Kratom has been used by opioid addicts to ease withdrawal symptoms. CDC researchers studied calls to poison centers about kratom and found that it was often combined with acetaminophen, benzodiazepines, other botanicals and narcotics.
In low doses, kratom acts as a stimulant, producing invigorating effects that improve work capacity, alertness and sociability. Higher doses can act as a sedative.
Capsules
kratom capsules are a convenient way to take the herbal supplement. They’re available online and in health food stores, and can be purchased in a variety of strengths. They can help reduce pain and anxiety, and improve mood. However, it’s important to purchase kratom from a reputable source that offers a money-back guarantee and lab-tested products.
In low doses, kratom can act as a stimulant, while in high doses it can produce a sedative effect. Its primary psychoactive compound is mitragynine, which binds to opiate receptors in the brain and can alter mood. It also binds to a-adrenergic receptors, with the highest affinity for the a1A receptor. In addition, it binds to serotonin receptors 5-HT 1A and 5-HT 2B with lower affinity.
The FDA doesn’t regulate kratom, so there’s no way to know how potent it is or whether it contains other substances. Some kratom products have been linked to liver toxicity. A report in The Oncologist described a 23-year-old man who took 85 grams of a kratom strain and developed dark urine, painless jaundice and light stools.
Regardless of its legal status, it’s never safe to use kratom in place of approved treatments for opioid addiction or withdrawal. A primary care provider should discuss these concerns with their patient and recommend alternatives such as exercise, yoga, acupuncture or meditation.
Powder
The leaves of the kratom plant produce stimulant effects in low doses and opioid-like effects in higher doses. The main alkaloids are mitragynine and 7-hydroxymitragynine, which bind to opioid receptors in the brain to produce feelings of pain relief, sedation and euphoria at higher doses. The DEA has considered making it a Schedule 1 drug, which would make it illegal to possess and sell. A person who takes kratom risks addiction, even when used in moderate doses.
Several studies have found that regular use of kratom can lead to liver damage. In one study, a person who regularly drank kratom tea developed cholestatic liver disease, which caused itching and dark urine. He also experienced muscle weakness, loss of appetite and fever. The person was able to recover after stopping his use of kratom.
Kratom does not require a prescription and is widely available over-the-counter, but it may interfere with some medications. The FDA does not regulate kratom, and the plants are often grown in unsanitary conditions with little or no quality control. This can increase the risk of contamination and infection.
Primary care providers should carefully consider the benefits and risks of recommending kratom to patients, especially those suffering from depression or opioid withdrawal symptoms. Patients should instead speak with a healthcare professional who can prescribe effective medications for the treatment of these issues.
Tea
The kratom plant has dozens of active components, and its effects can range from stimulant-like, energizing and uplifting to opiate-like, creating drowsiness or euphoria. Its two main chemicals, mitragynine and 7-hydroxymitragynine, have strong activity at the mu opioid receptors. It is most commonly ingested orally, often made into tea with added sweetener to overcome the bitter taste. Regular and addicted users chew the leaves to experience vigour and euphoria, while those with lower tolerance may swallow pills.
It is not uncommon for people who are battling addiction to use kratom to combat withdrawal symptoms, such as anxiety, insomnia and pain. However, the drug doesn’t appear to be a suitable replacement for pain relief medications, and it can cause a variety of side effects, including agitation, nausea, vomiting and constipation.
Another concern is that kratom doesn’t show up on standard drug tests, which could encourage some people to use it, especially in combination with other drugs. In fact, the CDC has reported that 91 deaths were linked to kratom in 2016, but it is important to note that most of those victims had other drugs present in their system at the time of death.
Primary care providers should ask patients why they want to use kratom, and only recommend it if there is evidence of its benefits in a controlled setting. It is also important to understand the potential for harm and drug interaction, and provide appropriate guidance on safe dosages.
Oil
While more research is needed on the effects of kratom, it is believed to be a safe and effective treatment for pain, anxiety and depression. It is also used to treat opioid withdrawal. The plant has been used as an herbal medicine in Southeast Asia for centuries. Some chemicals in kratom may bind to opioid receptors in the brain, leading to physical addiction and dependence. However, many users report a variety of health benefits, including energy, increased concentration and lessened opioid withdrawal symptoms.
Some kratom products are available over-the-counter in the United States, though some states have banned them or require a prescription to purchase them. The DEA is considering classifying it as a Schedule 1 drug, meaning it has a high potential for abuse and is likely to cause severe psychological or physical harm.
Prozialeck and his colleagues say rigorous clinical research on kratom is needed to test for its therapeutic benefits, behavioral intoxication effects and adverse side effects. They also recommend that people err on the side of caution and not mix kratom with other drugs or alcohol because some chemicals in the herb can interfere with drug-metabolizing enzymes, resulting in dangerous interactions.
While a large number of people use kratom, some people may experience side effects like nausea and vomiting. Those with serious side effects should contact their doctor immediately. They may prescribe other pain relievers or antidepressants to address their symptoms.