Treatment of Kratom Dependence With Buprenorphine-Naloxone Maintenance

J Addict Med. Nov/Dec 2018;12(6):481-483. doi: 10.1097/ADM.0000000000000428.


Introduction: Use of the unregulated herbal supplement kratom is on the rise in the United States. We present a case series of 2 patients who developed kratom dependence and withdrawal who were successfully transitioned to buprenorphine-naloxone maintenance.

Case summary: Two patients using kratom to self-treat chronic pain after prescription opioids were discontinued presenting to our clinic with evidence of kratom dependence and withdrawal. On examination, both patients showed signs of mild opioid withdrawal. Both patients were successfully transitioned to buprenorphine-naloxone maintenance via home initiation with control of both their opioid withdrawal and chronic pain.

Conclusions: Kratom use is on the rise and with increasing evidence of developing opioid-type dependence due to chronic kratom use. This case series shows that buprenorphine can be used to treat kratom dependence and underlying chronic pain that drives it use.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / pharmacology*
  • Buprenorphine, Naloxone Drug Combination / administration & dosage
  • Buprenorphine, Naloxone Drug Combination / pharmacology*
  • Chronic Pain / drug therapy*
  • Dietary Supplements / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitragyna / adverse effects*
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders / drug therapy*
  • Substance Withdrawal Syndrome / drug therapy*


  • Analgesics, Opioid
  • Buprenorphine, Naloxone Drug Combination