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What are the risks? How safe is it?
If kratom is chewed or taken as a tea by itself (without mixing it with other drugs), the greatest risk is falling asleep while engaged in hazardous activities. NEVER drive while under the influence of kratom, even if you feel stimulated, rather than sleepy, for sleepiness may come on you without warning. Use common sense. Do not use power tools, or climb ladders while under the influence of kratom. Be careful not to leave a pot on a lit stove and then fall asleep.
Pregnant women should not take any drug or medication except on medical advice. Since there have been no studies of the risks of kratom use by pregnant women, it is not known whether it could cause birth defects or fetal death. We strongly recommend that any woman who could possibly be pregnant NOT use kratom."
I have a FOAF (literally lol) who is an opiate addict. She just found out she's a couple months pregnant. She tried to withdraw but it was causing contractions, and the doctor told her that withdrawal is a serious miscarriage risk and wants her on a suboxone program. Now, one thing that my rat has learned through long years is that he does not believe in maintenance opiates. The purpose of replacement therapy is to keep you addicted to something so that you don't have the reckless pleasure-seeking behavior of actually wanting to do good opiates. Its also impossible (in my rats experience), to taper down using a substance such as suboxone or methadone, whose tolerance curve is such that you will reach a plateau of mild pleasure, where you feel very little euphoria, just a bunch of secondary effects. And you're loathe to go down from there, as A) its super long acting and B) theres no euphoria, even in small doses.
I'm sure every opiophile out there has experienced the sensation of taking a small to medium amount of opis during deep withdrawals. One will experience euphoria and withdrawals at the same time. This is the basic idea behind tapering down, in my estimation. You start off at say 60mg morphine per day, which has a metabolic life of say 48-72 hours. So every 2-3 days, you reduce by 6 mg, and in 30 or so you're at baseline with very little physical withdrawal to cope with. This cycling down is, as I mentioned, almost impossible with maintenance opis, and difficult with high-euphoria street opis (as when you're around that type of social group theres always the temptation to just F*** the plan and get high.) This is where the kratom comes in. My rat successfully switched his addiction to kratom (previously methadone 10mg twice a day, before that suboxone 4-8mg a day, before that hydromorphone whenever he could get it) and has had no thoughts of returning to opis, but hasn't really wanted to taper down because, dammit, he LIKES being euphoric. He's also not pregnant, however.
Sooooo my question is. Safety of kratom for use in getting off of opiates during pregancy. We're talking about two strong doses a day, reduced by say 10% every 3-4 days. Is there miscarriage risk? Is there any sort of documented risk at all, any sort of history of human use? Or is it all just a black void? Because, if its no more damaging to the fetus than opiates, I think it would be highly preferable to taper down while the things still in the womb, rather than having it be born with long-acting withdrawals (as if life wasn't horrifying enough.) The medical profession will be no help beyond expediting treatment for my friend.
So, lend me an opinion, hazard a guess, point me to some paper I missed. Is Kratom relatively safe to use to get off of opiates during pregnancy, or should my friend just get on a program and doom the baby to a congenitally overstimulated dopamine system? Your thoughts would be greatly appreciated.
I dont think anyone can give you a clear answer, as to the besy of my knowledge there are no studies on how kratom might interact with pregnancy. In fact there is very little scientific data available on kratom at all.
There is probably a lot more information available regarding other opiates and the possible issues with use during pregnancy.
I dont think it would be wise for anyone to make a guess, i certainly hope you would not take a persons guess onboard when making a decision on what to do.
While i believe that kratom is far safer to use than traditional opiates, that does not for one second mean it might not cause problems for an unborn baby.
Sorry, i hope you manage to curtail all drug use if in anyway possible, but you should probably discuss this with a doctor who might have better information. While they might not know about kratom they might be able to come up with some ideas based on what (if anything) is known about opiate receptor stimulation during pregnancy, or something else.
Remember that Kratom has many alkaloids, only a few of them give the opiate like effects, the others might pose their own problems when taken during pregnancy.
One thing to note, and I'm no doctor, is that kratom is related to coffee and coffee is a big no-no during pregnancy. Ianzombie is right on the money when he says that kratom has a lot of alkaloids, and only some of them are responsible for the opiod effects. There's just not enough reliable medical data to say whether or not it's safe during pregnancy and a guess isn't a good idea when pregnant. I would tell your friend to follow the doctor's recommendation and maintain on whatever during pregnancy, then make the switch.
