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Kratom

Anyone have thoughts?  If you're already on an opioid should you take this--or, better question wean off your opioid to using this?


Fiona

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  • I personally would not use it. It is not approved in the USA, there are concerns about seizures, side effects, no oversight in production, safety, purity, additives. Then there are concerns about using a substance not approved by the medical community and how a pm doctor May view it’s use. 

    The final consideration is the many stories I’ve read from those trying to get off it and for many, it seems to be similar to opiates in causing withdrawal and in quite a few I read, extended withdrawal concerns. 

    I know others here have used it, with varying results, and effects. Maybe some of them can offer their input. 

  • They sell it in the grocery stores here. I bought some the first part of the year but have yet to try it. Honestly, they say it is pretty nasty stuff as far as the taste goes but the pain relief is supposed to be right up there with opiates.

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  • I have researched alot about Kratom and to me it looks promising.  At one time the US tried to have a bill signed to make Kratom illegal but got so much backlash about it that it was stopped.  I am hoping that they will look into it, do studies and just see what kratom can do.  We will never know if we don't put in the effort.  I know in New York city they sell Kratom tea in little coffee shops.  People are using it with good results.  Why wouldn't we look into what the side effects are and if things looked good, find a way to ensure that the Kratom coming into the US is safe?  I think we should.

    Cindy

  • They used to sell ephedrine in convienence stores too, until it started killing people. Just because it is sold in c stores doesn’t mean it is safe, nor useful. 

    As I said in my original response, there are many concerns over it, for many reasons, and for me, after all I have read, it is not something I would consider using, but that’s my choice. It may not be yours. For some, the risks may be something they are willing to take. 

    Natural doesn’t equal safe, but that’s my view on it. 

  • With utmost respect to the question

    Kratom seems to have opiate effects at certain levels of ingestion...so in effect, would that not be looking to replace opiates with an opiate mimic?

    I understand that wanting to get off opiates is what many people want, but substitution of one for another when one is a pain reliever...to one  that mearly mimics the effects..

    Not deriding the posts intent and innocent question.

    But it does become a subject for further discussion about what and why a person may be motivated to substitute the effects of one to mimic the others without proven medicinal value.

    I hope we can open up a genuine dialog as to the motivation to substitute.


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  • William, I have often wondered the same thing, and that is part of my reasoning for not using it. To me, simply replacing/substituting one thing for a known, effective medication is strange, if the purpose is use something to treat the pain. 

    The same question would apply for using methadone or suboxone as pain treatment versus using methadone or suboxone to stop using opiates altogether. Using either methadone or suboxone to quickly taper off makes sense, but to simply replace another opiate and remain long term on either one is just exchanging one for another. They all are opiate derivatives. Absent of course substance abuse issues. 

    I don’t mean to offend anyone, am really interested in why people who do choose kratom feel it is a better option. Price wise, I I imagine it can get pretty expensive rather quickly, and what about concerns with addiction/withdrawal.

  • I am not saying Kratom use is safe because I don't know.  Pure opiates start as a plant so I am just thinking since so many pain patients are being forced off opiates Kratom should be looked at.  That's were my thinking is.  Sandi is right.  They used to sell Spice in stores too and we all know what happened there.  I don't think anyone should use it until it can be determined that it is safe but I believe its worth doing that. I don't know if it is a better option or not but for some people in pain, it could end up being their only option.  As far as exchanging opiates for suboxone or methadone treatment, my understanding is it does have some pain relief abilities for some and for some hardcore addicts, it may be the only way they can deal with drug craving long term.  Just depends on the individual. 

    Cindy

  • Cindy, 

    I was simply talking about using either methadone or suboxone to get off opiates, versus it’s uses in pain management. 

    I don’t know if I can explain what I was meaning, but I’ll try. Hopefully I won’t botch it up. 

    I have seen a lot of explanations of using kratom as alternative to pain meds, as a ‘natural substance’, and people saying they were switching to it to avoid pain meds. Like William said, they say that kratom mimics opiates pain relieving properties, they don’t want to deal with withdrawal symptoms etc.  We have also seen people who went on suboxone or methadone for the same reasons. But all 3 do cause withdrawal symptoms, some much more prolonged and exaggerated than there typically is with opiates. Sub and methadone are opiate derivatives, so if the purpose of going on either one is to avoid withdrawal, get off opiates, or side effects, using either one only substitutes the medication, and likely worsens withdrawal if stopped. 

    The only circumstances where I see avoiding withdrawal from sub or methadone is a very short usage period, a week or 10 days, with a rapid taper.

     Kratom, I have read can cause severe withdrawal symptoms in a short time, so I guess I am a bit confused about the difference in using it, to get away from opiates...or maybe there is something I don’t know/understand that explains how using it isn’t just substituting kratom for the opiates.. it’s late and I am trying to explain my curiosity, and hope you understand what I am asking. 

  • Also, if you google Kratom and Mayo Clinic you will get their verdict on this issue - Headline "Unsafe and ineffective".

