Ann Intern Med (2020) 173(1):59–60. (2019) 24:575–7. The abuse potential of kratom according the 8 factors of the controlledsubstances act: implications for regulation and research. Opioid use disorder and the COVID 19 pandemic: A call to sustain regulatory easements and further expand access to treatment. Risks of severe COVID and intensified mental health issues in people who use drugs (PWUD) include: physical comorbidity, e.g., lung or cardiovascular disease, HIV, viral hepatitis infections; psychological comorbidity, e.g., general distress, sleep disorders, anxiety/mood disorders, psychotic symptoms; and homelessness, incarceration, economic difficulties, and socioeconomic issues deriving from drug addiction (8, 11, 27, 28). When Epidemics Collide: Coronavirus Disease 2019 (COVID-19) and the Opioid Crisis. Journal Impact 2019-20; Frontiers in Psychiatry; Abréviation. Kratom as a substitute for opioids: results from an online survey. Abuse of medications that theoretically are without abuse potential. doi: 10.7326/M20-1210, 41. In an unexpected situation, if there is an imminent increase in kratom fatalities/toxicities arising from the COVID-19 pandemic, enforcement agencies may use the scenario as a precedent to legally or effectively ban kratom use. Psychiatry 11:574483. doi: 10.3389/fpsyt.2020.574483. Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. https://www.statnews.com/2020/03/17/covid-19-will-worsen-the-opioid-overdose-crisis-if-we-dont-prepare-now/ (Accessed May 25, 2020). (2014) 139:132–7. Advisory Council on the Misuse of Drugs (ACMD). Supplemental Research Bulletin. Alternative drugs or medications might be considered by users including quetiapine, gabapentinoids, Z-drugs (e.g., zolpidem) (37–39) and some Over-The-Counter (OTC) medications (37, 38), such as codeine; ephedrine and pseudoephedrine; and the antidiarrhoeal loperamide (“poor man’s methadone”). The widespread use of kratom and consistent reports of its benefits or therapeutic value that are important to users raises the question: would sudden decreases in the availability of the plant have negative impacts on kratom users? Import Alert 54-15. Risk of death associated with kratom use compared to opioids. These issues can also encourage shifts to more at-risk drug using behaviours such as use of drugs such as street benzodiazepines, and synthetic cannabinoids (31). Swogger MT, Walsh Z. Kratom use and mental health: a systematic review. Reger MA, Stanley IH, Joiner TE. Becker WC, Fiellin DA. Front. doi: 10.1080/14659891.2019.1638459, 7. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. (2004) 52:916–28. 35. Taux d'acceptation. The implications of COVID-19 for people who use drugs (PWUD) and drug service providers (March 2020). Brain Behav Immun (2020) 0889–1591(20):30643–7. Developing multidisciplinary support platforms could be helpful in reducing the mental distress due to misinformation and teaching problem-solving strategies to cope with the pandemic (13). Smith K, Ostinelli E, Cipriani A. Covid-19 and mental health: a transformational opportunity to apply an evidence-based approach to clinical practice and research. Silver Spring, MD: US Food & Drug Administration (2019). Brain Behav Immun (2020) 87:56–8. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. (2019) 57:847–54. Psychopharmacology (Berl). WellBeingTrust.org. Loop enables you to stay up-to-date with the latest discoveries and news, connect with researchers and form new collaborations. Nonetheless, in the US it is estimated that 10–15 million people consume kratom primarily for the self-treatment of pain, psychiatric disorders, to mitigate withdrawal from or dependence on opioids, and to self-treat opioid use disorder or other substance use disorders (SUDs). Hollander & Carr (36) compared and contrasted the acceptability and impact of telemedicine versus in-person consultations. https://www.epicentro.iss.it/en/coronavirus/sars-cov-2-stress-management-healthcare-workers (Accessed July 7, 2020). According to a recent study from the Well Being Trust (18) the high levels of stress, isolation and unemployment due to the COVID-19 pandemic could cause up to 75,000 “deaths of despair” related to deaths to drug, alcohol, and suicide (18). Inadequate treatment, treatment barriers, and increases in the sales of adulterated kratom products on the internet or in convenience stores could exacerbate circumstances further. 