Release the Kratom: Post-Acute Withdrawal Syndrome in a 70 Year Old Male

Centuries in Eastern medicine.. Kratom has been commonly used for chronic pain and opiate withdrawal symptoms with first reported cases in the United States in the early 2000s. It is a plant that consists of psychoactive alkaloids that target opioid receptors with different affinity. Effects from Kratom are dose-dependent, at lower doses, it acts as a stimulant, while at higher doses produces analgesia and euphoria. Although Kratom is legal and easily accessible over the counter, there have been increasing reports of potential for addiction and toxicity. Cessation of Kratom can result in withdrawal symptoms similar to opiate withdrawal. Here we discuss a case of a 71 year old male with inadvertent Kratom dependence, who had prolonged withdrawal weeks after cessation and required management of dysphoric mood and insomnia symptoms persisting after withdrawal