{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:02:51Z","timestamp":1780552971867,"version":"3.54.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Kratom is a habit-forming opioid-like substance with an acute toxidrome of various symptoms such as diaphoresis, dizziness, nausea, and vomiting. Chronic users require increasing dosages for the analgesic effects. Although kratom use dates back to the 1800s in Asia, kratom intoxication is still a novel (but increasing) toxidrome in the Western world. Here, we present a novel case of acute toxicity from overdose in a kratom-na\u00efve patient, taking place through recommendation by a family member who chronically takes this substance.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>We present the case of a 62-year-old woman arriving to the emergency department (ED) with a chief complaint of intractable vomiting after ingestion of kratom. After a day of yard work, she was in pain, secondary to her osteoporotic joints. She was recommended kratom from a family member, who stated he was using kratom to transition away from opioid dependence. She took two \u201cscoops.\u201d She proceeded to have multiple episodes of vomiting at home. She came to the ED, where she required multiple rounds of anti-emetic medication for resolution of her symptoms.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Discussion<\/jats:title>\n<jats:p>We present a classic case of a novel acute toxicity: kratom. A unique aspect of this case is the circumstance by which this toxicity took place: a family member who chronically takes this substance (that requires increasing dosages to remain effective) recommended a dosage to this kratom-na\u00efve patient, leading to overdose. This opioid family alternative substance is gaining popularity across the USA in the era of the opioid crisis. Further documentation of case reports and research is required to learn the associated risks of the use of this substance.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12245-020-00301-0","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T09:03:02Z","timestamp":1596618182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intractable nausea and vomiting in na\u00efve ingestion of kratom for analgesia"],"prefix":"10.1186","volume":"13","author":[{"given":"Vir","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadir","family":"Mulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Link","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Umansky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trilok","family":"Stead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7717-3864","authenticated-orcid":false,"given":"Latha","family":"Ganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"301_CR1","unstructured":"DrugFacts: Kratom | National Institute on Drug Abuse (NIDA), 2019, https:\/\/www.drugabuse.gov\/publications\/drugfacts\/kratom, Accessed 5 January 2020."},{"key":"301_CR2","unstructured":"Opioid Users Call Kratom a Godsend. The F.D.A. says it\u2019s a menace., 2019, https:\/\/www.nytimes.com\/2019\/04\/17\/us\/kratom-overdose-deaths.html, Accessed 5 January 2020."},{"key":"301_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bcr-2013-201554","volume":"2013","author":"JJ Gagnier","year":"2013","unstructured":"Gagnier JJ, Kienle G, Altman DG, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. BMJ Case Rep. 2013;2013:1\u20134.","journal-title":"BMJ Case Rep"},{"issue":"1","key":"301_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/ADM.0000000000000178","volume":"10","author":"R Saitz","year":"2016","unstructured":"Saitz R. International statement recommending against the use of terminology that can stigmatize people. J Addict Med. 2016;10(1):1\u20132.","journal-title":"J Addict Med"},{"issue":"2","key":"301_CR5","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.neubiorev.2012.11.012","volume":"37","author":"Z Hassan","year":"2013","unstructured":"Hassan Z, Muzaimi M, Navaratnam V, et al. From Kratom to mitragynine and its derivatives: physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev. 2013;37(2):138\u201351. https:\/\/doi.org\/10.1016\/j.neubiorev.2012.11.012.","journal-title":"Neurosci Biobehav Rev."},{"issue":"1","key":"301_CR6","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/0378-8741(88)90121-3","volume":"23","author":"KL Jansen","year":"1988","unstructured":"Jansen KL, Prast CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol. 1988;23(1):115\u20139. https:\/\/doi.org\/10.1016\/0378-8741(88)90121-3.","journal-title":"J Ethnopharmacol."},{"issue":"1","key":"301_CR7","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s00414-015-1279-y","volume":"130","author":"ML Warner","year":"2016","unstructured":"Warner ML, Kaufman NC, Grundmann O. The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. Int J Legal Med. 2016;130(1):127\u201338. https:\/\/doi.org\/10.1007\/s00414-015-1279-y.","journal-title":"Int J Legal Med."},{"issue":"1","key":"301_CR8","first-page":"49","volume":"115","author":"D Galbis-Reig","year":"2016","unstructured":"Galbis-Reig D. A case report of kratom addiction and withdrawal. WMJ. 2016;115(1):49\u201353.","journal-title":"WMJ."},{"key":"301_CR9","doi-asserted-by":"publisher","unstructured":"Fluyau D, Revadigar N. Biochemical benefits, diagnosis, and clinical risks evaluation of kratom. Front Psychiatry. 2017;8:62. Published 2017 Apr 24. doi:https:\/\/doi.org\/10.3389\/fpsyt.2017.00062.","DOI":"10.3389\/fpsyt.2017.00062"},{"key":"301_CR10","doi-asserted-by":"crossref","unstructured":"Anwar, Mehruba & Law, Royal & Schier, Josh. (2016). Notes from the field: kratom (Mitragyna speciosa) exposures reported to poison centers - United States, 2010-2015. MMWR. Morbidity and mortality weekly report. 65. 748-749. 10.15585\/mmwr.mm6529a4.","DOI":"10.15585\/mmwr.mm6529a4"}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-020-00301-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-020-00301-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-020-00301-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T23:13:48Z","timestamp":1628118828000},"score":1,"resource":{"primary":{"URL":"https:\/\/intjem.biomedcentral.com\/articles\/10.1186\/s12245-020-00301-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,5]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["301"],"URL":"https:\/\/doi.org\/10.1186\/s12245-020-00301-0","relation":{},"ISSN":["1865-1372","1865-1380"],"issn-type":[{"value":"1865-1372","type":"print"},{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,5]]},"assertion":[{"value":"4 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"HCA Centralized Algorithms for Research Rules on IRB Exemptions (CARRIE)\/IRB manager issued approval 2020-459.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of this case report was obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None of the authors have any conflict of interest to disclose. The manuscript is original and is not currently under revision with another journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42"}}