1. Chevance A, Gourion D, Hoertel N, Llorca PM, Thomas P, Bocher R, et al. Due to the global COVID-19 pandemic, a shortage in the supply of kratom products may place unexpected burdens on kratom users, potentially influencing some who use kratom for SUD self-treatment to regress to harmful drug use, hence increasing the likelihood of adverse outcomes, including overdose. Henningfield JE, Fant RV, Wang DW. Zhu S, Wu Y, Zhu CY, Hong WC, Yu ZX, Chen ZK, et al. Chicago, IL: American Medical Association, Center AR (2020). All authors contributed to the article and approved the submitted version. Previous disasters such as the Severe Acute Respiratory Syndrome (SARS) in … Impact Factor: 2.118 ℹ Impact Factor: 2019: 2.118 The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. JAMA Psychiatry (2020). Loop is the open research network that increases the discoverability and impact of researchers and their work. In this context, due to the disruption of drug markets, reduced supply and access to illicit drugs, internet drug-seeking activities may be on the increase. (2019) 128:105851. doi: 10.1016/j.ypmed.2019.105851, Keywords: COVID-19, kratom, SUD, OUD, withdrawal, Citation: Singh D, Brown PN, Cinosi E, Corazza O, Henningfield JE, Garcia-Romeu A, McCurdy CR, McMahon LR, Prozialeck WC, Smith KE, Swogger MT, Veltri C, Walsh Z and Grundmann O (2020) Current and Future Potential Impact of COVID-19 on Kratom (Mitragyna speciosa Korth.) South Med J (2015) 108(3):151–7. 20. Copyright © 2020 Singh, Brown, Cinosi, Corazza, Henningfield, Garcia-Romeu, McCurdy, McMahon, Prozialeck, Smith, Swogger, Veltri, Walsh and Grundmann. ISSN: 1662-5129. Covid-19 will worsen the opioid overdose crisis is we don"t prepare now (2020). Research Topics ... For more information: Frontiers’ Report. (2019) 202:24–32. 27. Hunger for Opioid Alternative Drives Boom in Borneo Jungle. See the latest science, research & news from Frontiers, an open access publisher of some of the world's most-cited journals including neuroscience, human neuroscience, immunology, plant science and more. All authors revised and finalized the paper. 22. Psychiatry Res (2020) 28:113145. doi: 10.1016/j.psychres.2020.113145. The number of kratom users outside of Southeast Asia has increased significantly in recent decades with use spreading to the Unites States (US) and Europe. Projected Deaths of Despair During the Coronavirus Recession. http://www.emcdda.europa.eu/publications/topic-overviews/covid-19-and-people-who-use-drugs_en (Accessed May 19, 2020). Wand APF, Zhong B-L, Chiu HFK, Draper B, De Leo D. Covid-19: The implications for suicide in older adults. ISSN: 0165-1781. Rusmana Y, Einhorn B. U.S. Chem Pharm Bull (Tokyo). Impact Factor: 2.118 ℹ Impact Factor: 2019: 2.118 The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. 18. Silver Spring, MD: Food and Drug Administration (2020). Cinosi E, Martinotti G, Simonato P, Singh D, Demetrovics Z, Roman-Urrestarazu A, et al. Green TC, Bratberg J, Finnell DS. Drug Alcohol Depend. High risk of mental illness was previously identified in individuals with existing or history of mental illnesses (1, 9, 12, 14, 19), but also vulnerable categories might be considered the elderly (>80 years old), children/adolescents, individuals from deprived areas, peri-natal women and BAME (Black, Asian and minority ethnicities) (1, 12, 14, 19). https://www.cdc.gov/coronavirus/2019-ncov/hcp/mental-health-healthcare.html (Accessed July 7, 2020). Impact Factor. Temps de Révision. Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic (2020). |, https://doi.org/10.3389/fpsyt.2020.574483, https://www.americankratom.org/mediak/news/consumer-alert-on-covid-19-claims-and-kratom.html, Creative Commons Attribution License (CC BY). Kruegel AC, Grundmann O. FDA. Citations (Scopus total) Articles published (total) ... Frontiers in Psychiatry. Impact Factor 2.849 | CiteScore 3.2More on impact ›, Drug and Behavioral Addictions During Social-Distancing for the COVID-19 Pandemic The Journal Impact 2019-2020 of World Psychiatry is 24.030, which is just updated in 2020. Received: 03 September 2020; Accepted: 18 November 2020; Published: 11 December 2020. 19. Drug Alcohol Depend. 30. Subst Abuse (2017) 11:1178221817696077. doi: 10.1177/1178221817696077, 42. (2016) 126:41–6. https://www.gov.uk/government/publications/acmd-advice-on-covid-19-emergency-legislation-to-enable-supply-of-controlled-drugs (Accessed May 21, 2020). Chronic consumption at high doses has a potential to cause dependence and withdrawal symptoms (5) consistent with a Substance Use Disorder (SUD) (6, 7). Smith KE, Lawson T. Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program. This is a serious concern as kratom, not currently regulated as a dietary supplement, may be adulterated by unscrupulous traders and cause users to relapse to opioid use and inevitably experience a significant increase in overdose risk (7, 9, 14–17). Healthcare providers, including pharmacists, and public health policies are challenged to: develop strategies to implement prevention measures against transmission of COVID-19 in drug users settings, such as preventing overcrowding or sharing drug-using equipment; and ensure continuity of care for drug-users and people with SUDs. doi: 10.1248/cpb.52.916, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. The Journal Impact 2019 of Frontiers in Psychiatry is 3.360, which is just updated in 2020. Kawohl W, Nordt C. COVID-19, unemployment, and suicide. Int Psychogeriatr (2020), 16. doi: 10.1017/S1041610220000770. Often overlooked in this scenario are those with SUD (26, 27), who may experience: (a) changes in levels of drug use—an increase is often seen as a reactive behaviour to negative impact of disasters; (b) a shift to other substances if access to those previously used become limited; (c) a relapse, if they had already recovered from alcohol/drug addiction. doi: 10.1016/j.drugalcdep.2017.08.034, 11. doi: 10.1016/S2215-0366(20)30168-1, 3. According to published user surveys, common reasons for kratom use include the self-treatment of acute and chronic pain, psychological distress, mitigation of dependence and/or withdrawal symptoms from an illicit or prescription drug use (7, 9, 15). J Clin Psychiatry (2020) 81(3):20com13370. https://www.samhsa.gov/sites/default/files/dtac/srb_sept2015.pdf (Accessed May19, 2020). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. N Eng J Med (2020). doi: 10.1056/NEJMp2008017, 12. doi: 10.1136/ebmental-2020-300155, 4. (2015) 2015:968786. doi: 10.1155/2015/968786, 15. In line with this, rogue/illicit pharmaceutical products, such as benzodiazepines, has also reportedly doubled their prices in some areas (24). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Though kratom vendors noticed an increased demand for kratom products among users in recent months, they did not perceive that the increase was associated with a novel indication or different uses of kratom. Kratom (Mitragyna speciosa Korth., Rubiaceae) is a tree native to Southeast Asia with psychoactive properties due to the presence of indole alkaloids (1, 2). Front. Kratom withdrawal symptoms are similar to those of opioids but with lower severity, presenting with transient gastrointestinal upset, muscle and nerve pain, insomnia, sweating, tremor, fatigue, and psychological distress including restlessness, irritability, increased cravings, depressed mood, and anxiety. COVID-19: ACMD advice on proposed legislative changes to enable supply of controlled drugs during a pandemic (April 2020). Drug Enforcement Administration (DEA). New York, NY: Bloomberg (2018). doi: 10.1016/j.neuropharm.2017.08.026, 3. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi (2020) 38(3):192–5. Aggregated COVID-19 suicide incidences in India: Fear of COVID-19 infection is the prominent causative factor. A first-of-its-kind study published in Frontiers in Psychiatry found that more than a third of medical staff responding to the outbreak during its peak in China suffered from insomnia. (2017) 134:108–120. Agapoff JR, Kilaru U. Outpatient buprenorphine induction and maintenance treatment for kratom dependence: a case study. Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm? Elderly suicide and the 2003 SARS epidemic in Hong Kong. Received: 24 June 2020; Accepted: 05 November 2020; Published: 26 November 2020. Warning Letter, The Golden Road Kratom, MARCS-CMS 607627. Similarly, due to COVID-19, manual laborers who were daily wage earners lost their income and could not afford kratom products to self-treat medical conditions. 15. WHO. doi: 10.1016/j.drugalcdep.2014.03.017, 6. Monitoring psychosocial needs and delivering psychosocial support to vulnerable patients as well as healthcare workers should be provided (2, 3, 8, 42, 43). Garcia-Romeu A, Cox DJ, Smith KE, Dunn KE, Griffiths RR. Reduced kratom access may also negatively impact the well-being of individuals who use kratom for the acute relief of psychological distress at a time of increasing socioeconomic uncertainty and stress. doi: 10.1136/gpsych-2020-100260, 25. doi: 10.1021/acs.jmedchem.6b00748, 4. The handling editor and two of the reviewers, JC and SC, declared a shared affiliation, though no collaboration, with two of the authors, EC and OC, at the time of review. 2019-2020 Frontiers in Psychiatry 影响指数是 3.360。 Frontiers in Psychiatry的最新影响指数分区 為1区。 Psychiatry and Mental Health: Publisher: Frontiers Media S.A. Does not comply with these terms Ye Bing Za Zhi ( 2020 ) their kratom consumption during COVID-19 Prevalence motivations! Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of researchers. 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