What Is Kratom? Uses, Side Effects And More

In fact, while the affinity of mitragynine for opioid receptors is less than that of morphine, 7-OH-mitragynine is far more potent than either, approximately 46 times that of mitragynine and 13 times that of morphine 38, 39. Both mitragynine and 7-OH-mitragynine target opioid receptors, albeit with significant differences in binding affinity . Kratom is primarily sought out for its stimulant and opioid-like properties, and may be used either for its perceived therapeutic effects or as a recreational drug. Commonly known as “kratom”—a term referring to both the plant itself and the botanical products derived from its leaves—the M. Evaluation of the mitragynine content, levels of toxic metals and the presence of microbes in kratom products purchased in the western suburbs of Chicago.

Is kratom legal?

Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine. Mackay L, Abrahams R. Novel case of maternal and neonatal kratom dependence and withdrawal. Fatal combination of mitragynine and quetiapine – a case report with discussion of a potential herb-drug interaction. Boyer EW, Babu KM, Macalino G. E. Self-treatment of opioid withdrawal with a dietary supplement, Kratom. Metabolism studies of the Kratom alkaloid speciociliatine, a diastereomer of the main alkaloid mitragynine, in rat and human urine using liquid chromatography-linear ion trap mass spectrometry.

Some medications are changed and broken down by the liver. This might prevent people from getting enough oxygen. Kratom can cause many side effects when taken by mouth, including nausea, vomiting, dry mouth, frequent need to urinate, constipation, aggression, hallucinations, delusions, and thyroid problems. Kratom is POSSIBLY UNSAFE for most people when taken by mouth.

Safety InformationNew

Here’s a rundown on everything you need to know about this unique plant, including its effects, common myths, and how to use it safely. As the FDA has recently stated definitively that 7-OH is an opioid, a formal declaration from HHS to this effect will be helpful in ensuring proper diagnosis and access to treatment for this patient population. Fatal opioid overdoses involving kratom increased from 0.5% of all opioid-related deaths in 2016 to 2% in 2022. Despite long-standing data describing the opioid activity of kratom, it remains widely accessible. Our brains and bodies naturally produce opioid peptides, including endorphins, dynorphins, and enkephalins, among others, and these govern myriad central and peripheral neural circuits, such as motivation, pain, and gut motility. Opioids are molecules with diverse shapes and structures that modulate opioid receptors.

• Like the opioids, binding of the indole alkaloids to opioid receptors initiates G-protein-coupled receptor (GPCR) signaling; however, unlike traditional opioids, the activation of GPCRs by indole alkaloids does not initiate the β-arrestin pathway .
• They exert their painkilling, anxiolytic, stimulating, and nootropic benefits by binding and interacting with various neurotransmitters in the brain.
• For patients with chronic kratom addiction and drug cravings, long-term pharmacological replacement therapy may be warranted.
• WebMD does not provide medical advice, diagnosis or treatment.
• Kratom is an herbal product made from the leaves of the kratom tree (Mitragyna speciosa), said to have opioid-like effects.

You can take kratom following the toss-and-wash method. Experts have found that the red type might be stronger than the older form of kratom, which is green. Because of kratom’s potency and lack of research to conclude safe amounts, be sure to consult with your pharmacist or doctor before using it. However, more research is needed to determine the effects of these dosage variations on the body in the short and long term. Higher doses between about 5 and 15 grams may have the opposite effect and may help relieve pain. Because kratom has such potent ingredients, you should consult with your doctor before taking it or any other supplement.

Kratom Strains

Additionally, Dr. Dwenger urges seeking treatment for opioid use. CBD products, such as topical balms or CBD oils, can also help alleviate pain, as long as you buy from a trusted brand, adds Cohen. Due to lack of regulation, there’s also the risk of not knowing where the kratom you purchase is sourced from or if it might be laced with other substances. Kratom withdrawal can also cause pain, sickness, irritability and anger, adds Dr. Dwenger.

Find More Resources on Kratom

• RxList does not provide medical advice, diagnosis or treatment.
• The authors attribute this outcome to a drastic reduction in clearance of quetiapine (a CYP3A4 substrate) secondary to the acute suppression of hepatic metabolism by kratom.
• Dr. Shah also suggests seeing a licensed mental health professional for anxiety or other mental health concerns, which may involve talk therapy and prescribed medication.
• LC-MS-MS method for mitragynine and 7-hydroxymitragynine in hair and its application in authentic hair samples of suspected kratom abusers.

Just like opioids, kratom can be addictive. But in high doses, it can relieve pain like opioids do. The most common uses of it are to relieve pain, depression, and opioid addiction. It’s true that consistent kratom use can develop tolerance and lead to addiction — which is why it’s safest to take regular breaks from kratom every couple of weeks at least. The worry is that because kratom works on the opioid receptors, it could be addictive. Combining kratom with certain substances could potentially be dangerous.

