In the fight against the opioid epidemic that’s raging against the United States, people are turning to a wide variety of potential solutions and treatments. As the problem reached critical levels, many people are desperate for cures or viable treatment options. Some are backed by science, carefully studied, and offer evidence-based solutions. Others turn to alternative methods, found in traditional medicine, that don’t have as much scientific support.
Suboxone is a medication that’s been approved for the treatment of opioid addiction and helps to remove people from active addiction so that they can get the help they need. Kratom is a plant with some natural psychotropic alkaloids that also play on opioid receptors in the human brain. It’s not approved for medical purposes, but it’s also not illegal, so some have used it to try to mitigate opioid withdrawal symptoms.
But what happens when these two worlds collide?
What would happen if you took kratom and Suboxone at the same time? Would one help the other or would the mixture be dangerous? Learn more about these two drugs and how they might interact with each other in the human body.
Suboxone is a medication that’s used to treat opioid dependence and addiction. It contains two primary active ingredients: buprenorphine and naloxone. Buprenorphine is a partial opioid receptor agonist, which means it can bind to opioid receptors in the brains and partially activate them.
Essentially, this stops cravings and opioid withdrawal symptoms without the risk of causing intoxication or a euphoric high. Buprenorphine allows people who seek treatment for opioid addiction to enter a recovery program without having to go through uncomfortable withdrawal symptoms before they start therapies. Ideally, this will help to remove people from a lifestyle of active addiction and get them into treatment. It’s especially helpful for people who have gone through treatment several times and relapsed.
Naloxone is an opioid receptor antagonist that can remove opioids and bind to their receptors, essentially blocking any opioid activity. It’s used to reverse opioid overdoses, particularly when a person is experiencing dangerous symptoms such as respiratory depression.
Suboxone is administered sublingually, and the buprenorphine goes to work by satisfying one’s cravings. However, the naloxone doesn’t do anything at all. This is because naloxone has a hard time making it into the bloodstream when it’s taken sublingually. It’s actually only there as a safeguard. Sublingual administration of buprenorphine doesn’t cause a high but intravenous administration could. However, if a patient injects Suboxone, the naloxone will activate, kick opioids off of their receptors, and they will immediately feel withdrawal symptoms.
Suboxone is fairly comprehensive in its treatment of cravings and withdrawal symptoms. But some people may seek to use other drugs while on Suboxone, especially if they have psychological addictions.
Kratom is a plant in the coffee family that’s native to Southeast Asia and has natural psychoactive properties. It has been used in traditional practices and medicine in its native region for centuries. As a drug, it defies classification somewhat. It has properties that are consistent with opioids and stimulant drugs. The drug isn’t approved in the United States for any medical purposes, and research into its therapeutic effects is lacking. However, it’s not illegal in some parts of the U.S., so many people use it for a variety of purposes, including the management of chronic pain, for recreation, and even to treat opioid withdrawal.
Still, the official position of the U.S. Food and Drug Administration (FDA) on kratom is that there is little evidence to suggest that the drug is effective or safe for any therapeutic purposes. There is also a growing concern as to the potential public health risk that kratom may pose. While the drug offers some of the effects of both stimulants and opioids, it can also cause a combination of both of their most serious adverse effects. Kratom can cause common symptoms like nausea, vomiting, and constipation, but it can also cause more severe symptoms like seizures, respiratory depression, addiction, and psychosis.
The way kratom works in the brain is poorly understood, and learning the exact mechanisms of its actions will require more research. However, the drug appears to be a partial opioid agonist, and it also stimulates specific adrenergic receptors that regulate adrenaline in the nervous system.
At low doses, especially ones that contain the raw leaves, kratom will produce stimulant effects, and its side effects will be mild, including anxiety, agitation, itching, and nausea. Moderate doses will start to cause some of the more dangerous effects like tachycardia (rapid heart rate) and hypotension (abnormally low blood pressure), which can potentially cause complications in people who have heart disease or heart-related related conditions. Heavy doses can cause hypertension, insomnia, panic, diarrhea, muscle and joint pain, and overdose.
Severe kratom toxicity is rare, but it can happen. The FDA reported 36 kratom-related deaths in 2018 and continued to warn of the substance’s potential danger. As with other opioid receptor agonists, respiratory depression is a major risk of using kratom. In high doses, the drug could suppress your nervous system to the point of slowing or stopping your breathing which can result in oxygen deprivation, brain and tissue damage, and death.
However, respiratory depression would require extremely high doses and has a lower risk than morphine and codeine, according to animal studies. But kratom’s effects on the human respiratory system has not been adequately studied. However, a kratom overdose can be treated with naloxone like any opioid.
Kratom can also cause chemical dependence, withdrawal, and addiction. Prolonged use of the drug can cause your brain to become reliant on it to maintain normal brain function. If you stop abruptly, you can experience withdrawal symptoms like muscle aches, insomnia, irritability, hostility, aggression, mood swings, runny nose, and jerky movements. If you continue to use the drug after experiencing adverse consequences like health complications, social problems, or financial instability, you may be addicted, which may require treatment.
Both kratom and Suboxone involve partial opioid agonists, which means they will both work to lower the opioid receptors in the person who takes them together. While both buprenorphine and Kratom act as low-level opioids, together, they might potentiate each other, which means they will increase their collective effects. Moderate-to-high doses of kratom with Suboxone could increase the risk of experiencing dangerous symptoms like respiratory depression.
However, it’s more likely that a user will achieve a euphoric high, which would defeat the purpose of taking Suboxone in the first place. On its own, Suboxone is an effective opioid addiction treatment that will take away withdrawal symptoms and cravings without causing euphoria or intoxication. Kratom, at best, would make Suboxone less effective, and if it works, the two together could be a dangerous combination.
If you or someone you love is struggling with an opioid-related substance use disorder, there is help available. Opioid addiction is notoriously difficult to overcome, especially on your own, but it can be effectively treated with the right help. To learn more about opioid addiction and how it can be treated, speak to an addiction specialist at Ocean Breeze Recovery. Call 855-960-5341 to learn about your therapy options and to take the first steps on the road to recovery today.
PEW Trusts. (2017, December 4) As Kratom Use Surges, Some States Enact Bans. Vestal, C. Retrieved from https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/12/04/as-kratom-use-surges-some-states-enact-bans
Office of the Commissioner. (2018, February 6). Press Announcements – Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency's scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm595622.htm
Office of the Commissioner. (2018, February 26). Public Health Focus – FDA and Kratom. Retrieved from https://www.fda.gov/NewsEvents/PublicHealthFocus/ucm584952.htm
Raffa, R. B. (2014, October 29). Kratom and Other Mitragynines | The Chemistry and Pharmacology of Opioids from a Non-Opium Source. Retrieved from https://www.taylorfrancis.com/books/9781482225198
NIDA. (2019, April 8). Kratom. Retrieved from https://www.drugabuse.gov/publications/drugfacts/kratom
Drugs.com. (2019, November 4) Suboxone. Entringer, S. PharmD. Retrieved from https://www.drugs.com/suboxone.html