Why Kratom Should Be Illegal

Opioid medications are prescribed for patients with painful conditions and the response is typically excellent pain relief. There are side effects which may include constipation, tolerance, depression, and sedation. With chronic pain affecting 15% of the US population, doctors are prescribing narcotic medications with alarming frequency.
Is it possible for chronic opioid therapy to make patients worse? The answer is yes, and it is termed opioid-induced hyperalgesia (OIH). It is a paradoxical condition whereby patients become oversensitive to acute pain. There is a scarcity of literature on the subject of how often it occurs, what presents risk factors for its occurrence, and whether or why kratom should be illegal not there is a dosing relationship for narcotics towards developing OIH.
Most importantly, no known strategies exist for the prevention of OIH or exactly how it should be managed once it develops.
Opioid induced hyperalgesia is not kratom illegal just having a patient develop a tolerance to medication. If that occurs, the dosage may simply be increased to achieve desired effect. With OIH, this will not be the case since it is a form of sensitization induced by the drug and increasing the dose would only worsen the pain.
A patient with OIH might actually become more sensitive to certain painful stimuli from the medication. The type of pain that the patient experiences may be the same as the underlying pain or quite possibly could be different than the original pain.
It is unknown exactly why patients develop kratom OIH. illegal There is some research showing that genetics may be a predisposing factor, however, it has not been explored sufficiently. Other studies have shown kratom illegal an association between opioid metabolites and hyperalgesia (increased sensitivity to pain).
Numerous observations have shown most often the OIH occurs with chronic opioid exposure. The main thing it needs to be differentiated from is simple tolerance or clinical worsening of the patient’s baseline pain with need for higher dosing.
OIH typically produces diffuse pain, which often extends to regions that were not painful before. OIH tends to mimic opioid withdrawal with some of its symptoms along with increased pain. Additionally, if the patient is dealing with tolerance, an increase in dose would lessen the pain. This does not happen with OIH, in fact, the pain would be worsened.
Treatment of OIH can be time-consuming, perplexing, and stressful for both the physician and patient. Rotating to a different opiate class may help. Trying non-opioid medications and decreasing opiate dosing is often helpful, along with administering interventional pain treatments to reduce the need for medications or eliminate the need altogether.
If these options are not possible or do not help sufficiently, the following may be attempted:
Attempt combination therapy with Cox-2 NSAID medications
Utilize a class of medications called NMDA receptor antagonists
Increase the opioid dose to see if it works, and the patient is dealing with tolerance rather than OIH.
Use opioids like methadone or buprenorphine which have properties with the potential to prevent or reduce OIH.
Opioid induced hyperalgesia should be considered when patients are failing chronic opioid therapy. It is becoming more prevalent as the number of patients receiving chronic pain medications has increased considerably over the past decade.