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Blindsided by Kratom: The Accessible Opioid

Virtual
1.5 CE Hour
General
Free

Presented By

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Dates and Times

  • -
    Live Webinar

Location

  • Live Webinar
    Access virtually on TPN.health
Description

In this workshop we will provide an overview of what Kratom is, its forms, and its natural history. We will cover how Kratom is used and how Kratom doses are measured. Dr. Ashbaugh will discuss the legality of Kratom, the attempt to classify it as a Schedule I drug, and regulations in Colorado. We will discuss pathophysiology, addiction, and withdrawal as it relates to Kratom use, including whether a person can overdose on Kratom. Finally, we will go over the treatment of Kratom Addiction.

Target Audience
  • • Counselor
  • • Marriage & Family Therapist
  • • Psychologist
  • • Social Worker
  • • Substance Use Disorder Professionals
Educational Goal

The educational goal of this workshop is to help participants learn more about Kratom, its forms, and how we can work together to spread awareness of this dangerous substance.

Learning Objectives

At the end of this course, participants will be able to:

  • Identify what Kratom is and how it is used.

  • Describe the neurophysiology of Kratom.

  • Explain the controversy surrounding treatment of Kratom addiction.

References

  • Abdullah, H. M. A., Haq, I., & Lamfers, R. (2019). Cardiac arrest in a young healthy male patient secondary to kratom ingestion: Is this “legal high” substance more dangerous than initially thought? BMJ Case Reports, 12(7), e229778. https://doi.org/10.1136/bcr-2019-229778

  • Agapoff, J. R., & Kilaru, U. (2019). Outpatient buprenorphine induction and maintenance treatment for kratom dependence: A case study. Journal of Substance Use, 24(6), 575–577. https://doi.org/10.1080/14659891.2019.1638459

  • Antony, A., & Lee, T.-P. (2019). Herb-induced liver injury with cholestasis and renal injury secondary to short-term use of Kratom (Mitragyna speciosa). American Journal of Therapeutics, 26(4), e546–e547. https://doi.org/10.1097/MJT.0000000000000802

  • Bowe, A., & Kerr, P. L. (2020). A complex case of kratom dependence, depression, and chronic pain in opioid use disorder: Effects of buprenorphine in clinical management. Journal of Psychoactive Drugs, 52(5), 447–452. https://doi.org/10.1080/02791072.2020.1773586

  • Burke, D., Shearer, A., & Van Cott, A. (2019). Two cases of provoked seizure associated with kratom ingestion. Neurology, 92(15 Supplement), P4.5-030.

  • Dorman, C., Wong, M., & Khan, A. (2015). Cholestatic hepatitis from prolonged kratom use: A case report. Hepatology, 61(3), 1086–1087. https://doi.org/10.1002/hep.27612

  • Diep, J., Chin, D. T., Gupta, S., Syed, F., Xiong, M., & Cheng, J. (2018). Kratom, an emerging drug of abuse: A case report of overdose and management of withdrawal. A&A Practice, 10(8), 192–194.

  • Drago, J. Z., Lane, B., Kochav, J., & Chabner, B. (2017). The harm in kratom. Oncologist, 22(8), 1010–1011. https://doi.org/10.1634/theoncologist.2017-0279

  • Eggleston, W., Stoppacher, R., Suen, K., Marraffa, J. M., & Nelson, L. S. (2019). Kratom use and toxicities in the United States. Pharmacotherapy, 39(7), 775–777. https://doi.org/10.1002/phar.2280

  • Fernandes, C. T., Iqbal, U., Tighe, S. P., & Ahmed, A. (2019). Kratom-induced cholestatic liver injury and its conservative management. Journal of Investigative Medicine High Impact Case Reports, 7, 2324709619836138.

  • Galbis-Reig, D. (2019). A case report of kratom addiction and withdrawal. WMJ, 115(1), 49–52.

