Category: Treatment, Recovery & Safety

Kava and kratom are sometimes sold in the same shops, beverages, or wellness settings, but they are different plants with different effects. Products labeled “kratom” may also differ substantially from one another. A traditional botanical product, an extract, and a concentrated 7-hydroxymitragynine product should not be treated as interchangeable.

For a person in recovery, the question is not only whether a product is legal, natural, or sold without a prescription. The more useful questions are: What does it do? Why is the person using it? Could it affect judgment, mood, sleep, medication, or physical dependence? Does its use fit the recovery plan agreed upon with qualified professionals?

Using kava or kratom does not prove that every person has relapsed. Recovery is too individual for a universal conclusion. At the same time, both substances raise concerns that should be addressed honestly rather than dismissed because a product is plant-derived.

Kratom and concentrated 7-OH products

Kratom comes from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. Its compounds include mitragynine and 7-hydroxymitragynine, often shortened to 7-OH. These compounds interact with some of the same receptors in the brain as opioids.

People report using kratom for pain, mood, energy, opioid withdrawal, or other reasons. The U.S. Food and Drug Administration has not approved kratom or its compounds as prescription or over-the-counter drugs for any medical use. The FDA continues to warn about serious adverse effects associated with kratom products, including liver toxicity, seizures, and substance use disorder. Reported effects can also include sedation, nausea, constipation, physical dependence, withdrawal, and respiratory depression.

Product differences matter. In recent years, concentrated or manufactured 7-OH products have appeared as tablets, gummies, shots, drink mixes, and other forms. The FDA distinguishes these products from natural kratom leaf containing only trace amounts of 7-OH and has identified concentrated 7-OH as an emerging opioid threat. Some items may be marketed simply as “kratom,” “enhanced kratom,” or “7-hydroxy,” leaving consumers uncertain about what they are taking.

Kava has a different risk profile

Kava comes from Piper methysticum, a plant traditionally used in South Pacific cultures. In the United States, kava may be sold as a beverage or dietary supplement and is often promoted for relaxation or anxiety.

Kava is not kratom and does not act in the same way. It can nevertheless affect alertness and coordination. The National Center for Complementary and Integrative Health advises that kava should not be combined with other sedating substances, including alcohol or benzodiazepines. Kava products have also been associated with rare but sometimes serious or fatal liver injury. Product quality, plant variety, preparation, dose, length of use, and the person’s health may all affect risk.

A person taking medication or living with a liver condition, mental health concern, or substance use disorder should discuss kava with a qualified clinician rather than assuming a supplement is harmless.

Why these products may matter in recovery

Recovery is not defined solely by a product list. It involves health, safety, honesty, stability, and the goals of the individual treatment plan. Several questions can help clarify whether kava or kratom use is becoming a problem:

• Is the product being used to change mood, escape distress, manage withdrawal, sleep, or feel intoxicated?
• Is the amount or frequency increasing?
• Does the person become defensive, secretive, or misleading about use?
• Are responsibilities, relationships, treatment participation, judgment, or finances being affected?
• Does stopping lead to withdrawal symptoms or an inability to function normally?
• Is the product being combined with alcohol, opioids, benzodiazepines, sleep medication, or other substances?
• Does the prescriber, therapist, treatment program, or recovery team know about the use?

A single “yes” does not make a diagnosis. A pattern of concern deserves a direct conversation and professional assessment.

How families can respond

Begin with observable facts. “I found several 7-OH packages and noticed you have been difficult to wake” is more useful than “You have thrown away your recovery.” Ask what the person is taking, how much, how often, and why. If possible, retain the packaging or photograph the label so a clinician or poison specialist can identify the product.

Avoid turning the conversation into a debate about whether the substance is technically an herb, supplement, food, or drug. Labels do not determine safety. Focus on the person’s health, behavior, recovery commitments, and the need for accurate medical information.

If regular use, dependence, withdrawal, or other substances may be involved, do not create an unsupervised detoxification plan. A qualified medical professional should assess the situation and advise on the safest next step. Abrupt changes can be difficult, and the contents of an unregulated or inaccurately labeled product may not be known.

When immediate help is needed

Call 911 for severe difficulty breathing, unresponsiveness, seizure, collapse, extreme confusion, or another immediate threat to life. If opioid effects are possible and naloxone is available, give it according to the product directions while emergency help is on the way.

For a suspected poisoning or concerning reaction in the United States, Poison Control is available at 1-800-222-1222 or poison.org. Do not wait for an online article or ordinary consultation when emergency symptoms are present.

