Kratom, Trendy Indigenous Plant Medicine or Another Dangerous Opioid In Disguise?

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Kratom, officially known in the plant kingdom as Mitragyna speciosa, is a tropical tree part of the coffee family Rubiaceae, with its native habitat being Southeast Asia.  Typically chewed or brewed into a tea, kratom has likely been part of indigenous cultures for thousands of years and used for everything from fever symptoms to mitigating withdrawal symptoms from opium and later heroin.  Having weaved its way into Western cultures, kratom has become less holy, more trendy, and more abused.  Before one decides to give the plant a try, especially those in recovery from substance use disorders, there are many things to consider.

Kratom use patterns in Southeast Asia indicate a few important things: a majority of users had a history of drug abuse and are often self-treating opioid and stimulant withdrawal, dependence on kratom is not uncommon, and withdrawal symptoms from kratom are almost identical to opioid withdrawal.  Besides the fact that these findings are somewhat concerning for obvious reasons, one may be thinking why concern myself with kratom use patterns in Southeast Asia?  This is because studies of use patterns in the United States, and of kratom in general, are few and far between.  But with the little we do know, it seems the use patterns and findings obtained in Southeast Asia are similar to what is being seen within the United States.

While the research around Kratom and its usage within the US is limited, the hype around Kratom certainly is not.  A Leaf of Faith, a documentary created by director and recovering addict Chris Bell, make it somewhat hard to argue against kratom.  He interviews addicts, veterans with severe PTSD, and those with chronic pain who all claim in one way or another kratom has given them their life back.  They are non-addicted, pain free, and able to live freely within the world and freely within themselves.  For these users, Kratom is their god-send and in some ways, kratom does seem to have holy healing powers.  For others, kratom is a slippery slope which leads to abuse and addiction.  Either way, one must be armed with the facts and at the very least, a broad rundown of the plant.

In general, you are typically going to experience effects for three to four hours.  A low dose is going to stimulate you in a way similar to coffee but without the horrible anxiousness and jitters that cause a love-hate relationship with caffeine.  Higher doses alleviate pain, induce relaxation, support sleep, and ease anxiety and muscle tension.  Kratom can aid in withdrawal symptoms from opioids, act as a nootropic (fancy way of saying improve executive functioning), and if you perfect your dosage it can act as an aphrodisiac. Kratom is not illegal (in most places) and relatively easy to get your hands on.  Kratom can be purchased in places like herbal stores, gas stations, head shops, through online vendors, or sipped at your nearest herbal bars (swanky places serving up all the imbued indigenous beverages).  There are several different strains which all accomplish different things, it will only show up on a drug test if the drug test is specifically testing for kratom, and it can take your body anywhere from one day to several weeks to clear kratom from your system.  And according to kratom.org (check out their Kratom 101 page to get a full bio on the plant), the withdrawal symptoms of Kratom are mild, if existing at all for the user.

But before you hit up your local herbal spot looking for pain relief, it’s important to remember everyone’s favorite adage – too much of a good thing can be well, too much.  Not to mention just because something is “natural,” does not mean there are no risks involved.  While kratom is legal in the majority of US states, there is no regulation of kratom, often leaving its purity in question, sometimes leaving Kratom laced with opioids or other drugs, creating a fatal outcome for its users.  And although the side effects of Kratom can be mild, they can also be severe for some users.  According to a study published in the International Journal of Legal Medicine, a low to moderate dose, 1-5 grams, will yield mild stimulant effects.  At this dose, a user may experience anxiety, agitation, and/or slightly contracted pupils and blushing.  At 5-15 grams is when the user will experience opioid like effects and this is also the level where one may be helped with any withdrawal symptoms.  At this dosage gastro-intestinal effects are possible.  If one exceeds 15 grams of kratom, they will feel as though they are in an opioid like stupor.  Sweating, dizziness, nausea, and dysphoria often occur at this dosage and are then followed by a calmness and dreamlike state.  Frequent kratom users can also experience tremors, anorexia, weight loss, seizures, and psychosis.  Other side effects for frequent users can include, hyperpigmentation, insomnia, nausea, low libido, poor appetite, dizziness, loss of muscle coordination, low blood pressure, and itchiness of the skin.  In regard to long term effects, it is not certain at this point in time what they may be and the ones indicated thus far are purely anecdotal.  And while kratom is generally considered nontoxic, most research has been conducted only in animals.

The question remains as to whether or not kratom in itself is addictive.  Some studies deem kratom addiction to be a significant issue, while other studies say it depends upon the person, their dosage, and history.  It seems the main take away is that kratom can become addictive.  And this is where things get personal.  This is where one’s (very personal) stance on addiction, recovery, and sobriety all come into play.  For some, because kratom activates the opioid receptors in one’s brain and in turn alters mood, regulates pain, and so forth, this may not fall under their definition of sobriety.  For others, if the intentions of use are pure and remain so, others may feel this falls under their umbrella of sober behavior.  However, for those who have a futile history with substances, the question remains, is Kratom even worth it?  With all of this said, what is kratoms place in recovery?  Should it even have one? And is it a plant or a drug?  Or is it both?  After educating oneself and honest inquiry, that is for you to decide.