Kratom – A relative new drug in Washington State is becoming popular

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A heads up to parents and health care providers: I’ve recently had a surge of patients who come in or call us at Urgent Care due to the dangerous and addictive effects of Kratom, so I thought it was important to mention this drug since I’ve just recently learned about it.

Kratom has been used for many years in Southeast Asia as a painkiller, recreational drug and to treat diarrhea.  The substance originates from the leaves of the Kratom tree. In Washington State, it is sold in a capsule filled with the powdered leaf material.  It may also be chopped up and used to make tea, or smoked.

Kratom is in a newly defined class of drugs called “New Psychoactive Substances” named by the United Nations Office on Drugs and Crime.  It is listed in the same class of drugs as Khat (a plant from east Africa), Salvia divinorum (plant widely available in the USA), and synthetics Ketamine and Mephedrone.

Since Kratom is not technically considered illegal (yet), it is being sold at many recreational Marijuana shops in town, despite the dangerous and addictive effects that it has.  In Thailand, where it is widely used, it is illegal – in 2011, more than 13,000 people were arrested for Kratom-related crimes.

The effects of Kratom come on rather quickly and last between 5-7 hours.  It is abused for it’s sedative or stimulative effects.  At low dosages it is a stimulant, making a person more talkative, sociable, and energetic, but at higher doses it creates lethargy and euphoria.  The experience and effects are not pleasant for every user.

Possible Undesirable effects:  Nervousness, nausea & vomiting (can be severe), sweating, itching, constipation, delusions, lethargy, respiratory depression, tremors, aggressive behavior, psychotic episodes, hallucinations, paranoia.

Possible Addiction effects:  Loss of sexual desire, weight loss, darkening of skin on face, cravings for more of the drug.

Possible Withdrawl effects:  Diarrhea, muscle pain, tremors, restless & sleeplessness, severe depression, crying, panic episodes, sudden mood swings, irritability.

The Drug Enforcement Administration (DEA) was initially moving to ban its sale as of Sept. 30, citing an “imminent hazard to public safety.” In August, the DEA announced that it would make Kratom a Schedule 1 drug — the same as heroin, LSD, Marijuana, and Ecstasy. More recently, the DEA has however withdrawn its intent to make Kratom a Schedule 1 drug, and established a public comment period through Dec. 1. This is according to a preliminary document available on the Federal Register website and set to be published on Oct. 13. After the public comment period, the DEA could proceed with banning Kratom, (which would trigger another comment period,) take no action, or temporarily make Kratom a Schedule 1 drug.

If you or someone you know is having health problems due to Kratom, I recommend consulting your healthcare provider.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

Mystery Illness Seen in Washington State – AFM (Acute Flaccid Myelitis)

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Very recently, a handful of patients (8 children) in Washington State have recently been diagnosed with AFM (Acute Flaccid Myelitis) which is a rare condition that affects the central nervous system (spinal cord) and cause weakness in arms/legs, and possibly facial droop/weakness, difficulty with moving they eyes, drooping eyelids and/or difficulty with speech or swallowing. As of September, 2016 – 89 people in 33 states were confirmed to have the rare illness according to the CDC website.

Diagnosis:  If you think you or a family member has this condition, you should seek consultation with a medical provider.  But how do you know if it’s AFM that is causing the symptoms?  A doctor may be able to diagnose AFM by doing a careful examination and sometimes an MRI may also be helpful in assisting in the diagnosis.  An examination of the spinal fluid (which surrounds the brain) may be collected by a spinal tap (lumbar puncture) procedure and may aid in the diagnosis.

There are also nerve tests that can be done which may also aid in the diagnosis however they have to be done at 7-10 days after the onset of the illness.

Causes:  There are a number of viruses which have been though to possibly be the causal agents in the disease including enteroviruses (including polio), West Nile Virus, Japanese Encephalitis, Saint Luis Encephalitis, and various adenoviruses.

AFM is not the only cause of weakness in arms or legs:  Other causes can include viral infections, environmental toxins, genetic disorders, or GBS (Guillain-Barre syndrome).  There are neurological disorders such as stroke (cerebral vascular accident) that can also cause weakness in an arm or leg or facial drooping so it’s important to seem medical attention immediately (call 911) if you or someone you know has these symptoms.

Treatment:  No specific treatment exists for AFM, however a neurologist (nerve specialist) may be consulted to help make recommendations and help with the diagnosis.

If you or your child is having problems walking or standing, or develop sudden weakness in an arm or leg, you should contact a medical provider right away.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

*This information comes from the CDC website About Acute Flaccid Myelitis

Kauai – Hawaii Photo Journal

These are a few random photos from Kauai.  It’s one of my favorite places!