A plan should address the reason for use

Simply removing a product may leave the underlying problem untouched. The person may be managing pain, anxiety, insomnia, trauma symptoms, opioid withdrawal, social pressure, or fear of returning to formal treatment. Those concerns need appropriate evaluation.

A coordinated response may include medical assessment, treatment for a substance use disorder or co-occurring mental health concern, medication review, family boundaries, recovery coaching, or a higher level of care. The right plan depends on the individual—not on a broad rule applied to everyone who has used kava or kratom.

When trauma is part of a person’s history, families may hear EMDR mentioned among several treatment options. The name can sound technical, and online descriptions sometimes present it as either a breakthrough for nearly everyone or a treatment that is difficult to understand.

The more useful view is measured: Eye Movement Desensitization and Reprocessing, or EMDR, is a structured, trauma-focused psychotherapy. It has an established role in the treatment of posttraumatic stress disorder (PTSD), but it is not the only evidence-based treatment and it is not appropriate for every person at every stage of care.

What EMDR is

EMDR was developed to help people process distressing memories that remain connected to strong emotional, physical, or behavioral reactions. Treatment is delivered by a trained mental health professional through a series of phases. Those phases generally include understanding the person’s history, preparing coping and stabilization skills, identifying the memories and beliefs to address, processing them, and evaluating progress.

During portions of treatment, the clinician asks the person to focus on aspects of a distressing memory while also attending to a form of alternating—or bilateral—stimulation. Side-to-side eye movements are common, though other methods may be used. The person does not have to describe every detail of an experience aloud for treatment to proceed, but EMDR is still active trauma work and should occur within a sound clinical relationship.

What the evidence supports

EMDR is recommended for PTSD in several clinical practice guidelines. The U.S. Department of Veterans Affairs’ National Center for PTSD reports moderate evidence that EMDR can reduce PTSD symptoms and the likelihood that a person continues to meet criteria for a PTSD diagnosis. It also notes that available evidence does not establish that EMDR is superior to every other trauma-focused psychotherapy.

Other strongly supported PTSD treatments include Cognitive Processing Therapy and Prolonged Exposure. The right treatment depends on a qualified clinician’s assessment, the person’s preferences, symptoms, medical and psychiatric needs, readiness, and access to a properly trained provider.

Claims that EMDR reliably treats a broad list of unrelated conditions should be viewed carefully. Research is strongest for PTSD. A clinician may consider trauma-focused work when other concerns are present, but the treatment plan should be based on an individualized assessment rather than a promotional list of diagnoses.

Trauma, substance use, and recovery planning

Trauma and substance use disorders can occur together. Some people use alcohol or other substances to manage memories, sleep problems, anxiety, emotional numbness, or physical distress. Others discover during treatment that trauma symptoms affect relationships, decision-making, or the ability to feel safe without substances.

This does not mean that every person with a substance use disorder needs EMDR. It means trauma should not be overlooked when treatment is being planned. The timing of trauma-focused therapy also matters. A person may first need medical stabilization, withdrawal management, a safer living environment, greater day-to-day stability, or skills for managing intense emotions.

Good coordination allows the therapist, physician, substance-use treatment provider, case manager, and other authorized professionals to work from compatible priorities. The goal is not to delay appropriate trauma care indefinitely. It is to introduce it in a way the individual can use safely and consistently.

What a course of EMDR may involve

EMDR is not a single technique performed in one standard-length session. Treatment usually begins with assessment and preparation. The clinician considers the person’s history, current stability, dissociation, coping resources, safety, and ability to manage distress between appointments.

Processing work may focus on past experiences, current situations that trigger distress, and skills or beliefs needed for future circumstances. The number of sessions varies. A single-event trauma may require a different course than prolonged or repeated trauma, and co-occurring conditions may affect timing.

Temporary increases in distress can occur during trauma-focused treatment. A qualified clinician should explain how sessions will be paced, what support is available between visits, how safety will be monitored, and how the plan will change if symptoms become difficult to manage.

Questions to ask a prospective EMDR clinician

• Are you licensed to provide psychotherapy in the state where the client will receive services?
• What formal EMDR training and supervised experience have you completed?
• How do you assess whether EMDR is appropriate now?
• How do you address substance use, dissociation, self-harm risk, or other co-occurring concerns?
• What preparation or stabilization occurs before trauma processing?
• How will you measure progress and decide whether to continue, pause, or use another approach?
• With the client’s permission, how will you coordinate with the treatment team?

