It is sometimes sold as a green powder in packets labeled “not for human consumption.” It has many street names, such as biak, ketum, kakuam, ithang, and thom. Kratom can be ingested in many ways, including being taken as a pill, an extract, being smoked, put in food, or even sold as a gum. Kratom is a tree native to Southeast Asia known for its psychotropic properties and is easily obtained over the Internet. Further documentation of case reports and research is required to learn the associated risks of the use of this substance. This opioid family alternative substance is gaining popularity across the USA in the era of the opioid crisis. A unique aspect of this case is the circumstance by which this toxicity took place: a family member who chronically takes this substance (that requires increasing dosages to remain effective) recommended a dosage to this kratom-naïve patient, leading to overdose. We present a classic case of a novel acute toxicity: kratom. She came to the ED, where she required multiple rounds of anti-emetic medication for resolution of her symptoms. She took two “scoops.” She proceeded to have multiple episodes of vomiting at home. She was recommended kratom from a family member, who stated he was using kratom to transition away from opioid dependence. After a day of yard work, she was in pain, secondary to her osteoporotic joints. We present the case of a 62-year-old woman arriving to the emergency department (ED) with a chief complaint of intractable vomiting after ingestion of kratom. Here, we present a novel case of acute toxicity from overdose in a kratom-naïve patient, taking place through recommendation by a family member who chronically takes this substance. Although kratom use dates back to the 1800s in Asia, kratom intoxication is still a novel (but increasing) toxidrome in the Western world. Chronic users require increasing dosages for the analgesic effects. But if that doesn’t work, you should consult a medical professional.Kratom is a habit-forming opioid-like substance with an acute toxidrome of various symptoms such as diaphoresis, dizziness, nausea, and vomiting. If you’ve noticed persistent dry mouth in conjunction with your headaches, a remedy could simply be to drink more water. Headaches are a common symptom of dehydration. If you’re experiencing headaches and it’s not from quitting smoking, it’s possible that you’re dehydrated. If you’ve recently quit smoking and are vaping with nicotine, it’s possible that nicotine alone may not be enough to ward off the headaches in the beginning, and you may be withdrawing from other chemicals and alkaloids found in tobacco. These tobacco minor alkaloids work in concert with nicotine and are believed to increase potential dependency. Nicotine is the major alkaloid in tobacco, accounting for about 95% of the alkaloid content, but there are other tobacco minor alkaloids in tobacco smoke, not present in e-liquid. Alkaloids have a physiological effect on the user, and cessation from habitual usage may cause headaches. Although you can still get nicotine from vapes, nicotine is not the only alkaloid found in tobacco. If you’ve recently quit smoking, it’s not uncommon for headaches to occur. If that doesn’t seem to clear up the sore throat, make an appointment with your physician. If the specific coil metal isn’t available, replace it with one that clearly states it uses Kanthal or stainless steel-stainless steel might also contain nickel but usually only up to 10%. Check the specs of the device and see if it has a nickel coil or a coil with nickel content such as nichrome (often listed as Ni80). If you’re certain it’s not the liquid or the nicotine, it may be the vaping wire type used in your vape coil. If you think these issues are related to the e-liquid, try a higher percentage of VG, a new flavor-like a mentholated juice-or lower the nicotine concentration. Some coils used in vaping are nickel-based, and it’s not uncommon for users to discover they have an allergy to nickel.Īlso, several reports online can be found associating a sore throat with high nicotine, especially when used with high levels of propylene glycol (50% or more). A sore or scratchy throat may be caused by a number of things: nicotine, propylene glycol, flavorings, or even the coil used in the atomizer.
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