The assessment and treatment of kratom dependence: findings from a physician survey in Malaysia.
Source: PubMed, NCBI / U.S. National Library of Medicine
While physiological dependence on kratom (indicating tolerance and withdrawal) has been differentiated from kratom use disorder (KUD) in the West, the emphasis in Malaysia remains on kratom dependence. This has implications for treatment approaches.This study was initiated to assess the extent to which medical practitioners treat patients with kratom dependence, their fields of specialization, their knowledge of kratom, and the treatment protocols used.An online questionnaire was distributed to approximately 17,000 Malaysian Medical Association (MMA) members, yielding 148 responses (0.9% response rate).Male respondents comprised 58% of the sample, and 62% of physicians worked in public hospitals. Fifty-nine percent had treated patients for kratom dependence, with the majority having a background in psychiatry. Those treating kratom dependence had higher odds of being in public service (OR: 3.3: 1.64-6.56; < .018), and had shorter mean duration of service (15.6 years), relative to the group that had not treated kratom dependence (18.3 years). Nearly 68% percent of those treating kratom dependence believed kratom to have similar effects as opioids and therefore prescribed treatments for kratom withdrawal that were designed for opioid withdrawal.Our findings suggest that opioid agonists are commonly used for the treatment of kratom withdrawal. However, kratom's distinct pharmacology relative to classical opioids suggests that treatment approaches deve
Abstract
While physiological dependence on kratom (indicating tolerance and withdrawal) has been differentiated from kratom use disorder (KUD) in the West, the emphasis in Malaysia remains on kratom dependence. This has implications for treatment approaches.This study was initiated to assess the extent to which medical practitioners treat patients with kratom dependence, their fields of specialization, their knowledge of kratom, and the treatment protocols used.An online questionnaire was distributed to approximately 17,000 Malaysian Medical Association (MMA) members, yielding 148 responses (0.9% response rate).Male respondents comprised 58% of the sample, and 62% of physicians worked in public hospitals. Fifty-nine percent had treated patients for kratom dependence, with the majority having a background in psychiatry. Those treating kratom dependence had higher odds of being in public service (OR: 3.3: 1.64-6.56; < .018), and had shorter mean duration of service (15.6 years), relative to the group that had not treated kratom dependence (18.3 years). Nearly 68% percent of those treating kratom dependence believed kratom to have similar effects as opioids and therefore prescribed treatments for kratom withdrawal that were designed for opioid withdrawal.Our findings suggest that opioid agonists are commonly used for the treatment of kratom withdrawal. However, kratom's distinct pharmacology relative to classical opioids suggests that treatment approaches developed for opioid withdrawal may not fully address the clinical features of kratom withdrawal.