#533: What’s the Tea on Kratom?
Summary
Hosts Carolyn Chan and Xena Huxley-Riker interview Dr. John Tanawan about kratom and synthetic mitragynine derivatives like 7-OH. They discuss pharmacology, withdrawal management, and buprenorphine induction strategies for these substances. The episode also covers patient histories, regulatory challenges, and the clinical differences between natural kratom and potent synthetic analogs.
Topics discussed
Intro, disclaimers, and show welcome
Guest introduction: Dr. John Tanawan
Guest background and passion for addiction medicine
Clinical case: 29-year-old male with Kratom use
Kratom basics: alkaloids, forms, and designer compounds
Pharmacology: Mitragynine, 7-OH, and receptor effects
Sponsor breaks: FIGS and Freed
Patient history taking and reasons for use
Diagnosis controversies and usage statistics
Overdose risks and reversal agents
Withdrawal symptoms and timeline for Kratom vs 7-OH
Managing withdrawal: Clonidine and buprenorphine induction
Sponsor break: Continuing Education Company
Buprenorphine dosing strategies and precipitated withdrawal
Long-term treatment: Maintenance, tapering, and LAI
Behavioral interventions and DEA scheduling updates
Take-home points, resources, and outro
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