# The Complexities of Kratom: Insights on an Increasingly Frequent Clinical Encounter

## TL;DR

This paper discusses a case where a man experienced kratom withdrawal and was treated with buprenorphine-naloxone, highlighting kratom's medical complexities and drug interactions.

## Contribution

The paper presents a case study demonstrating buprenorphine-naloxone's effectiveness in treating kratom withdrawal.

## Key findings

- Buprenorphine-naloxone reduced kratom withdrawal symptoms and cravings in a 72-year-old man.
- Kratom may interact with other drugs by inhibiting cytochrome P450 enzymes and P-glycoprotein.
- The case adds to evidence supporting buprenorphine-naloxone for kratom dependence.

## Abstract

Mitragyna speciosa (kratom) is a tropical tree native to Southeast Asia with dose-dependent stimulant and opioid properties. Kratom has garnered attention due to its increasing popularity and potential for dependence, tolerance, and withdrawal. We report the case of a 72-year-old man admitted to the hospital for a deep vein thrombosis and obstructive uropathy who began experiencing kratom withdrawal. He experienced less cravings and improvement in withdrawal symptoms with buprenorphine-naloxone 8 mg/2 mg daily. Notably, our case highlights kratom's contributions to a medically complex presentation and potential kratom-drug interactions due to its posited inhibitory effect on cytochrome P450 enzymes and P-glycoprotein. Our case adds to the growing literature which describes buprenorphine-naloxone as an effective treatment for kratom dependence and withdrawal.