Kratom & Stimulant Co-Addiction: A Case Series and Brief Review

Kratom (Mitragyna speciosa) is an easily accessible dietary supplement gaining notoriety in medicine for its use as a surrogate form of self-driven opioid use disorder treatment, albeit one with a lack of evidence and significant risks. Both misuse and withdrawal from kratom have been appreciated in the literature and addressed in a fashion analogous to that of opioids. Because of this, it has largely been studied through the looking glass of its properties of agonizing μ-opioid and likely α₂-adrenergic receptors. While an important area of study, the correlation with kratom and stimulant use, reflected in the National Survey on Drug Use and Health, is one that often gets neglected clinically. In our manuscript we present three unique cases, demonstrative of the overlap kratom misuse may have with stimulant use disorders in distinct settings. We provide a discussion and review of this correlation in light of kratom use increasing in the United States.