    Kevin
  • Kevin, I just read the article you referenced. It’s scary given the info and number who think kratom is harmless. Thank You for sharing that info. 

  • Off..and on topic

    Getting off opiates the easy way..withdrawls are horrendous in my book..the docs simply cutting people off from the meds...instead of a tapering down period to allow a patient time to adjust to lesser levels should be an alternative imho.

    People turn to "naturopaths"out of desperation against a fear 

    Drug seeking behaviors 

    Tryng to alleviate\avoid withdrawals

    I think that a better solution is out there

  • @William Garza

    Completely agree with you... Sometimes the cutoff is necessary, but it should be managed, with the patient given a range of options.  Granted, some won't take advantage of those options... 

    In my opinion pain management contracts need to change slightly.  Instead of dismissal for any violation, they should indicate that violations can cause the patient to enter into a different status where options might be limited to abuse resistant medications and referral to addiction specialists might be indicated, etc.  Dismissal for these patients after a single incident seems like the incorrect treatment - causing fear and desperation (see any number of posts on this site for examples!), rather than modification of problem behaviors.  There are many options that can be tried before giving up on a patient.  

    Kevin

  • memerainboltmemerainbolt IndianaPosts: 4,132

    Kevin and William,

    I agree with you, PM doctors need to better handle their patients. We have read on the forum too many times about the fear and desperation when being cut off or dismissed.

    It would be great if we could get the word out to everyone to talk to your doctor about all of this before you sign a contract. Give me options, don't just pull everything out from under me. 

  • I think part of the problem is by law, doctors can not continue to give opiates to someone they KNOW is misusing them, so that creates a huge problem, and little alternative but cutting them off and referral to treatment/help. At least that’s what I was told by several and my understanding of the issue. 

    I agree with both of you that in most cases, there should be something in between, but even with abuse deterrents there are ways to get around it, if that’s what someone chooses to do. Then there is how many chances do you give a patient? Was there really a misunderstanding or is there a pattern? 

    Thirdly, there is a liability problem. Civil and legal in some instances. Families and attorneys line up sometimes to sue the doctor for misuse/abuse. 

    There just aren’t easy answers to any of this in my humble opinion. 

  • Sandi,

    Thanks - that does make a lot of sense.  I had not thought of the need for doctors to document that they are immediately stopping these meds for people the suspect have an issue.  If they don't, I can see the liability issue.  

    But I think all of us who know how well these medications can work to make chronic pain patients more functional must really feel for those that struggle to use them correct. 

    As you mention, no easy answers!

    Kevin

  • I just wrote a really long post and accidentally somehow wiped the entire text out.... aaarrrgghhh :s

  • BRONCOFANBBRONCOFAN Posts: 144
    edited 11/03/2019 - 6:22 PM

    @sandi123

    We'll just assume your wiped out post had the magical formula to solve everything then!  In all seriousness I hate it when that happens - will drive you nuts!

    Kevin

  • Hi Kevin, 

    Not sure it solved much, but explored more in depth how I think we got to where we are in pain management now.. managing acute vs chronic pain.. what constitutes success in managing chronic pain versus acute pain.. getting to zero pain etc. I will try again, maybe tomorrow. Tonight, I am tired and hurting myself, so not the right time to try to do it again.. 

    I wish I knew the answers, for all of us, but I am just another long term chronic pain sufferer like all of us.. no more than that.

  • Zero pain

    Even before injury i never had zero pain

    That was just an idle fantasy over whiskey. I went through that phase if not wanting to be in pain,  be at zero level-zero sum pain

    But I lived a physical life and was never in a state like that.

    Being brutally honest, to wish for that is an impossibility and a exercise in futility.

    Wish too long on an impossibility and a form of thinking not conducive to healthy outlooks, realistic expectations begins.

    What was

    What we wish was

    What never was 

    And what is...are two sides of two coins 

    They told me there is nothing more to be done....its a case of more money and diminishing to no returns on treatment.

    Meds wont help all that much, add ro your coping skills

    Time wont heal your body but will give you room to grow into it(it did)

    Pain will always be part and parcel of everything you do

    I may be in pain(physical) but i dont suffer too much(emotional) because i choose not to suffer(mental).

    Attitude determines outcome sometimes

    They cold turkeyed me and I went to hell.

    I wanted and wished for an end to come for several weeks..i suffered in silence because it was so overwhelming i didnt know what to say and to whom 

    I Survived because i got angry...and used that as a fuel to power me.negative reinforcement 

    The experience of survival of that was key to opening doors to healing. I chose to live to spite the pain and then sufferring.

    I chose to give the proverbial finger to the systems that failed me, used  me for whatever agenda and the injustice of being hit by a drunk driver..someone elses choices sent me to hell.

    I have had no meds for years

    I have had no treatment for years

    I still have all the same issues,pain etc as before

    What the hellish withdrawals did was kill off any softness or self deception. 