  • Griffiths, C. L., Gandhi, N., & Olin, J. L. (2018). Possible kratom-induced hepatomegaly: A case report. Journal of the American Pharmacists Association (2003), 58(5), 561–563. https://doi.org/10.1016/j.japh.2018.05.006

  • Hanapi, N. A., Chear, N. J., Azizi, J., & Yusof, S. R. (2021). Kratom alkaloids: Interactions with enzymes, receptors, and cellular barriers. Frontiers in Pharmacology, 12, 751656. https://doi.org/10.3389/fphar.2021.751656

  • Hassan, Z., Suhaimi, F. W., Ramanathan, S., Ling, K.-H., Effendy, M. A., & Muller, C. P. (2019). Mitragynine (Kratom) impairs spatial learning and hippocampal synaptic transmission in rats. Journal of Psychopharmacology, 33(7), 908–918. https://doi.org/10.1177/0269881119844186

  • Hemby, S. E., McIntosh, S., Leon, F., Cutler, S. J., & McCurdy, C. R. (2019). Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine. Addiction Biology, 24(5), 874–885. https://doi.org/10.1111/adb.12639

  • Henningfield, J. E., Chawarski, M. C., Garcia-Romeu, A., et al. (2023). Kratom withdrawal: Discussions and conclusions of a scientific expert forum. Drug and Alcohol Dependence Reports, 7, 100142. https://doi.org/10.1016/j.dadr.2023.100142

  • Ilmie, M. U., Jaafar, H., Mansor, S. M., & Abdullah, J. M. (2015). Subchronic toxicity study of standardized methanolic extract of Mitragyna speciosa Korth in Sprague-Dawley rats. Frontiers in Neuroscience, 9, 189. https://doi.org/10.3389/fnins.2015.00189

  • Jaliawala, H. A., Abdo, T., & Carlile, P. V. (2018). Kratom: A potential cause of acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine, 197, A6604.

  • Khazaeli, A., Jerry, J. M., & Vazirian, M. (2018). Treatment of kratom withdrawal and addiction with buprenorphine. Journal of Addiction Medicine, 12(6), 493–495. https://doi.org/10.1097/ADM.0000000000000435

  • Kruegel, A. C., Gassaway, M. M., Kapoor, A., et al. (2016). Synthetic and receptor signaling explorations of the mitragyna alkaloids: Mitragynine as an atypical molecular framework for opioid receptor modulators. Journal of the American Chemical Society, 138(21), 6754–6764. https://doi.org/10.1021/jacs.6b00360

  • Kruegel, A. C., & Grundmann, O. (2018). Pharmacology of kratom and its constituents: Towards a better understanding of the drug. Frontiers in Pharmacology, 9, 196. https://doi.org/10.3389/fphar.2018.00196

  • Lynn, A. M., Gopalan, G., Khosravi, M., Kline, J., & Levy, C. (2020). The effects of kratom on opioid withdrawal symptoms: A case report. American Journal of Therapeutics, 27(3), e373–e375. https://doi.org/10.1097/MJT.0000000000000734

  • Mason, D. M., & Zoller, J. E. (2018). Exploring the intersection of kratom use, opioid use disorder, and chronic pain: A case report. Pain Medicine, 19(3), 604–606. https://doi.org/10.1093/pm/pnx131

  • Meyer, M. R., & Peters, F. T. (2020). The effects of kratom (Mitragyna speciosa) on opioid receptors: A systematic review. Drug Testing and Analysis, 12(8), 1218–1230. https://doi.org/10.1002/dta.2752

  • Morita, Y., Matsuda, Y., Watanabe, K., Takagi, Y., & Nakae, T. (2022). The analgesic effects of mitragynine and 7-hydroxymitragynine in mice: A behavioral and pharmacological study. Biological & Pharmaceutical Bulletin, 45(3), 384–392. https://doi.org/10.1248/bpb.b21-00854

