Kratom: What Are The Facts?

In recent months, the DEA has had some trouble deciding whether or not to ban the substance known as kratom. Kratom (Mitragyna speciosa) is a plant native to Southeast Asia. It is a tropical tree, a relative to coffee, that has been used medicinally in its native land for centuries. It does, indeed, contain opioid compounds. The rest of the story on kratom is fuzzy, and a lot of conflicting information has been thrown around.

How Does Kratom Affect The Brain?

Researchers have found over 20 biologically active compounds in kratom, but there are two main alkaloids that give it its psychoactive properties. The first is mitragynine, which binds to opioid receptors in the brain, much like heroin and prescription opioids. The difference between kratom and other opioids is that mitragynine prefers delta and kappa opioid receptors, and only binds to mu-opioid receptors (the same ones that heroin and prescription painkillers hit) in high doses.  Mitragynine also has other opioid affinities.

The most important distinction is that mitragynine an opiate agonist that tricks the brain into thinking there is actually an opioid there by binding to opioid receptors. This means that it produces all the same effects as other narcotics (it kills pain and produces a general euphoria) without any of the highly addictive side effects. This is why kratom is believed to lessen the intense effects of opioid withdrawal that are seen with other substances.

The second alkaloid is 7-hydroxymitragynine, which stimulates the central nervous system in much the same way as cocaine does. This alkaloid also hits specific opioid receptors in the brain.

For these reasons, kratom has stimulant effects in lower doses and narcotic effects in high doses. Kratom also contains biological compounds that hit serotonin receptors in the brain, which means that it is also an effective treatment for depression, anxiety, and sleep disorders. The narcotic effects treat pain and the stimulant effects can help with a number of issues, including fatigue and depression. The unique subset of opioid receptors hit by the alkaloid compounds in kratom is also why it’s considered less addictive than other opioids.

Is Kratom Addictive?

The fact of the matter is that there is not enough research on the subject to be able to tell if kratom is addictive, and if so, just how addictive it is. The fact that it is an opioid agonist isn’t enough to place it on the throne of a cure-all for any opioid addiction. While it has been used to help tens of thousands of people overcome narcotic addictions, some disturbing things have been noted.

In an interview with Scientific American, Dr. Edward Boyer (Director of Toxicology and Professor of Emergency Medicine at University of Massachusetts) said that his gut feeling was that kratom was addictive. Dr. Boyer was allowed a unique opportunity to study kratom and its effects after treating an emergency room patient who had suffered a seizure after mixing kratom with modafinil. He agrees that there is not enough research out there to say whether or not it is, and notes the fact that animals as well as his human test subject had both been shown to build up tolerance to kratom.

It is very common for individuals to build up a tolerance to opiates, but at this point, there’s no way to tell if the tolerance build up is simply one of the ways opioid agonists mock actual opiates, or whether it is a trademark sign of addictive properties.

How Are People Using It, And Why?

Kratom is derived from the leaves of the Mitragyna speciosa tree. In its traditional medicinal uses, the leaves were often chewed, but today they are more commonly ground up into a powder and sold in the form of teas and, occasionally, chewing gums.

In the U.S., kratom is commonly used to either treat the especially intense symptoms of heroin withdrawal and also to curtail opiate addictions entirely. Smaller numbers of individuals have used it to treat addiction to alcohol and other drugs. Many people say they have managed to stay clean for long periods of time solely because of kratom.

In Thailand, kratom has been used to treat meth addiction, which has been a growing problem there. Kratom has seen several stages of legality in Thailand over the past 100 years, but the Mitragyna speciosa is native to the area and grows there in large numbers, meaning that it has always been difficult to control.

Kratom has also been used to treat pain, depression, mood disorders, ADHD, insomnia, and anxiety around the world. It also has anti-diarrheal and appetite suppressant properties, so its auxiliary medicinal uses are wide and varied. In recent years, kratom has also gained a bit of steam by recreational users, who enjoy its euphoric and stimulant effects, and occasionally, the intensity it can add to sexual encounters.

What Are Kratom’s Dangers?

There haven’t been enough studies on the substance to name and quantify all of its potential problems, one of which could possibly be addiction. However, there are two well-known and very real dangers of kratom that have been documented.

The first is the possibility of overdose. When taken in large quantities, opiates cause respiratory depression and can lead to acute respiratory distress syndrome. What this means is that when in the throes of a narcotic overdose, the lungs stop depressing, and this can lead to respiratory system injuries, long-term respiratory problems, and death. Unfortunately, opioid agonists are not free from this side effect, which means you can overdose on kratom, and it can be deadly.

The next is the issue of mixing it with other drugs. Because kratom acts much in the same way as actual opiates, it can be very dangerous when combined with other medicines and mind-altering substances. In the above mentioned interview, Dr. Boyer states that he doesn’t know why his patient began seizing from the mixture of kratom and modafinil, but he did. Given the narcotic-like effects of kratom, it’s safe to say that there is a very real danger of causing serious health issues if it’s mixed with other substances.

Can Kratom Be A Natural Alternative To Methadone?

There are myriad people who self-testify that kratom has helped them recover from addiction and stay clean. On top of this, opiate agonist therapy is a widely accepted and used method to treat opiate addiction. Its effectiveness is only partially understood, though, and more research needs to be done on just how effective an addiction treatment it is.

The other issue with kratom as addiction treatment is the fact that it is currently unregulated. Kratom bought on the streets can be mixed with other substances, and could even be fake. It could contain varying degrees of potency, and unknown additives that could cause severe allergic reaction.

Because of these dangers, and the little-understood nature of kratom itself, the DEA banned it and placed it alongside heroin and cocaine as a schedule 1 controlled substance. However, this decision faced a huge stream of backlash, both from those currently treating themselves with it, and those studying it. Once defined as a controlled substance, it would be incredibly difficult to study kratom and its ability to treat addiction further.

Mere weeks after the ban was set in place it was lifted, mainly in response to the backlash. The DEA still feels as though kratom can be dangerous, but also understands that it needs to be researched more thoroughly as a medicinal treatment and not just considered a recreational drug. While the waters are a little muddy regarding kratom and its benefits and dangers, there is hope that the future will bring better understanding of what exactly it can do for people, and how best to utilize that safely.