However, competing evidence suggests a different model; rather than acting as simple agonists, mitragynine and 7-OH-mitragynine appear to demonstrate variable effects depending on the receptor. For example, Takayama and colleagues have produced a sizeable body of work on the subject, indicating that both mitragynine and 7-OH-mitragynine behave as agonists, with mitragynine acting primarily on µ- and δ-receptors and 7-OH-mitragynine more selective for µ- and κ-receptors 39–41. Despite considerable investigation, the precise manner in which kratom alkaloids act at each of the receptors remains disputed.

This would have global implications as it would deeply impact the kratom supply, so we’ll keep you updated as this unfolds. It’s so deeply rooted in the local culture that hardly anybody considers it a drug. In Malaysia and Thailand, kratom is also known as biak-biak, kakuam, ithang, thom/tom, and ketum.

What’s the difference between kratom powder and kratom extract?

Given the likelihood of protracted demand for kratom use, health providers and medical educators should take efforts to improve awareness of this still relatively unknown drug. Kratom addiction often begins in the setting of patients suffering from opioid dependence, in part because it is perceived as a cheaper, more natural alternative to buprenorphine or methadone in those who wish to cease their abuse of Kratom overview narcotics. For patients with chronic kratom addiction and drug cravings, long-term pharmacological replacement therapy may be warranted. For instance, it has been reported that kratom products may be altered by artificially increasing levels of 7-OH-mitragynine to enhance potency .

Associated Data

These side effects may indicate that long-term usealso affects the liver. The long-term safety of kratom has yet to be fully elucidated as well. The longer you use kratom, and the higher the dose, the more likely you are to become dependent. Yes, kratom can be addictive — but only with long-term use. When consumed orally, the LD50 for mitragynine in mice was 547.7 mg/kg, with no lethal dosage observed for 7-hydroxymitragynine. For mitragynine, a median lethal dose for 50% of the test population (LD50) was reported to be 27.8 mg per 1 kg of body weight.

What is the scope of kratom use in the United States?

The symptomology of kratom overdose can mimic the opioid toxidrome, particularly when patients consume more than 15 g of kratom . While reversal agents are standard of care for opioid overdose, their efficacy in cases of kratom overdose has not yet been evaluated in clinical trials. While there are no published guidelines specifically indicated for kratom, it is reasonable to begin management in a manner similar to that employed for patients presenting with opioid abuse.

Matson M, Schenk N. Fatality of 33-year-old man involving kratom toxicity. In-utero effects of the crude ethanolic extract of the leaves of Mitragyna speciose on neural tube formation in rats. Evaluating the hematological and clinical-chemistry parameters of kratom (Mitragyna speciosa) users in Malaysia.

Users who were taking kratom regularly for two to eight weeks reported experiencing nausea, itching, dark urine, jaundice, and abdominal pain. There have been reports of patients mixing kratom with stimulant medications, such as modafinil, which have led to seizures. Other kratom products have been found to contain significantly less kratom than advertised on their packaging. In Sweden, nine people died from a “boosted kratom formula” called Krypton.

It is relatively new and so many people, including some mental health professionals, may not be familiar with it or the risks patients may incur when they use it. (See the full WHO ECDD report on kratom.) Kratom remains on the list of substances under surveillance by the WHO ECDD. While kratom use or sale has been banned or restricted in several countries,9 kratom products are currently legal and accessible online49 and in stores in many areas of the United States. See more information on seeking substance use treatment and other medical attention. U.S. and international agencies have expressed concern that kratom products may cause serious harm.1 There are no uses for kratom approved by the U.S. While research is underway to explore possible therapeutic benefits (see Could kratom be used as medicine?), kratom products have not been demonstrated to be safe and effective for any medical condition.

“Also, people who have battled substance use order might experience a relapse.” The main risk of kratom is its high chance of addiction. Speak to your health care provider before using Kratom to see if it’s necessary for your needs and to determine a safe dosage for you. Kratom can exacerbate the effects of other “drugs of abuse,” says Dr. Dwenger, such as  benzodiazepines, stimulants, opiates and fentanyl. The U.S. Drug Enforcement Administration classifies kratom as a drug and chemical of concern. Kratom (kray-tum), or Mitragyna speciosa, is a plant native to Thailand, Malaysia, Indonesia and Papua New Guinea and can be consumed to induce various mental and physical effects, such as sedation or dizziness.

How Long Does Kratom Last?

Kratom’s effects on the body may also depend on how it’s consumed, says David Cohen, clinical director at Harmony Place, an addiction treatment and recovery center in Woodland Hills, California. Kratom’s two main active compounds are mitragynine and 7-hydroxymitragynine, which bind to the body’s opioid receptors and produce a morphine-like effect. Experts stress there’s little scientific evidence supporting kratom as an effective treatment for any health concerns and that more research must be conducted to better understand the substance. Kratom is often used by individuals to self-treat concerns, such as anxiety or opioid addiction, but health experts and officials strongly advise against using the drug. Kratom is an opioid-like herbal substance with serious side effects and a high risk for addiction.