    Everything is It is what it is

    I don't  wish for a fantasy past life because it wasnt all that to begin with

    I live today,this moment and in the.present because i have a little control over things that cause me pain.

    Body aches,burns,sparkles,burns,spasms etc...ok fine, i got better things to do than sit there and wallow in my personal sorrows and misery. 

    I guess i am a post pain high function spiney.

    I am fortunate to have a little income from a not to physical job and rest time that lets me recover enough to do it again the next day 

    It was a mental battle for me to get here

    Those still in the trenches and (NON DEROGATORY) low to mid function- able Spineys  who are or will go through your crucible. I hope you can come to terms with having to muster the courage every hour to do what you need to get through the day.

    When you can? Come and share what you can to those who cant today

    When you cant, allow yourself to be comforted and held up by others who walk along side you

    Thats the only way sometimes I think we can make it through 

    Ill hold you up...youll hold me up 

    Be well as can be Spiney



  • I agree that Kratom needs to be regulated and there needs to be quality standards imposed, but I think that further study is warranted before we decide that it is too dangerous or it merely mimics the effects of prescription opiates and is just swapping one for the other.  Shouldn’t we be searching for a better and different solution to prescription opiates, especially in this climate where lawmakers are telling our doctors how to practice medicine? I have been taking opiates for 5 years for cervical and lumbar issues, and I for one, would love to find something that last longer, is more effective, interacts with fewer medicines, has fewer side effects, doesn’t require monthly Dr appointments and pricey compliance testing, is always in stock at pharmacies/dispensaries, and doesn’t meet with disapproving looks from retail Pharmacy staff when seeking to fill a prescription. There appear to be few studies of Kratom vs thousands for prescription opiates. The Mayo article talks about 36 deaths associated with Kratom, but aren’t there tens of thousands associated with prescription opiates?

  • The media reported stats on overdoses and deaths are misleading. They report any death in which there are opiates/benzodiazepines/stimulants/antidepressants, legally prescribed and illegal drugs under one umbrella. I know this because my husband and daughter work in our county’s Medical Examiners office, and help compile reporting stats. The individual offices may further break down categories- illegal substances/ legal prescribed, but most are not reported to states by category. 

    Most drug related deaths are one of two circumstances- poly pharmaceuticals- more than one substance combined with another- opiates of which heroin falls into, and benzodiazepines, or heroin overdose. Benzodiazepines/alcohol or opiates/alcohol comes next.

    The reporting methods need to be refined in my opinion, differentiating between legally prescribed and legal amounts in tox screens, and illegal street drugs. Then you would get real numbers on actual deaths attributed directly to opiate misuse.

  • @William Garza

    Thanks for sharing that.  We all have to figure out what works best for us, and then get moving.  I am very early in attempting to manage "chronic pain" now that I've accepted that's the way it is.  One thing I think there needs to be a lot more of is patient counseling prior to using pain medications for chronic pain.  Expectations need to be realistic, pitfalls need to be addressed. 

    I know in my own case taking a little break from the medication helped to reset my thinking.  I can live without if necessary, and there a lot of other modalities that can be used to get some relief.  During the break, I used heat, ice, and ibuprofen/tylenol.  I still went back to using pain medications, but without the belief that I had to have them, without the expectation they would fix everything.  I think this point has been learned by everyone on this board that uses the medications successfully, but the concept can be elusive.  

    If your pain without doing anything is a 7, it's important to use exercise, OTC, heat/ice/tens/whatever to get it to a 5.  Then if a relatively low dose of pain medications can get it down another point or two, you've gone from a 7 to a 3-4 and you can function somewhat normally there... that's the goal.  If you try to use enough pain meds alone to go from 7 to 3, it seems like that is a recipe for sub-optimal results and long term disappointment.  

    And, lot's of respect to you for finding a way to get to that high functioning level without the pain medication.  Something for me to aspire too!

    Kevin

  • I was lucky, one of my pain docs had tapered me before so i had a taste of a reset which was a eye opener. I agree with what you said about modalities and some light exercise. I get plenty of lay down time to help with the back pain and am able to sit or move as i want  to at work. It wasn't always like this and i had tremendous back pain from  it

    High amd low functioning is a relative term in that i was low to very low functioning a few years ago when my job was more physical 

    I still have more days than not where i can not get up at any speed from sitting or standing too long. Low function isnt a  bad thing, it just means i can do mu job at an acceptable level. My heart breaks for the ones in so much pain  that have their lives tossed upside down right now and  have yet to find a medium level.

    Like you said, pain meds alone cant bring it down to very low levels.i had some counseling from a couple of docs when it came time to stop treatments as they were diminishing returns. Since i was an ctive participant in that process it was no shock when the zero hour came.


  • ArizonaAArizona ArizonaPosts: 182

    What Sandi123 said! I don't think there's ever been a single death from kratom. Big pharma doesn't like it because the can't make money off tree leaves. There are some very big kratom forums online. There you can learn which sources are reliable. I don't think I'm allowed to post links here but you can probably search them out.

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