{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:38:18Z","timestamp":1792093098642,"version":"4.4.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background<\/jats:italic>\n                    : The use of the natural product, kratom, has increased significantly in recent years. The active compounds in kratom have been shown to produce both opioid and stimulant-like effects. While kratom is marketed as a safe, non-addictive method to treat pain and opioid withdrawal, there have been reports demonstrating that kratom is physiologically addictive and linked to overdose deaths. A limited number of case-reports are available describing treatment of kratom use disorder in middle-aged adults, generally in the context of chronic pain and in inpatient settings. Our case is unique in that we describe outpatient treatment of kratom use disorder in a young adult with comorbid attention deficit hyperactivity disorder (ADHD) and in the absence of chronic pain.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic toggle=\"yes\">Case:<\/jats:italic>\n                    A 20-year-old college student with ADHD presented to an office-based opioid agonist treatment clinic (OBOT) for treatment of kratom use disorder. He was unable to attend inpatient or residential substance use treatment due to work and school obligations. Additionally, he had stopped taking his prescribed stimulant due to cardiac side effects. The OBOT team successfully initiated buprenorphine-naloxone (BUP\/NAL) sublingual films via home induction to treat his kratom use disorder. The patient is being monitored monthly with plans to slowly taper his BUP\/NAL dose as tolerated.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic toggle=\"yes\">Discussion:<\/jats:italic>\n                    We present a case of a young adult male with kratom use disorder, complicated by a diagnosis of ADHD, successfully treated with BUP\/NAL via home induction. The patient is currently kratom-free, reports improved mood and sleep patterns since initiating BUP\/NAL, and is able to once again tolerate his ADHD stimulant medication. Healthcare providers should be aware of the use of kratom and consider utilizing BUP\/NAL to treat dependence to this botanical drug.\n                  <\/jats:p>","DOI":"10.1080\/08897077.2019.1671945","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T14:57:07Z","timestamp":1571842627000},"page":"311-314","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Home Induction and Outpatient Treatment of Kratom use Disorder with Buprenorphine-Naloxone: A Case Report in a Young Adult"],"prefix":"10.1177","volume":"41","author":[{"given":"Kelsey K.","family":"Schmuhl","sequence":"first","affiliation":[{"name":"The College of Pharmacy, The Ohio State University, Columbus, Ohio, USA;"},{"name":"Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spencer M.","family":"Gardner","sequence":"additional","affiliation":[{"name":"The College of Medicine, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8126-4950","authenticated-orcid":false,"given":"Casey B.","family":"Cottrill","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA;"},{"name":"The College of Medicine, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5874-1942","authenticated-orcid":false,"given":"Andrea E.","family":"Bonny","sequence":"additional","affiliation":[{"name":"The College of Medicine, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"issue":"12","key":"e_1_3_4_2_2","first-page":"792","article-title":"Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects","volume":"112","author":"Prozialeck WC","year":"2012","unstructured":"Prozialeck WC, , Jivan JK, , Andurkar SV. Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. J Am Osteopath Assoc. 2012;112(12):792\u2013799.","journal-title":"J Am Osteopath Assoc."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1811055"},{"issue":"20","key":"e_1_3_4_4_2","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1001\/jama.2019.6339","article-title":"Kratom-related deaths","volume":"321","author":"Kuehn B","year":"2019","unstructured":"Kuehn B. Kratom-related deaths. J Am Med Assoc. 2019;321(20):1966.","journal-title":"J Am Med Assoc."},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bks073"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.5811\/cpcem.2018.11.40588"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000428"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000435"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002871"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1807054"},{"key":"e_1_3_4_11_2","unstructured":"U.S. Food and Drug Administration. FDA issues warnings to companies selling illegal unapproved kratom drug products marketed for opioid cessation pain treatment and other medical uses. https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-issues-warnings-companies-selling-illegal-unapproved-kratom-drug-products-marketed-opioid. 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Accessed May 10 2019."},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1806486"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000035"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6814a2"},{"key":"e_1_3_4_18_2","first-page":"1","article-title":"Non-prescribed buprenorphine use mediates the relationship between heroin use and kratom use among a sample of polysubstance users","author":"Smith KE","year":"2019","unstructured":"Smith KE, , Bunting AM, , Walker R, , Hall MT, , Grundmann O, , Castillo O. Non-prescribed buprenorphine use mediates the relationship between heroin use and kratom use among a sample of polysubstance users. J Psychoactive Drugs. 2019;1\u201312. [epub ahead of print].","journal-title":"J Psychoactive Drugs."},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/14659891.2018.1436599"},{"key":"e_1_3_4_20_2","unstructured":"National Institutes of Health. What complementary and integrative approaches do Americans use? Key findings from the 2012 National Health Interview Survey. https:\/\/nccih.nih.gov\/research\/statistics\/NHIS\/2012\/key-findings. 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