Most if not all opioids fall under undetermined or cat C (risk not ruled out) and seeing as kratom interacts with delta and mu opioid receptors I think it would be fair to at least treat them as such and do not take kratom when pregnant.
Kratom likely interacts with other receptors in the body as well when you consider the quite unique energy boost kratom can provide. So really there is likely a higher risk
Doctors don't give anything heavier than acetaminophen unless the benefit to risk ratio is necessary.
First, may I add my voice to the clamour of opinion that kratom in pregnancy is an unknown quantity and therefore best avoided.
That said, I do not think that we have any solid reason to believe that it would be harmful: we should recognise that this is pure speculation either way, and therefore playing it safe by abstaining makes sense (given that it's only a few months of your life).
This interested me:
Originally Posted by Karmageddon
One thing to note, and I'm no doctor, is that kratom is related to coffee and coffee is a big no-no during pregnancy.
I'd never heard that, despite the fact that I've got three kids so I've heard quite a lot of advice of that nature! A quick web search didn't immediately turn much up, just a warning about too much coffee that's high in caffeine. Is that why you say that coffee is a no-no - because of the caffeine content?
yesterday i thought i was pregnant, did a ton of drugs and realised that all it was was a huge shit. In retrospect i realise that males cant get pregant. I just wish somebody had explained this to me before, would of saved me a ton of stress.
One's personal feeling regarding maintenance treatments for an adult human being are fine, but we're talking about a fetus here who can't make any choices of its own, is dependent upon said human, and is at a very high risk of miscarriage due to opioid withdrawal.
The purpose of methadone during pregnancy is to eliminate opioid withdrawal during the pregnancy. If the adult human being wants the fetus to develop into a healthy baby, the best thing to do would be to take the methadone, then reduce it right after labor. The adult will be on methadone less than 9 months; this isn't very long in the grand scheme of things.
Anything else that might be considered needs to be certain that it is long-acting - your goal is to prevent withdrawal symptoms at all cost. Short-acting opioids leave one with large peaks & troughs in the blood serum levels of said opioids, & the constant up & down is dangerous to a fetus.
If someone wanted to let this fetus develop into a healthy baby, why would someone want to expose it to such a huge unknown factor? Things that are safe for adults aren't necessarily safe for children, and we often know even less about something's safety profile regarding a fetus.
If it is desired to let said fetus develop, it would be best to get on methadone or buprenorphine ASAP. ORT might suck a bit for the adult human being, but the adult human being is gonna have to start getting used to doing things that suck for it for the good of the adult's offspring.
It's not terribly difficult to get off of ORT, just time consuming if one wants to do it properly & prevent immediate relapse. The adult human being can start the taper as soon as she leaves the hospital, and work her way down from there. Additionally, she may not even require that high of a dose, making it even easier for her to taper when she wants to.
Is that why you say that coffee is a no-no - because of the caffeine content?
Yes, I believe a lot of it has to do with the caffeine content. My best friend is a total coffee fiend and has been told to abstain during her pregnancy and other pregnant friends of mine have been cautioned against drinking coffee as well. Here's what I came up with on my Google search:
"The March of Dimes advises women to limit their caffeine intake to less than 200 mg per day (that's about one 12-ounce cup of coffee). This recommendation was prompted by the results of a study published in the March 2008 issue of the American Journal of Obstetrics and Gynecology that showed that moms-to-be who consumed 200 mg or more of caffeine a day had double the risk of miscarriage compared with those who had no caffeine."
Also, "Because caffeine causes blood vessels to constrict, it may reduce blood flow to the placenta. And because it easily crosses the placenta and reaches your baby (who then metabolizes it very slowly), caffeine may directly affect your baby's developing cells.
A study in Denmark found that the risk of stillbirth more than doubled in women who drank a great deal of coffee per day – eight cups or more – compared with women who didn't drink coffee. Some studies suggest that high caffeine consumption may slightly reduce a baby's birth weight, but other research has shown no association.
One study found a link between maternal caffeine consumption equal to three cups of coffee per day and an increased risk of having a son born with undescended testes. This happens when the testes don't move from the pelvis into the scrotum as they usually do in late pregnancy.
Other research has shown that newborns whose mothers consumed more than 500 mg of caffeine a day had faster heart rates and breathing rates and spent more time awake in the first few days after birth."
I know this is not necessarily about kratom (I have no idea if kratom has caffeine in it or not) but given that it's closely related, I would be very cautious about using it during pregnancy. That was the point I was trying to make.