OPINION: Kratom users need resources for treatment

I read with interest the article on the city confiscating kratom and 7-hydroxymitragynine (“7-OH”) products in the Journal on Saturday, “ABQ cracks down on kratom sales.” As a physician who is board certified in both addiction and internal medicine, I have taken care of countless patients who have developed addiction to both of these products and am writing out of concern for people using these products.

As noted in the article, people take kratom and/or 7-OH for many reasons. At high doses, kratom acts like an opioid. Similarly, 7-OH binds in our bodies 40 times as strongly as morphine. As a result of this and these products’ widespread availability in gas stations, vape shops and on the internet, many people who begin using them for recreation, relaxation or for managing pain develop harrowing dependence. Many of my patients have such severe symptoms that they wake up in the middle of the night to take additional doses due to cravings or withdrawal.

With this in mind, it is unquestionable that these products are not safe. However, it is also unquestionably unsafe for individuals with dependence or addiction having a substance they use regularly being suddenly unavailable without having treatment available to them. The best available evidence supports treating these individuals with buprenorphine (often known by the brand name Suboxone, or by the term ‘bupe’), which is a medication that is more commonly known as a medication that reduces the risks for overdose, death, HIV and hepatitis C infections, and illegal behaviors among people with opioid use disorder.

I urge city leaders and public health officials to rapidly engage people using kratom and 7-OH products with resources for quickly accessing evidence-based treatment for dependence and addiction, such as buprenorphine. Not doing so is unintentionally cruel and risks these individuals having mental and physical health crises.