Several months ago, a 26-year-old man from Northern Virginia came to our Richmond office for a Heroin Detox.
He had been using heroin for about 2 years after being on oxycodone for surgeries he’d had shortly after high school. Jim had graduated from a good HVAC program and was a reliable employee. He loved working with his hands. But unfortunately, he was just blowing all his money on heroin.
He was scheduled for a 3-day Heroin Detox because he was using under 2 grams of heroin. Usually, if someone uses over 1.5 or 2 grams of heroin daily, or if there might be some fentanyl involved, we will have them come in for 4 to 5 days.
More like this: How to Detox Off Heroin: What It Takes & Getting Help
Is There Such a Thing as a Comfortable Heroin Detox?
The first day of a patient's detox off heroin at the Coleman Institute is usually pretty comfortable. After that, we give patients a small dose of naltrexone with several other medications to minimize any symptoms they may experience. So it was a little unusual when Rene, Jim's girlfriend, and support person, called us saying that Jim was displaying strong withdrawal signals.
He's having diarrhea and has vomited a couple of times. He has terrible body aches and says he feels like he needs to beat on his legs to stop the pain.
Those are the classic signs of acute opioid withdrawal. But why was Jim having such a violent reaction when most people generally sleep through their first day with the Coleman Institute's detoxification protocol?
More like this: How Can I Avoid The Pain of Heroin Withdrawal?
Kratom for Opioid Withdrawal
We had Rene bring Jim back to the office, and after further conversation with him, the answer emerged. Jim had neglected to mention that—and we had failed to ask if—he had been using Kratom to help withdraw from heroin. This is a common self-treatment, as an estimated 2,101,000 individuals over the age of 12 have reported using Kratom in 2020. He had purchased the Kratom about a week before coming to our facility.
In Jim’s case, however, this only compounded his problem. As we delivered naltrexone to remove the opiates already present on his opioid receptors, Jim was loading them up again with Kratom, exacerbating his withdrawal symptoms.
We get it.
It was a little like playing Whack-A-Mole. As we pushed the heroin off, freeing his receptors, the Kratom was ready to take a position on an empty receptor. So, instead of just the original 1.5 grams of heroin, which we could easily and comfortably handle during a 3-day Heroin Detox, Jim’s use of Kratom made it more difficult and actually added more time to the process.
Kratom For Opioid Withdrawal
Kratom is a plant-based drug that is native to Thailand, Malaysia, Indonesia, and Papua New Guinea. Small doses of Kratom can create a stimulant effect so many believe it can increase energy and stamina. But in truth, Kratom is physically addictive as well. More troublesome is that Kratom is often promoted as a potential cure for substance use disorder by presenting it as an herbal product that can aid in the treatment of opioid addiction, including heroin, fentanyl, opioid-based pain medications, and more.
Large doses of Kratom produce a sedative effect very similar to opioids and it affects the brain in the same way that opioids do, turning a potential cure into another crippling addiction. Kratom is difficult to wean oneself off of, as Kratom withdrawal symptoms (like opioid withdrawal symptoms) can turn severe and dangerous.
Common Myths About Kratom
With this misrepresentation of Kratom, it can be difficult to know what is true and what a myth about Kratom. Here are the most common myths about Kratom that we hear from our outpatient detox patients:
- Kratom is completely safe because it's natural: This is false. Just because something is natural does not necessarily make it safe. There are many natural substances that can be harmful or even deadly in the wrong doses.
- Kratom can't be addictive: The truth is the impact of Kratom on the brain is very similar to opioids and you can even experience Kratom withdrawal symptoms, much like opioid withdrawal symptoms.
- Kratom is legal everywhere because it's just a plant: The legal status of kratom varies by country and even within regions of countries. In some places, it's completely illegal, while in others, it's restricted or regulated.
- Kratom is safe to mix with other substances: Combining kratom with other drugs or medications can be dangerous.
Can I Use Kratom To Detox Off Heroin?
At one time, researchers thought it would make sense that Kratom would help with opioid withdrawal.
But, if you think about it, for a person withdrawing from heroin, heroin will “help” with the opioid withdrawal. So will oxycodone, fentanyl, Percocet, etc.
The problem is that you are simply perpetuating the situation.
More like this: How to Detox Off Heroin: What It Takes & Getting Help
Kratom Withdrawal Experience
"Kratom: Unsafe and ineffective," an article on the Mayo Clinic website, describes multiple problems and safety concerns regarding Kratom, including death.Although many individuals attempt to use Kratom to get off of heroin, they do not realize the negative effects. Some of the severe outcomes of using Kratom were seizures, high blood pressure, and multiple side effects, including:
- Weight loss
- Dry mouth
- Chills, nausea, and vomiting
- Changes in urine and constipation
- Liver damage
- Muscle pain
Kratom also affects the mind and nervous system:
- Dizziness
- Drowsiness
- Hallucinations and delusion
- Depression and delusion
- Breathing suppression
- Seizure, coma, and death
I was surprised to hear that substances made from Kratom may be contaminated with salmonella bacteria.
Again, from the Mayo Clinic article, “As of April 2018, more than 130 people in 38 states became ill with Salmonella after taking Kratom. Salmonella poisoning may be fatal, and the U.S. Food and Drug Administration has linked more than 35 deaths to Salmonella-tainted Kratom. Salmonella contamination has no obvious signs, so the best way to avoid becoming ill is to avoid products that may contain it.”
How Does Kratom Affect a Heroin Detox?
So, after cracking the Kratom quandary, Jim's detox proceeded with much more ease and comfort. We were able to give him a little extra comfort medication and extend his detox for another day. He ultimately did very well, and it is now a standard part of our protocol to question our patients about using Kratom.
Jim's ultimate goal was to go on long-acting naltrexone, which is an opioid blocker and does not cause any physical dependency. Providing Medically Assisted Treatment (MAT) with naltrexone has been our specialty at the Coleman Institute for nearly 20 years. However, all the opioids must be out of the system before a person starts on naltrexone, including Kratom.
Questions About Using Kratom to Detox off of Heroin?
It can be very confusing to know the ins and outs of various treatments and what substances should and shouldn’t be used to help a patient detox off opioids like heroin, morphine, and codeine, and opioids such as Percocet®, Vicodin® Roxicet®, Dilaudid®, etc. Please schedule a callback if you have any questions or concerns about kratom or other addictive substances.
Joan R. Shepherd, FNP
