Kratom

Kratom is a tropical evergreen tree in the coffee family found in Southeast Asia. The leaves of the tree have been used for centuries in traditional medicine to help manage a variety of health concerns. Experts have found that the two compounds in kratom, mitragynine and 7-hydroxymitragynine, interact with opioid receptors in the brain and can cause both stimulant and sedative effects.

Although the U.S. Food and Drug Administration (FDA) has not approved kratom as safe for any medical purposes, it is currently legal and widely available online and in some stores as a supplement, gum, or herbal extract.

Some consider this substance a “gray zone” as there are conflicting views on the uses and safety of kratom. Some promote kratom as a healthy and natural way to boost energy, relieve pain, or improve mood, while others see the substance as a problematic drug that creates unwanted side effects and addiction. Research on kratom is in its early stages, so there is still much to learn about its effects and the risk for abuse.

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Kratom is known by a variety of street names, including:

• Biak
• Ketum
• Kakuam
• Ithang
• Thom

Kratom can be consumed in a variety of ways. The leaves of the tree can be chewed, brewed into tea, or taken as capsules or tablets. Some people also use kratom extracts, which are concentrated forms of the active compounds found in the leaves. Kratom is legal in many parts of the world, but it is important to check local laws and regulations if you decide to use it.

Although not backed by most healthcare experts, kratom users turn to the drug in belief that it will help manage their chronic pain, boost their mood, and unwind. Some of the most common reasons for consuming kratom include:

• Pain relief: Kratom is believed to have analgesic properties and is often used by individuals seeking relief from chronic pain conditions, such as arthritis, fibromyalgia, or back pain.
• Mood enhancement: Kratom is known to have stimulating and sedating effects, depending on the strain and dosage. Some people use it to improve mood and increase energy levels. One study found that 58% to 67% of individuals use kratom to self-manage depressive symptoms and other mental health concerns.
• Opioid withdrawal management: Kratom interacts with opioid receptors in the brain, leading some individuals to use it as a potential aid for managing withdrawal symptoms during opioid addiction recovery.
• Increased focus and productivity: Certain strains of Kratom are reported to enhance focus, concentration, and productivity, making it appealing to students, professionals, and individuals seeking cognitive enhancement.

The effects of kratom can vary depending on the dose and method of consumption. At low doses, kratom can have stimulating effects, including increased energy and alertness. At higher doses, kratom can have sedative effects, causing feelings of relaxation and even euphoria. Other short-term effects of kratom may include dry mouth, itching, sweating, dizziness, and nausea.

The long-term effects of kratom are not yet fully understood. According to NIDA, some experts report that users can experience a wide range of rare but dangerous effects associated with kratom exposure—including mental and neurological symptoms (confusion, tremors and seizures), heart and lung problems (high blood pressure and slow breathing), gastrointestinal problems (nausea and vomiting) and liver problems.

Combining kratom with other substances is not recommended as it can cause harmful and unpredictable side effects. Kratom should never be combined with prescription painkillers, benzodiazepines, or other sedatives. This can lead to a dangerous combination of effects, including respiratory depression and even death.

Kratom should also not be used together with alcohol as it can increase the central nervous system depressant effects of both substances. This may result in heightened sedation, respiratory depression, and impaired coordination. Mixing kratom and alcohol together can exacerbate dehydration and place extreme strain on the liver.

A 2022 study found that nearly one-third of people in the U.S. who use kratom met the criteria for kratom use disorder. Some sites claim that you cannot become addicted to kratom or say that it is “safer” than synthetic opioid addiction. However, other organizations, like the FDA, advise against kratom use because of its side effects and high potential for addiction.

Dr. Randall Dwenger says, “Kratom really checks all the boxes of being an addictive substance. People need to use more to get the desired effect, they have cravings, they have withdrawal, they develop tolerance and spend a lot of money on this product.”

Common signs of addiction may include social isolation, urges to use kratom, neglecting responsibilities, and consuming kratom despite negative consequences. If you are concerned about your use of kratom or someone else’s use, it is important to seek professional help.

Want to learn more about kratom? Join us for a weekly virtual support group and discussion about this trending herbal substance, every Tuesday at 7 PM (ET) Learn more.

It is difficult to overdose on kratom alone. There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A study analyzing data from the National Poison Data System found that between 2011-2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine.

Symptoms of a kratom-involved overdose may include:

• Chills
• Nausea
• Vomiting
• Drowsiness
• Hallucinations
• Confusion or delusion
• Slowed or difficult breathing
• Seizures
• High blood pressure
• Coma

If you suspect that you or someone else has overdosed on kratom, seek medical attention immediately.

Kratom withdrawal produces many of the same symptoms as opiates and opioids withdrawal, though they aren’t always as severe.

Physical symptoms include:

• Insomnia
• Muscle aches
• Runny nose and watery eyes
• Severe abdominal cramps
• Nausea and vomiting
• Diarrhea
• Fever
• Decreased appetite
• Seizures

Psychological symptoms include:

• Irritability
• Insomnia
• Mood changes
• Anxiety
• Depression

The range and severity of your withdrawal symptoms depend on how much of the drug you were taking, and how frequently you used kratom, polysubstance use, and other factors. These side effects can typically last 3 to 10 days, but varies for each person.

While withdrawal symptoms aren’t necessarily life-threatening, they are uncomfortable and can raise the risk of relapse. Therefore, it is highly recommended that you detox in a medically assisted environment so healthcare providers can monitor your vitals and ensure comfort and safety as your body expels the substances.

Currently, there are no approved guidelines for treating kratom use disorder. Some studies suggest that buprenorphine can be used to treat kratom dependence and underlying chronic pain that drives it use.

Jana Wu, Director of Cultural Integration, shares that, “For my clients struggling with kratom use disorder, suboxone appears to be an effective remedy for relieving their drug cravings. Those taking suboxone reported having an increase in energy and a decrease in depressive mood and anxiety.”

Other treatment routes may include behavioral therapy, support groups, and holistic practices. Behavioral therapy can help individuals learn new coping strategies and address underlying mental health concerns. Support groups can provide a sense of community and accountability. Dr. Dwenger adds that yoga, acupuncture, and massage therapy are safe pain management alternatives and promote healing for the mind, body, and spirit. As more research emerges, we will better understand how kratom affects people over time, and best treatment practices.