Kratom Use in Primary Care: A Nurse Practitioner Case Study and Clinical Considerations.

AIMS: To describe the clinical presentation, diagnostic challenges, and successful management of kratom withdrawal syndrome in a primary care setting, and to highlight the need for increased clinical awareness of this emerging substance use disorder. DESIGN: Single case report. METHODS: Clinical case description of a 42-year-old male presenting with acute withdrawal symptoms after abrupt cessation of long-term kratom use. The patient's clinical course, differential diagnoses, treatment approaches, and response to buprenorphine/naloxone therapy are documented. RESULTS: The patient presented with severe insomnia, restlessness, anxiety, and agitation after stopping kratom. Initial symptomatic treatments (lorazepam, quetiapine) were ineffective. After psychiatric consultation and treatment as opioid withdrawal with buprenorphine/naloxone, the patient experienced rapid symptom resolution with a limited medication course and no relapse. CONCLUSIONS: Kratom withdrawal presents significant diagnostic and therapeutic challenges in primary care due to limited clinical awareness, lack of standardized assessment tools, and absence of treatment guidelines. This case underscores the importance of considering kratom in differential diagnoses of unexplained withdrawal symptoms, the effectiveness of opioid-based treatment approaches, and the critical need for interdisciplinary collaboration, enhanced clinical education, and evidence-based protocols to manage emerging substance use disorders.