Kratom Withdrawal: A Case Report and Review of Epidemiology, Incidence, and Prevalence

Why it matters

A severe case of kratom withdrawal resulting in cardiac arrest highlights the serious neurological and cardiovascular risks associated with sudden cessation after chronic high-dose use. This is particularly relevant for patients with opioid use disorder history.

The big picture

While kratom withdrawal has generally been considered milder than opioid withdrawal, emerging clinical evidence shows severe cases can occur, especially in individuals with pre-existing opioid use disorder. The case demonstrates the importance of medical supervision during kratom discontinuation. Early intervention with medications like buprenorphine may prevent life-threatening complications.

Key findings

• A 29-year-old with opioid use disorder history consumed 5-7 kratom shots daily and developed life-threatening withdrawal symptoms upon cessation
• Withdrawal symptoms included hypoxia, confusion, intractable rigors, and eventual cardiac arrest requiring 23 minutes of CPR
• Patient was sedated and mechanically ventilated for 8 days with no identifiable cause for cardiac arrest except kratom withdrawal
• Most common withdrawal symptoms documented: agitation, tachycardia, drowsiness, vomiting, and confusion
• Opioid agonists like buprenorphine may have prevented severe complications if administered early

What they say

""Kratom withdrawal can cause severe, potentially fatal complications in high-dose users with opioid use disorder history, requiring early medical intervention and consideration of buprenorphine treatment."" — Goodwin et al., Ocean University Medical Center

Bottom line

**Kratom withdrawal can cause severe, potentially fatal complications in high-dose users with opioid use disorder history, requiring early medical intervention and consideration of buprenorphine treatment.**