of Kratom exposures occurred in adults over 20 years of age?
What percentage of Kratom exposures occurred in adults over 20 years of age?
What was the range of concentration of mitragynine found in Kratom-related deaths?
What was the range of concentration of mitragynine found in Kratom-related deaths?
What percentage of subjects had adverse effects after Kratom use?
What percentage of subjects had adverse effects after Kratom use?
What is a characteristic of the active ingredients of Kratom?
What is a characteristic of the active ingredients of Kratom?
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What was the outcome of the case reported by Tobarran et al.?
What was the outcome of the case reported by Tobarran et al.?
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What was the diagnosis of the 56-year-old patient who presented to the emergency department?
What was the diagnosis of the 56-year-old patient who presented to the emergency department?
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What is a challenge in diagnosing Kratom overdose?
What is a challenge in diagnosing Kratom overdose?
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What procedure did the 56-year-old patient undergo prior to the current admission?
What procedure did the 56-year-old patient undergo prior to the current admission?
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What is a common feature of Kratom exposures reported to United States Poison Control Centers?
What is a common feature of Kratom exposures reported to United States Poison Control Centers?
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What percentage of Kratom exposures were intentional?
What percentage of Kratom exposures were intentional?
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Study Notes
Kratom Overview
- Kratom (Mitragyna speciosa) is a tropical evergreen tree native to Southeast Asia.
- It is gaining popularity in the U.S. as an herbal supplement for its stimulating properties and analgesic effect.
- Estimated 2.1 million US residents used kratom in 2020 for pain, opioid withdrawal, and other conditions.
Kratom Toxicity and Deaths
- Severe toxicity and death have been reported from Kratom use.
- More than 90 deaths have been caused by Kratom between July 2016 and December 2017 according to CDC.
- Kratom abuse is an emerging public health emergency.
Kratom Exposures
- From 2011 through 2017, 1807 kratom exposures were reported to United States Poison Control Centers.
- Most exposures occurred in adults over 20 years of age (88.9%) and males (70.8%).
- Almost two-thirds (65.0%) of these exposures occurred during 2016–2017 and most exposures were intentional (74.3%).
- After Kratom use, 51.9% of subjects had adverse effects.
Active Ingredients and Pharmacological Effects
- Active ingredients of Kratom are indole-based alkaloids with no similarity to opiates.
- They bind with mu-opiate receptor, resulting in pharmacological effects.
- Urine drug screen is negative in a suspected Kratom overdose patient.
Case Report
- A 56-year-old patient with a past medical history of hypertension, hypothyroidism, nephrolithiasis, and biliary stricture causing hepatic dysfunction presented to the emergency department with acute liver injury and jaundice.
- The patient was using Kratom on a regular basis for almost one year for pain relief.
Treatment and Outcome
- Treatment of Kratom overdose is mostly conservative as symptoms resolve after supportive therapy in most cases.
- However, severe overdose may not respond to supportive therapy, causing fatality.
- Plasma exchange was used to reverse Kratom overdose, and the patient was discharged on day 5 at stable condition with a total bilirubin value of 21.3 mg/dL.
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Description
Learn about Kratom, a tropical evergreen tree native to Southeast Asia, its stimulating properties, and its usage in the U.S. Also, explore the reported toxicity and deaths associated with its use.
