Medication-Assisted Treatment for Kratom Use Disorder

Introduction to MAT

• The American Society of Addiction Medicine identifies Medication-Assisted Treatment (MAT) as the gold standard for opioid use disorder, combining medications with behavioral therapies 1

Evidence for MAT in Kratom Use Disorder

• For patients with opioid use disorder (which includes kratom-related opioid receptor agonist dependence), treatment with buprenorphine/naloxone is essential if the clinician is DEA-waivered, or referral to addiction treatment should be arranged 2, 3

MAT Implementation for Kratom Users

• Physicians can obtain a DEA waiver through SAMHSA-approved training to prescribe buprenorphine in office-based settings 3
• Clinicians without a waiver should arrange referral to a substance use disorder treatment specialist or SAMHSA-certified opioid treatment program 3
• Combined pharmacotherapy with cognitive-behavioral therapy (CBT) shows greater efficacy than pharmacotherapy alone 1

Critical Safety Considerations

• The FDA has warned against kratom use and recommended discontinuation when possible, particularly in perioperative settings due to opioid agonist properties and withdrawal potential 4

Harm Reduction Approach

• Offer naloxone for overdose prevention, as recommended for all patients with opioid use disorder 3
• Provide harm reduction services including safe use education and referral to appropriate programs 1