{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:10:16Z","timestamp":1756372216148,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,2]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Kratom is an herbal product derived from Mitragyna speciosa which, depending on the dose, has stimulant and opioid-like effects and is increasingly being used recreationally to self-medicate symptoms of anxiety and depression. This case describes a man in his 30\u2009s who presented to a community drug and alcohol service seeking support for problematic Kratom use, which he started using to try and manage obsessive-compulsive disorder symptoms and low mood. Despite attempts to reduce his use, he was unable to discontinue Kratom use independently. Initiation of low-dose sublingual buprenorphine led to complete abstinence within 3\u2009weeks. This case highlights not only the potential use of low-dose buprenorphine to manage Kratom withdrawal but also the complexity in managing co-existent mental health disorders in addiction services, emphasising the importance of psychiatry within a multidisciplinary approach.<\/jats:p>","DOI":"10.1136\/bcr-2025-265834","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T18:50:19Z","timestamp":1750013419000},"page":"e265834","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of obsessive compulsive disorder and Kratom dependence with buprenorphine and supportive care"],"prefix":"10.1136","volume":"18","author":[{"given":"Filipa","family":"Teixeira","sequence":"first","affiliation":[{"name":"South West London and Saint George\u2019s Mental Health NHS Trust, London, England, UK"},{"name":"South London and Maudsley NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluwatobi","family":"Ajewole","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9301-6508","authenticated-orcid":false,"given":"Mihai","family":"Picior","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Foundation Trust, London, England, UK"},{"name":"Brighton and Sussex Medical School, Brighton, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmert","family":"Roberts","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Foundation Trust, London, England, UK"},{"name":"National Addiction Centre, King\u2019s College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,15]]},"reference":[{"key":"2025082801321511000_18.6.e265834.1","first-page":"792","article-title":"Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects","volume":"112","author":"Prozialeck","year":"2012","journal-title":"J Osteopath Med"},{"key":"2025082801321511000_18.6.e265834.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugalcdep.2020.107849","article-title":"Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic","volume":"208","author":"Garcia-Romeu","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"2025082801321511000_18.6.e265834.3","unstructured":"NICE . Overview | obsessive-compulsive disorder and body dysmorphic disorder: treatment | guidance. NICE; 2005. Available: https:\/\/www.nice.org.uk\/Guidance\/CG31"},{"key":"2025082801321511000_18.6.e265834.4","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/jcpp.12915","article-title":"A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism","volume":"59","author":"Weiss","year":"2018","journal-title":"J Child Psychol Psychiatry"},{"key":"2025082801321511000_18.6.e265834.5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s40263-019-00637-z","article-title":"Buprenorphine Treatment for Opioid Use Disorder: An Overview","volume":"33","author":"Shulman","year":"2019","journal-title":"CNS Drugs"},{"key":"2025082801321511000_18.6.e265834.6","doi-asserted-by":"crossref","DOI":"10.1002\/hup.2805","article-title":"A systematic review of (pre)clinical studies on the therapeutic potential and safety profile of kratom in humans","volume":"37","author":"Prevete","year":"2022","journal-title":"Hum Psychopharmacol"},{"key":"2025082801321511000_18.6.e265834.7","first-page":"54","article-title":"Pharmacotherapy for Management of 'Kratom Use Disorder': A Systematic Literature Review With Survey of Experts","volume":"120","author":"Stanciu","year":"2021","journal-title":"WMJ"},{"key":"2025082801321511000_18.6.e265834.8","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/10550887.2022.2066459","article-title":"Kratom & Stimulant Co-Addiction: A Case Series and Brief Review","volume":"41","author":"Sablaban","year":"2023","journal-title":"J Addict Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:32:23Z","timestamp":1756369943000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":8,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,15]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/bcr-2025-265834"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265834","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}