  • Murray, A. R., & Stiles, M. A. (2020). Adverse effects of kratom: A review of the literature. Journal of Medical Toxicology, 16(4), 309–316. https://doi.org/10.1007/s13181-020-00749-2

  • Nathanson, D. (2017). The kratom controversy: An overview of the use, effects, and potential health risks of kratom. Journal of Addiction Medicine, 11(4), 245–250. https://doi.org/10.1097/ADM.0000000000000316

  • Rogers, M. C., & Flentke, G. R. (2020). Kratom: A comprehensive review of its pharmacology and potential health effects. American Journal of Health-System Pharmacy, 77(10), 757–766. https://doi.org/10.1093/ajhp/zxaa048

  • Sawyer, K. L., & Williams, C. K. (2019). Kratom: A comprehensive review of the literature and future research directions. Journal of Addiction Medicine, 13(3), 1–10. https://doi.org/10.1097/ADM.0000000000000521

  • Sweeney, K. (2021). A report of kratom dependence. American Journal of Psychiatry, 178(12), 1194. https://doi.org/10.1176/appi.ajp.2021.1781216

  • Wang, C. M., Hsiao, Y. T., Cheng, M. C., & Chiu, P. Y. (2019). Kratom (Mitragyna speciosa): A review of the pharmacological and toxicological effects. Drug Safety, 42(8), 865–874. https://doi.org/10.1007/s40264-019-00891-0

Intermediate
General
Counselor

TPN.health has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7267. Programs that do not qualify for NBCC credit are clearly identified. TPN.health is solely responsible for all aspects of the programs.

Trusted Provider Network, LLC is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0220.

Marriage & Family Therapist

TPN.health is a CAMFT-approved continuing education provider, provider #1000101.

Trusted Provider Network, LLC is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed marriage and family therapists #MFT-0097.

Psychologist

Pending approval.

Social Worker

TPN.health, #1766, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. TPN.health maintains responsibility for this course. ACE provider approval period: 03/31/2022 – 03/31/2025. Social workers completing this course receive 1.5 General continuing education credits. ASWB ACE Credit is not available in NY and NJ.

Trusted Provider Network, LLC is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0654.

Substance Use Disorder Professionals

This course has been approved by TPN.health, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #198061, TPN.health is responsible for all aspects of the programming.This course has been approved by TPN.health, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #198061, TPN.health is responsible for all aspects of the programing. Counselor Skill Group: Legal, Ethical, and Professional Development

CE Policy
This course is fiscally sponsored by the Red Point Center. There may be potential biases or conflicts of interest inherent to this relationship, and it must be disclosed to participants. These conflicts of interest have no bearing on the course content and have been resolved.
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Honor Ashbaugh, MD

Dr. Ashbaugh received her medical degree with honors and trained at the prestigious University of Texas Southwestern Medical School in Dallas. She has over 30 years of experience as a licensed and board-certified Internal Medicine physician. While working as a primary care physician in the past, Dr. Ashbaugh has always had a passion for treating mental health problems. Striving for more knowledge of mental health problems, their diagnosis and treatment, Dr. Ashbaugh participated in and completed the Train New Trainers Primary Care Psychiatry Fellowship at The University of California, Irvine, School of Medicine, in December of 2021. With over 20 years of experience as a general internal medicine specialist, Dr. Ashbaugh has vast experience treating adolescents and adults for complicated physical illness, mental health disorders, and addiction, and is passionate about developing a strong therapeutic relationship with her patients in order to facilitate their recovery and healing. With her knowledge and personable bedside manner, Dr. Ashbaugh aims to get to know her patients as individuals and guides them through the medical aspects of their recovery. Unlike the Medical Directors of other substance abuse and mental health Intensive Outpatient treatment programs, Dr. Ashbaugh remains onsite at the Redpoint Center and dedicates all of her time to the treatment of our clients. Dr. Ashbaugh truly empathizes with all of her clients and draws from her own personal journey in recovery.

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