Erwin psychiatric clinic offers assistance following kratom bans in Tennessee

As Tennessee tightens restrictions on kratom products starting July 1, the owner of an Erwin psychiatric clinic believes the changes could have unintended consequences, including driving some people back to opioids and increasing overdose deaths. Walt Ray, owner of Raydiance Psychiatry in downtown Erwin, said his clinic is preparing for a potential influx of patients seeking treatment for kratom dependence once the law takes effect. "We are," Ray said when asked if the clinic is ready for an increase in patients. Kratom, a plant native to Southeast Asia, has gained popularity in recent years and is commonly sold at vape shops, gas stations and smoke shops. While lower doses can act as a stimulant, Ray said higher doses produce effects similar to prescription opioids. "In low doses, it acts like a stimulant. It kind of peps people up, and then in higher doses, it acts like an opiate, like hydrocodone or oxycodone, and is kind of a downer," Ray said. Ray said he is particularly concerned about products containing 7-hydroxymitragynine, often shortened to "7-OH" which he described as significantly more potent than traditional kratom products. "The 7-OH is really a problem," he said. "There's some thought that this is going to be the third wave of the opioid crisis." He said many people struggling with kratom addiction spend hundreds of dollars each week to maintain their habit and warned that eliminating legal access without expanding treatment options will almost certainly push some users back toward illicit opioids. "We're probably going to see an increase in opioid-related deaths because people won't be able to get the kratom, so they'll be trying to get something off the street — some type of opioid — to prevent the withdrawal," Ray said. "Or the ERs will be full." Ray said withdrawal symptoms can be severe, in most cases rivaling withdrawals similar to what those addicted to heroin experience. To help patients overcome opioid dependence, Raydiance Psychiatry prescribes Suboxone, a medication approved to treat opioid use disorder. Unlike methadone, which typically requires patients to visit specialized clinics, Suboxone can be prescribed in an office setting and gradually reduced over time. "Our goal is to get people off of it," Ray said. "You can titrate it slowly, and you can get off of it or stay on it long-term if need be." Ray said the clinic has not encountered community opposition to providing medication-assisted treatment. "The community's been very supportive of our side," he said. While some residents may be aware of the upcoming restrictions, Ray believes many others — including some who regularly use kratom — have little idea the changes are imminent. "I was giving out flyers yesterday, and about 50% of the people knew it was going to happen," he said. "The other half had no idea what kratom was." He added that substance use disorders are more common than many people realize. "One in seven people have a substance abuse issue," Ray said. "So it's impacting everybody." Ray said his clinic's mission extends beyond treating addiction and focuses on improving the overall mental health of its patients. The practice recently moved locations to 218 Gay Street in downtown Erwin where Ray said he is hopeful the clinic will be more visible for those who may need it. "Our goal here is to provide the best psychiatric care possible and do all we can for our patients," he said. Ray emphasized that the practice serves more than just those struggling with addiction. Services include therapy for those suffering from anxiety or depression. Ray added that his clinic is very well equipped people coping with addiction. With the new restrictions approaching, Ray hopes people struggling with kratom dependence will seek medical help rather than return to more dangerous opioids. "If people need treatment," he said, "we're here."