What is sold as natural kratom leaf is often something far more potent, and the products sharing the shelf with it are multiplying fast. This webinar is a practical guide to kratom and the substances marketed alongside it. Dr. Kristina Domanski, an emergency physician and medical toxicologist, will walk through the alkaloids found in the natural leaf, how leaf products differ from concentrated and semisynthetic 7-OH extracts, and how synthetic opioids are obtained and used. She will also cover what opioid withdrawal looks like, why standard urine drug testing often misses kratom use, and the recent regulatory changes to 7-OH products, including the challenges those changes may create for both patients and the clinicians who care for them. Attendees will leave better equipped to understand what people are actually using, what the labels do and do not tell them, and how a shifting legal landscape is likely to play out.
Learning Objectives:
By the end of this presentation, participants will be able to:
- List the alkaloids found in Kratom leaves
- Describe how synthetic opioids can be obtained
- Describe the differences in alkaloid content between kratom leaf products and those containing semisynthetic extracts
- List the physical exam findings seen in opioid withdrawal
- Discuss the limitations of urine drug immunoassays in the assessment of patients who use Kratom
- Discuss recent regulatory changes of 7-OH products and potential challenges faced by patients and clinicians that may occur as a result
Presented by: Kristina Domanski, MD
Kristina Domanski, MD is an Emergency Physician with eighteen years of clinical experience in several fields. She received two degrees from Imperial College, London in 2008 and began practicing in the UK before relocating to the United States in 2011. Dr. Domanski completed residency at John Peter Smith Hospital in Fort Worth, followed by a Toxicology fellowship at UT Southwestern in Dallas.
Now practicing as an attending physician in Las Vegas and Core Faculty/Research Director for the Emergency Medicine Residency Program at Kirk Kerkorian School of Medicine at UNLV, she is passionate about mentorship, and her research interests include gender equity, novel psychoactive substances and snake envenomations.
Continuing Education Units: 1.5 CEUs
This training is approved for continuing education by the boards listed here.
Funding for this activity was made possible in whole or in part by the Nevada Department of Health and Human Services (DHHS) Director’s Office through the Fund for a Resilient Nevada, established in Nevada Revised Statutes 433.712 through 433.744. The opinions, findings, conclusions, and recommendations expressed in our courses are those of the author(s) and do not necessarily represent the official views of the Nevada Opioid Center of Excellence or its funders.