The DEA’s plan to place kratom in schedule 1 would put it on par with heroin and LSD. But the agency’s move was met with public and supplement industry pushback.
Instead of turning to a potentially dangerous drug, experts recommend other ways to manage pain, anxiety or fatigue. Yoga, acupuncture, exercise and CBD products are all safe options.
What is Kratom?
Kratom is a tropical tree (Mitragyna speciosa) with psychoactive leaves that can be chewed, brewed as tea or placed in capsules. It is sold as a legal, safe alternative to opioids to reduce pain and anxiety and for energy. It is also believed to be a potential treatment for opioid addiction and withdrawal.
Kratom has stimulant and sedative effects, depending on the dosage used. At low doses, it increases energy and endurance, while at high doses it has opiate-like effects. The kratom plant is known as thang, ketum, kahueng, thom or biak in Southeast Asia where it is traditionally grown and consumed. The kratom leaves contain two psychoactive chemicals, mitragynine and 7-hydroxymitragynine, which have been shown to have opioid-like and stimulant properties.
Long-term kratom use can lead to dependence and addiction. People who become dependent on kratom experience cravings and difficulty stopping use. Long-term users can also build up a tolerance to the drug and require increasingly higher doses to feel the same effects. Some long-term kratom users have reported experiencing symptoms similar to those of opioid withdrawal, including anxiety, muscle aches, insomnia and constipation.
Experts recommend avoiding kratom to avoid its risks and instead seek out other alternatives to address chronic pain, anxiety or mood disorders. For example, acupuncture, exercise, yoga and CBD products can all be helpful for managing pain, while meditation is a great way to relax and relieve stress.
How Does Kratom Work?
The two active compounds in kratom, mitragynine and 7-hydroxymitragynine, bind to the body’s opioid receptors and produce morphine-like effects. In low doses, kratom acts as a stimulant and promotes feelings of euphoria and physical energy, while in high doses it can induce sedation and pain relief. The exact way it works is not fully understood, but researchers believe that kratom has both opioid and nonopioid mechanisms of action in the brain.
Unlike most prescription medications, kratom is not regulated by the Food and Drug Administration (FDA), which means there’s no way to know how potent any given batch of kratom might be or whether it may contain other substances such as lead or nickel. Kratom is also not recognized as a substance use disorder, which makes it difficult for patients to get insurance coverage for treatment.
Even when used as directed, kratom can have dangerous side effects. The Natural Medicines Comprehensive Database rates kratom as POSSIBLY UNSAFE for most people when taken by mouth, and it can cause addiction and withdrawal symptoms. Common side effects include nausea, vomiting, dry mouth, frequent need to urinate, constipation, anxiety, muscle spasms, twitches, mood changes and aggression. In some cases, kratom users have experienced seizures and even death. One patient reported in a 2008 issue of Addiction who was using kratom to manage his opioid withdrawal symptoms suffered from thoracic outlet syndrome and a generalized tonic-clonic seizure.
What are the Side Effects of Kratom?
Two compounds found in kratom, mitragynine and 7-a-hydroxymitragynine, interact with opioid receptors in the brain to produce opioid-like effects, such as pain relief and pleasure. However, they also interact with other receptor systems in the brain to create stimulant effects in smaller doses. When used in large amounts, kratom can cause psychotic symptoms.
Long-term kratom use can lead to addiction, withdrawal and other unpleasant side effects. In fact, a recent study found that kratom has been linked to at least seven deaths in the United States, including one young man who was hospitalized in the emergency department with a severe opioid withdrawal after drinking a kratom tea.
According to a report in the American Journal of Emergency Medicine, tachycardia (fast heart rate), altered mental status, agitation and seizures are among the most common symptoms reported in calls to a regional poison center from people who took kratom. Other potential side effects include nausea, constipation, dizziness and dry mouth. Because kratom is not regulated, products may contain contaminants and other chemicals, making it difficult to know what you’re getting.
Instead of turning to a drug with unknown side effects, experts recommend addressing anxiety and pain through alternative methods like exercise, yoga, massage therapy and CBD products. Many are in-network with insurance providers so that you can get the help you need quickly and easily.
How Can I Take Kratom?
There are several ways to take kratom: the leaves can be chewed fresh or dried and can also be brewed as a tea. Kratom can also be crushed into a powder and taken in capsules. It’s important to start small and gradually increase dosage to avoid negative side effects.
A few grams of kratom powder typically takes effect within 10 minutes and produces invigorating effects that last up to one and a half hours, according to research. At higher doses, kratom can produce opioid-like effects that are more sedating and may cause a person to feel numbness in the mouth and lips, dilated pupils, and tremors of the hands or face.
More research is needed to understand how kratom interacts with other substances, but a recent study found that high doses of kratom may lead to seizures. Researchers also note that a large number of kratom products are contaminated with the potent opioid fentanyl, so those who use kratom should always carry fentanyl test strips and naloxone to prevent an overdose.
Doctors should be cautious about recommending kratom to their patients. The FDA recommends that people who are struggling with opioid use disorder seek treatment for their condition, which can be treated with FDA-approved medications like buprenorphine, methadone, and naltrexone. They should also consider mental health treatment, which can be done through talk therapy and medication. Kratom capsules