The U.S. government has twice tried to classify kratom as a controlled substance, but public outcry and pushback from Congress thwarted those efforts.

A 2017 survey of about 2,800 self-described kratom users in the U.S. showed that they\’re typically middle-aged and white, and use the substance to treat the symptoms of anxiety, depression, pain and opioid withdrawal.

A World Health Organization meeting next week could determine the future of kratom, a widely available herbal supplement some tout as an alternative to opioid painkillers, in the U.S. and elsewhere.

Kratom, a plant indigenous to Southeast Asia, produces narcotic-like effects when smoked or taken in liquid or capsule form. Its advocates say the substance is a promising replacement for opioids that could help wean people addicted to those drugs, which killed nearly 70,000 people in the U.S. in 2020.

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Rapid detox, sedation-assisted detox, nor any other form of detoxification under anesthesia is not a cure for addiction and should not be described as one.

For individuals struggling with opiate dependence, detox and, subsequently, withdrawal symptoms can be the first step in gaining freedom. Successful opioid detoxification can help accomplish this goal. Rapid detox allows for a complete detoxification from opiates while the patient is under sedation. The process is also beneficial because it enables the patient to immediately start Naltrexone or Vivitrol therapy, both non-addictive drugs that significantly help reduce physical cravings after detox. Controlled studies have found that this form of detoxification is both practical and cost-effective.

However, it\’s important to note that not all forms of detoxification under sedation are the same. Since anesthesia detox was developed in 1988, centers have adopted various protocols; some might even promise complete treatment after one day. While the idea of immediate relief from opioid dependency and the withdrawals accompanying detoxification efforts may appeal to those in the grip of addiction, such promises are not fair, accurate, and sadly enough, often not safe.

The continued use of opioid drugs causes the body to become dependent. Opioid dependence leads to withdrawal symptoms, which makes it difficult to discontinue use. Once a user stops using opioids, the body goes through tremendous physical and emotional distress associated with withdrawal. Symptoms can include muscle pain and spasms, gastrointestinal distress like nausea or vomiting, depression and anxiety, fatigue, and sleeplessness. Dependence is often followed by addiction. Addiction occurs when opioid dependence interferes with daily life. Symptoms of addiction include uncontrollable cravings and the inability to control drug use regardless of the adverse effects on every aspect of one\’s life. 

Although rapid detox, sedation-assisted detox, or any other form of detoxification under anesthesia might be extremely appealing, it is not a cure for addiction and should not be described as one. Withdrawal symptoms may be too challenging and physically unsafe for a person already physically and emotionally in a fragile state, making medically supervised detoxification a more viable option. Instead, when performed responsibly, at a proper facility, by an experienced anesthesiologist, sedation-assisted detox is an excellent option for complete opioid detoxification and for reducing physical cravings. 

That\’s why Waismann Method® Opioid Treatment Specialists and Rapid Detox Center do not support one-day detox protocols. The Waismann Method team believes that patients deserve comprehensive and responsible medical care. Furthermore, opioid use leads to significant physiological changes that affect the individual on many levels. Having enough inpatient time before detox for stabilization, evaluation, and tailoring of an individualized protocol is as essential for the safety and comfort of the patient as providing inpatient recovery care for a few days after detox.

In 1998, Clare Waismann RAS/SUDCC founded Waismann Method, located in Southern California. After a few years, Mrs. Waismann understood that patients deserved more. Sending them to a hotel room or home immediately after detoxification under sedation was no longer an option. In 2005, Domus Retreat was created: a safe environment where patients can start adapting to this new opioid-free state while receiving professional assistance, care, and guidance around the clock.

For the last 23 years, patients have traveled from all over the world to California, where they receive treatment from a quadruple-board certified medical doctor in their private room of a full-service accredited hospital.

Although most patients come for detoxification under sedation, there are several medically assisted detox options. From a clinical standpoint, opioid withdrawal is one of the most influential factors driving opioid dependence and addictive behaviors. Waismann Detox™ tailors every treatment based on the understanding of each individual\’s specific health needs. 