Training is important, but it is not the only consideration. The clinician should also have appropriate experience with the person’s primary concerns and practice within the limits of their license and competence.

Where Silver Lining fits

Silver Lining is not presenting EMDR as a service we provide. Our role is to help families and individuals understand recommendations, identify qualified treatment resources, coordinate authorized communication, and keep the broader recovery plan organized.

For a family, the practical questions may extend beyond the therapy appointment: Is the person at the right level of care? Are substance use and mental health being addressed together? What support is available at home? How will work, travel, family contact, and other responsibilities be managed while treatment proceeds?

Those questions are often where experienced case management adds value. It helps the family see the whole plan without attempting to replace the clinicians who provide treatment.

Naloxone is an emergency medication that can temporarily reverse the effects of an opioid overdose. Narcan is one familiar brand name, but naloxone is available under other brand names and as generic products. Some nasal-spray products are sold over the counter, which means they can be purchased without a prescription.

Keeping naloxone nearby is a practical safety measure for families, friends, employers, and others who may be present during an opioid emergency. It is not an accusation and it is not a substitute for treatment. It is a way to be prepared for a situation in which minutes matter.

What naloxone does

Opioids can slow or stop breathing. Naloxone blocks opioid effects for a limited period and may restore normal breathing when it is given in time. It can be used when an overdose is known or suspected, including an overdose involving fentanyl, heroin, or prescription opioid medication.

Naloxone only works on opioids. It will not reverse an overdose caused solely by alcohol, benzodiazepines, stimulants, or another non-opioid substance. However, people do not always know what a substance contains, and fentanyl may be present unexpectedly. According to the CDC, naloxone will not harm someone if opioids are not responsible for the emergency. When an opioid overdose is possible, give naloxone and call 911.

Warning signs of a possible opioid overdose

Signs may include:

• The person cannot be awakened or does not respond to voice or touch.
• Breathing is slow, irregular, very shallow, or has stopped.
• There are choking, gurgling, or snoring-like sounds from someone who cannot be awakened.
• The lips, fingernails, or skin appear blue, gray, pale, or unusually clammy, depending on skin tone.
• The pupils are very small or “pinpoint.”
• The body is limp.

Do not wait for every sign to appear. If someone is unresponsive and an opioid overdose is possible, treat the situation as an emergency.

What to do

1. Call 911. Tell the dispatcher the person is unresponsive or not breathing normally and that an opioid overdose may be involved.
2. Give naloxone. Follow the instructions for the product you have. Nasal sprays and injectable products are not all used in exactly the same way.
3. Support breathing and prevent choking. Follow the dispatcher’s instructions. If appropriate, place the person on their side.
4. Watch for a response. CDC guidance says to wait two to three minutes to see whether normal breathing returns before giving a second dose. Follow the specific product directions and emergency instructions.
5. Stay with the person. Naloxone’s effects are temporary. Overdose symptoms can return, and medical evaluation remains necessary even if the person wakes up.

A person may wake confused, frightened, nauseated, or experiencing withdrawal. Speak calmly, explain that help is coming, and do not allow the person to use more substances.

Who should keep naloxone available?

Naloxone is relevant wherever opioid exposure is possible. A physician or pharmacist may specifically recommend it when someone takes prescription opioids, has an opioid use disorder, has recently stopped using opioids, or uses other substances that could contain fentanyl. Reduced tolerance after detoxification, treatment, hospitalization, incarceration, or a period of abstinence can increase overdose risk if opioid use resumes.

Families do not need to wait for certainty. It is reasonable to ask a pharmacist or clinician which product is appropriate, how many doses to keep, where it should be stored, and when it expires. Household members and other trusted people should know where it is and how to use it.

Access and storage

The FDA approved the first over-the-counter naloxone nasal spray in 2023 and has since approved additional nonprescription products. Availability and cost vary by location and product. Pharmacies, community programs, health departments, and harm-reduction organizations may offer naloxone.

Follow the package instructions for temperature, light, expiration, and replacement. Do not leave naloxone where heat or cold could damage it. Check the expiration date periodically, and replace any dose that has been used.

Naloxone is emergency protection—not a recovery plan

Surviving an overdose does not resolve the conditions that led to it. After the immediate emergency, a qualified professional can assess medical needs, substance use, mental health, prior treatment, withdrawal risk, and the appropriate level of care.

Families may feel pressure to solve everything at once. A more useful goal is to move from the emergency toward one clear next step. That may include medical stabilization, treatment, intervention planning, case management, family guidance, or recovery support.