Kratom products may be promoted as safe and legal by people who support their use, but federal authorities say the drug can be dangerous and lead to chemical dependence and addiction.
Though some people use kratom to manage chronic pain and treat opioid withdrawal symptoms, little has been reported about whether the substance is safe to use as a therapeutic agent.
Federal officials began to pay closer attention to kratom in 2016 when they noticed more kratom or kratom ingredients were being shipped into the U.S. In February 2018, the U.S. Food and Drug Administration (FDA) reported there is no evidence that kratom is a safe or effective treatment for any condition.
The U.S. Drug Enforcement Agency (DEA) has considered including kratom as a Schedule I drug, a category reserved for substances that have no accepted medical use and possess a high potential for abuse.
Kratom (Mitragyna speciosa) is an herbal tree in the coffee family native to Southeast Asia, and it has been used in traditional medicine in Indonesia, Malaysia, Myanmar, Thailand, and Papua New Guinea since the 19th century.
Kratom leaves come from a tropical evergreen tree and are said to have opioid properties and some stimulant-like effects. Typically, fresh or dried kratom leaves are chewed or made into tea—they are rarely smoked. The primary psychoactive components in the leaves are mitragynine and 7-hydroxymitragynine.
There has been growing international concern about a potential “threat to public health” from kratom use as of 2018. Government officials mostly view kratom as an unregulated opioid with no medical benefit while users who support the drug believe it is an herbal pain reliever.
Many jurisdictions have restricted the sale and importation of kratom, and it is even considered a controlled substance in 16 countries. Although kratom is not “controlled” in the U.S., it is considered a drug of concern.
Though not as common as in other substances, kratom use can result in a range of adverse events. Common minor side effects can include constipation, nausea, and vomiting. However, side effects can be more severe, like addiction, psychosis, and respiratory depression (decreased breathing). People also have reported experiencing high blood pressure and heart rate, trouble sleeping, and liver toxicity.
The euphoric effects of kratom can be felt within 10 minutes after people take a few grams of the dried leaves. Many users have reported feeling more alert, sociable, and sometimes having a heightened sexual desire. Other signs of kratom use include:
Kratom addiction, though not quite as common, can happen pretty quickly after use. If you suspect that you or someone you love is battling kratom dependence and/or addiction, watch for psychological and behavioral changes especially when kratom use has stopped, and contact a health care specialist right away.
There is not much known about kratom, especially when it comes to the withdrawal symptoms associated with it. A 2010 case study concluded that kratom withdrawal symptoms were similar to that of opioids.
According to the European Addiction Research report, those symptoms include:
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These are other withdrawal symptoms reported with kratom, according to Healthline:
According to that same European Addiction Research article, a case report described kratom withdrawal as “considerably less intense but more protracted” than opioid withdrawal.
Ending kratom addiction can be difficult to accomplish on your own. A drug rehabilitation treatment program is the first step, and nearly all of these programs begin with medical detox to flush the human body of kratom and any other substances used.
Withdrawal from kratom detox is unpleasant and can be unpredictable, so it is not advised to do so on your own. Instead, health care professionals encourage going to a proper medical facility to detox in a safe environment where experts are available to monitor the process, which can last from three to 10 days—as each person is different. Depending on the person, medication-assisted treatment (MAT) can be an option for recovering substance users to help any health issue resulting from withdrawal.
After completing detox, recovering substance users are encouraged to explore tailored treatment options to continue their road to recovery. Based on your medical analysis, health care professionals will advise what options best fit your needs and will recommend inpatient or outpatient treatment.
Inpatient, also known as residential treatment programs at some facilities, typically last 30 days to 90 days and requires the person to stay on site at the residential facility for the duration of treatment. This inpatient or residential option is ideal for anyone with moderate-to-severe addictions because it provides a proper setting away from triggering factors.
This treatment facility involves common tools needed to learn how to cope with sobriety. One particular treatment, cognitive-behavioral therapy, is especially beneficial to understand why people fell into the depth of substance abuse. Pinpointing those triggers and influences can help break those negative thought patterns boost them to make more positive choices.
The other option, outpatient programs, offers a minimum of nine hours a week of therapy. People in the early stages of kratom addiction may want to consider an outpatient program.
These programs also help people in recovery as they rejoin society since a supportive network can help make the process much smoother.
People also can find support in sober homes and other kinds of transitional housing that promotes sobriety.
It’s nice to be surrounded by others who have experienced the same hardships and can be a positive influence on you to continue your recovery journey.
According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), “The chemical composition of kratom in commercial products is unspecified and depends on various factors, such as the particular variety and age of the plant, the environment, and the time of harvest.” Once kratom has entered the body, it binds to the delta opioid receptors in the brain instead of the mu opioid receptor, unlike other opioids.
At a low dose, the substance can be used for its stimulant effects and combat fatigue during long working hours. However, taken at higher doses, kratom can have morphine-like, sedative-narcotic effects, and consuming large amounts of kratom over time can lead to addiction.
Since the drug is so new, and there are few studies conducted on the effects it has on the brain and body, the legality of kratom has been under long debate. However, many states have begun to pass legislation controlling its use. A study published by the NCBI confirmed the idea of kratom helping opioid addiction to be dangerous and ineffective.
Anecdotal reports suggest that kratom can dangerously impact the mind and nervous system. In fact, some of the symptoms resemble what a user would experience with opioid overdose. According to the Mayo Clinic, those dangerous effects include:
Boyer, E. W., Babu, K. M., Adkins, J. E., McCurdy, C. R., & Halpern, J. H. (2008, June). Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670991/
The U.S. Drug Enforcement Administration. Drug scheduling. from https://www.dea.gov/drug-scheduling
Commissioner, O. O. (n.d.). Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency's scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm595622.htm
DiLonardo, M. J. (2019, April 12). What is kratom and is it dangerous? Retrieved from https://www.mnn.com/health/fitness-well-being/stories/what-kratom-and-it-dangerous
Healthline. (n.d.). Kratom Addiction: Symptoms, Getting Help, Detox, Treatment, and More. Retrieved from https://www.healthline.com/health/addiction/kratom-addiction#detox
Kratom (Mitragyna speciosa) drug profile. (n.d.). Retrieved from http://www.emcdda.europa.eu/publications/drug-profiles/kratom#control
Mayo Clinic. (2019, April 25). Kratom: Unsafe and ineffective. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171