However, not all opioid detox treatment facilities follow the same stringent protocols as Waismann Method. To that end, Waismann and her associates suggest the following criteria when considering a rapid detox or treatment center that offers detoxification under sedation:

1. The treating physician should be a board-certified doctor with a degree from a reputable educational institution. Board certifications are rigorous programs that require doctors to continually assess and enhance medical knowledge, professional judgment, and clinical techniques.
2. Detox should occur at a full-service accredited hospital. A hospital allows access to medical specialists and immediate medical support with no time constraints for inpatients. This requirement is one of the most frequently overlooked by potential patients, especially those seeking lower-cost options.
3. Patients should receive their own private ICU hospital room and individual attention from medical professionals. These are common oversights for patients, and while shared rooms and medical attention may reduce costs, they also carry the potential for greater risk during the procedure and personal discomfort.
4. One-day and overnight detox centers can be dangerous for several reasons. Though the potential for instant cures can be appealing, it is usually not the safest option. Doctors must have the time to give patients a comprehensive inpatient evaluation and stabilization care for at least a day before the sedation-assisted detox. Before the procedure, they must also have enough information on the patient\’s intake – food, medication, and other substances – to avoid adverse reactions when the detox drugs are introduced to the patient\’s system.
5. Post-detox patients should have access to FDA-approved medication like naltrexone and Vivitrol. They should also stay in a specialized recovery center for a few days where their mental and physical stabilization can be observed and attended to. The additional few days of care allows the patient to become more stable while reducing the risks of immediate relapse.

Waismann advises that individuals considering any form of rapid detoxification conduct comprehensive research into a facility\’s protocols, promises, and, more importantly, physician’s credentials, experience, and affiliation with reputable organizations. It is important to know that although medically assisted detoxification can be a life-saving procedure, there are no overnight miracles; nor is there one exclusive treatment that fits every patient\’s unique health needs.

Opioid use disorder is a multifaceted condition that needs to be treated by a team of specialists with a tailored protocol for each person. No single approach to opioid detoxification is guaranteed to work well for all patients. Therefore, detox centers should offer several options, so no patient is pushed into a procedure that does not meet their specific health needs. 

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Recovery emerges from hope.

The belief that recovery is real provides the essential and motivating message of a better future—that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Hope is internalized and can be fostered by peers, families, providers, allies, and others. Hope is the catalyst of the recovery process.

Recovery is person-driven.

Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives.

Recovery occurs via many pathways

Individuals are unique with distinct needs, strengths, preferences, goals, culture, ad backgrounds— including trauma experience — that affect and determine their pathway(s) to recovery. Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual.

Recovery pathways are highly personalized

They may include professional clinical treatment; use of medications; support from families and in schools; faith-based approaches; peer support; and other approaches. Recovery is non-linear, characterized by continual growth and improved functioning that may involve setbacks. Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to
foster resilience for all individuals and families. Abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal for those with addictions. Use of tobacco and nonprescribed or illicit drugs is not safe for anyone.

In some cases, recovery pathways can be enabled by creating a supportive environment. This is especially true for children, who may not have the legal or developmental capacity to set their own course.

Recovery is holistic

Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing: self-care practices, family, housing, employment, transportation, education, clinical treatment for mental issues or challenges and substance use issues or challenges, services and supports, primary healthcare, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, and community participation. The array of services and supports available should be integrated and coordinated.

Recovery is supported by peers and allies

Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community. Through helping others and giving back to the community, one helps one’s self. Peer operated supports and services provide important resources to assist people along their journeys of recovery and wellness. Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths.

While peers and allies play an important role for many in recovery, their role for children and youth may be slightly different. Peer supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery.

Recovery is supported through relationship and social networks

An important factor in the recovery process is the presence and involvement of people who believe
in the person’s ability to recover; who offer hope,support, and encouragement; and who also suggest strategies and resources for change. Family members, peers, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people leave unhealthy and/or unfulfilling life roles behind and engage in new roles (e.g., partner, caregiver, friend, student, employee) that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation.

Recovery is culturally-based and influenced

Culture and cultural background in all of its diverse representations—including values, traditions and beliefs—are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs.

Recovery is supported by addressing trauma

The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with alcohol and drug use, mental health problems, and related issues. Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

Recovery involves individual, family, and community strengths and responsibility

Individuals, families, and communities have strengths and resources that serve as a foundation
for recovery. In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. Individuals should be supported in speaking for themselves. Families and significant others have responsibilities to support their loved ones, especially for children and youth in recovery. Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery. Individuals in recovery also have a social responsibility and should have the ability to join with peers to speak collectively about their strengths, needs, wants, desires, and aspirations.

Recovery is based on respect

Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems— including protecting their rights and eliminating discrimination—are crucial in achieving recovery.

There is a need to acknowledge that taking steps towards recovery may require great courage. Self acceptance, developing a positive and meaningful sense of identity, and regaining belief in one’s self are particularly important.

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