September 2018

Natural Medicines for opioid withdrawal: do any work?

Not likely, and many can be unsafe. Despite the risks with these products, many patients are still attempting to self-treat withdrawal symptoms by using 'natural alternatives.'

Phenibut, a chemical similar to the brain chemical gamma-aminobutyric acid (GABA), has become increasingly popular for this use. But there's no evidence that it actually works. And much like opioids, it can cause dependence when taken regularly. Even at low doses, it has been linked to many side effects such as dizziness, hangover, and nausea. At higher doses, it has been linked to sedation, reduced consciousness, agitated delirium, and trouble breathing. Providers should be aware that many phenibut products, including Healthy Sleep UltraMax Zzz, and Anabolic Dreams Tropical Berry, are still on the market.

Poppy seed, which comes from the opium poppy plant, is making a comeback as a 'legal' opioid alternative. The outer surface of poppy seed can become coated with morphine if it comes in contact with opium of the poppy plant. When soaked, the morphine on the unwashed seeds can seep into the water. Some retailers make claims that poppy seed tea can treat pain or reduce anxiety. However, there is no good scientific evidence supporting these claims. In fact, poppy seed tea products promoted for these indications are considered misbranded. The FDA recently issued a warning to the distributors of PoppySeed Wash for making claims that it can be used for opioid withdrawal. Furthermore, ingestion of poppy seed tea has been linked with several recent deaths.

In addition to phenibut and poppy seed, kratomkava and passion flower are also found in a number of products being promoted to help with withdrawal symptoms. There's no good scientific evidence supporting the use of these products for withdrawal symptoms. And at least some of these pose their own health risks.

For advice on appropriate treatment options for patients affected by the opioid epidemic, be sure to review a new resource from Pharmacist's Letter on the Treatment of Opioid Withdrawal.

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