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Kratom is a plant used to boost mood, increase physical endurance, ease anxiety, and treat pain. Kratom has a long history of traditional medicinal use in Africa and Southeast Asia, but its recreational use in the U.S. is steadily increasing.
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Although not currently listed as a controlled substance, kratom misuse is associated with physical dependence, addiction, and dangerous side effects. Kratom is not approved by the U.S. Food and Drug Administration (FDA) for any medical use, and the Drug Enforcement Administration (DEA) lists kratom as a Drug of Concern. Drugs of Concern are substances that, while not currently banned by the Controlled Substances Act, pose risks to individuals who abuse them.
Understanding kratom's use, physical and psychological effects, and health risks are essential for preventing severe side effects and addiction.
An estimated 3 to 5 million people in the United States use kratom, and the number of kratom-related calls to U.S. poison centers increased 10-fold from 2010 to 2015.
Kratom, known scientifically as Mitragyna speciose, is a tree native to several tropical Southeast Asian countries, including Thailand, Malaysia, Indonesia, and Papua New Guinea. Several alternative names for kratom exist, including:
Kratom leaves contain compounds with mind-altering and stimulant effects, and kratom products have long been used in Africa and Southeast Asia to manage medical conditions. Kratom leaves are commonly crushed and brewed into tea, chewed, or smoked. The leaves are also ingested in capsule, tablet, or extract form to produce the desired physical or psychological effects.
Kratom is commonly sold on the internet as an extract, gum, or powder in packets with warnings against human consumption. Although kratom is not currently an illegal substance in the U.S., several states and cities have enacted bans on the sale or use of kratom.
As a recreational drug, kratom uses include elevating mood, increasing physical endurance, and improving sexual performance. As a medicinal drug, kratom leaves are used to treat several conditions, including:
According to the FDA, individuals should avoid kratom use for treating medical conditions or as an alternative to prescription opioids.
Recreationally, individuals use kratom to get high. The kratom dosage impacts the drug’s effects. Consumption of low kratom doses produces stimulant effects and consumption of high doses produces sedative effects. Kratom leaves contain two main psychoactive components: mitragynine and 7-hydroxymitragynine. These compounds bind to opioid receptors in the brain, producing sedative effects such as:
Mitragynine also binds to other receptors in the brain to generate kratom’s stimulant effects, including increased:
Kratom use is associated with several health risks, including severe physical and psychological side effects, especially at higher doses. Reported kratom side effects include:
In some users, kratom use can also cause severe psychotic symptoms, including:
Due to reports about the dangers of kratom use, the FDA continues to warn consumers not to use any products labeled as containing kratom or its mind-altering compounds, mitragynine, and 7-hydroxymitragynine. More research is needed to determine kratom's safety and long-term side effects.
Despite its dangers, there is an increase in kratom street use in Western countries as a natural alternative for self-treatment of opioid withdrawal and pain.
There is little to no research on kratom's interaction with other drugs. More research needs to be done in order to provide accurate information. It is not recommended to use kratom with opioids, antidepressants, benzodiazepines, or prescription stimulant drugs.
Adderall and Vyvanse are medications used to treat attention deficit hyperactivity disorder (ADHD). They are both prescription drugs that stimulate the central nervous system Adderall is made of amphetamine salts (amphetamine and dextroamphetamine) and Vyvanse is made of lisdexamfetamine dimesylate, which is converted to dextroamphetamine by the body.
Some users of kratom and Vyvanse or Adderall claim that the calming effects of a low dose of kratom can help them sleep after a full day on dextroamphetamine. However, since both of these drugs are stimulants, other users note the opposite effect.
More research needs to be done in order to find out the full extent of kratom's drug interactions. Until then it is highly recommended to not mix kratom with any other substance.
By binding to receptors in the brain, kratom alters the levels of chemicals involved in the body’s reward pathways, motivating individuals to continue using the drug. Over time, kratom misuse can lead to physical dependence and addiction. Individuals who use high levels of kratom over an extended period are at a higher risk of addiction.
Kratom addiction symptoms vary from person to person, depending on individual factors and the use of other drugs. An individual addicted to kratom may show several signs, including:
Like other drugs with opioid-like effects, kratom can cause physical dependence. Physical dependence occurs when the body adapts to functioning with the drug present. When an individual develops a kratom dependence and subsequently stops using the drug, unpleasant withdrawal symptoms occur.
Kratom withdrawal symptoms include:
Although limited information exists regarding overdose rates, kratom is linked to multiple death reports. However, most of these individuals also ingested other substances, so it is challenging to determine kratom’s role in the deaths. In addition, kratom is sometimes contaminated or laced with other potentially deadly substances. Mixing kratom with other drugs or alcohol is dangerous and should be avoided.
A 2019 study found 11 kratom-associated deaths between 2011 and 2017. Of these 11 deaths, nine involved the use of other drugs, such as antihistamines, alcohol, cocaine, and fentanyl. In 2017, the FDA reported at least 44 deaths related to kratom, with at least one case linked to pure kratom.
If a kratom overdose is suspected, seek emergency medical attention, or call 911 immediately. Find a local poison control center by calling the Poison Help hotline: 1-800-222-1222.
Currently, there are no specific medical treatments for kratom addiction. Additional research on kratom addiction treatment is needed to determine which methods are effective. However, several treatment approaches may be helpful, including:
Kratom’s mind-altering effects may make it challenging to quit using the drug without assistance. Find professional treatment options today.
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“Kratom.” DEA, www.dea.gov/factsheets/kratom
NIDA. "Kratom." National Institute on Drug Abuse, 8 Apr. 2019, https://www.drugabuse.gov/publications/drugfacts/kratom. Accessed 26 Feb. 2020.
Commissioner, Office of the. “FDA and Kratom.” U.S. Food and Drug Administration, FDA, www.fda.gov/news-events/public-health-focus/fda-and-kratom
Fluyau, Dimy, and Neelambika Revadigar. “Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom.” Frontiers in psychiatry vol. 8 62. 24 Apr. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402527/
Veltri, Charles, and Oliver Grundmann. “Current perspectives on the impact of Kratom use.” Substance abuse and rehabilitation vol. 10 23-31. 1 Jul. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612999/.