According to the book Medical Toxicity of Drug Abuse: Synthesized Chemicals and Psychoactive Plants, Mitragyna speciosa korth (Kratom) is a tree that appears to be indigenous to countries in Southeast Asia, such as Malaysia and Thailand. The tree belongs to the same family as the coffee tree and reaches a fairly significant height. The leaves of the tree have been used by natives in Southeast Asia as an herbal remedy. The leaves have also been used by laborers in Southeast Asia as a stimulant to help them continue to work long hours in the heat. The leaves are mostly chewed, or they can be brewed as a tea.
It also appears that kratom has been used as a replacement drug for opium and to assist in the management of the withdrawal symptoms that occur in chronic users of opioid drugs. Even though it has been deemed illegal in Thailand, it remains a popular drug due to its stimulant qualities, and it is often used by young Thai militants to give them courage.
Kratom appears to have no legitimate medicinal uses even though there are studies reported in journals that it may have antidepressant properties and may be useful in opioid withdrawal management. Kratom is not listed by the United States Drug Enforcement Administration as a controlled substance, although it appears that at least one state (Alabama) has made the drug illegal.
What Are the Effects of Kratom?
Kratom is described as having stimulant effects at lower doses and effects similar to opioid drugs, such as sedation and euphoria, at higher doses. Pharmacological studies indicate that the main psychoactive ingredient in kratom, mitragynine, causes activity in the brains of animals that is similar to that caused by opioid drugs.
According to a number of reports, at small doses, its use results in:
- Increased alertness
- Increased energy
- Increased sociability
- Increased talkativeness
At larger doses, it apparently results in sedation, pain suppression, and mild euphoria.
Side effects may include:
- Itching
- Sweating
- Dry mouth
- Nausea
- Constipation
- Loss of appetite
- Increased urination
Is Kratom Addictive?
According to recent sources, such as an article in the journal Substance Abuse that introduced a scale for the determination of physical dependence to kratom, a study of Thai individuals who use the drug chronically indicated that they had chewed the leaves daily for a mean number of 18.6 years (range of 3-30 years). The sample displayed a withdrawal syndrome that consisted of the following symptoms:
- Emotional lability (mood swings)
- Aggression
- Hostility towards others
- Muscle aches
- Nausea
- Vomiting
- Tremors
- Possible seizures
Several chronic users displayed psychotic symptoms during withdrawal, such as hallucinations, confusion, and delusions. Long-term use of kratom is also associated with the development of constipation, darkening of the skin, anorexia, and insomnia.
Who Uses Kratom?
According to the United States Drug Enforcement Administration, there is little information regarding the demographics of kratom users in the United States; however, one would suspect that a number of individuals who have immigrated from Southeast Asia would constitute a significant proportion of users.
The Internet has a number of different sites marketing and promoting the use of kratom for a number of different conditions, including withdrawal from opioid drugs. The drug appears to be most commonly used as a tea, according to the Drug Enforcement Administration. It is also ground up and sold in capsule form. There are references online to individuals making kratom milkshakes and pastes, snorting, smoking, and even injecting the drug.
According to a January 2016 New York Times article, kratom bars have opened in Florida, Colorado, New York, and North Carolina. A bill to ban kratom in Florida failed to make it through, and there are a number of differing opinions on the potential danger of this particular drug. A small but relatively active association, the American Kratom Association, touts the medicinal properties of the drug and downplays research indicating its addictive potential, whereas there is evidence that the drug does have addictive qualities (see above).
Conclusions
Kratom is a psychoactive substance that has its origins in Southeast Asia. It appears to have stimulant qualities at low doses and produces effects similar to opioid drugs at higher doses. While the United States Drug Enforcement Administration has yet to issue controls and sanctions regarding distribution of the drug, there appears to be a relatively widespread market for its use that is fueled by the Internet and local businesses in several different states.
There is research to suggest that kratom may be effective in reducing the symptoms of withdrawal from opiates, may have pain-suppression qualities, and that lower doses may have mild stimulant properties; however, there is also evidence that chronic use of the drug leads to potential issues with substance abuse and physical dependence. Currently, controlled studies regarding the actual effects of kratom and its potential for abuse appear to be lacking. Most of the information presented online is cherry-picked and does not display both sides of the story, whereas even regulatory bodies, such as the United States Drug Enforcement Administration, have not yet classified the drug as a controlled substance. This results in a confusing situation regarding any potential benefits of the drug, how it should be dispensed, who should take it, etc.
Because the substance is not regulated by the FDA and because of evidence that indicates that it does have the potential for the development of physical dependence and abuse, it would be prudent for individuals not to purchase or use the drug. Because there are no quality standards for the manufacture of the drug being enforced, there can be no assurance that individuals purchasing the substance are getting what the seller is claiming they are getting.
In addition, there is sufficient evidence to suggest that chronic use of the drug results in potentially harmful effects. Certainly, individuals using kratom who mix it with other medications or with other drugs of abuse may be putting themselves at significant risk. Therefore, it is best to consider kratom to be a drug with a serious potential for abuse and the development of physical dependence, and to discourage individuals from using it.