When kratom is taken in small amounts, users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects. There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A paper analyzing data from the National Poison Data System found that between there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine an antihistamine , alcohol, caffeine, benzodiazepines, fentanyl, and cocaine.
Two deaths were reported following exposure from kratom alone with no other reported substances. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances, including illicit drugs, opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications, such as cough syrup.
Also, there have been some reports of kratom packaged as dietary supplements or dietary ingredients that were laced with other compounds that caused deaths. People should check with their health care providers about the safety of mixing kratom with other medicines. Like other drugs with opioid-like effects, kratom might cause dependence, which means users will feel physical withdrawal symptoms when they stop taking the drug.
Some users have reported becoming addicted to kratom. Withdrawal symptoms include:. There are no specific medical treatments for kratom addiction. Some people seeking treatment have found behavioral therapy to be helpful. Kratom has been linked with withdrawal syndrome, but Swogger said this is typically only found in those who take doses of more than 5 g, and 21 doses a week.
Others outside of the FDA raised questions with how that agency has attempted to restrict access to kratom. Jack E. Henningfield , PhD, is an adjunct professor at Johns Hopkins University and vice president for research, health policy and abuse liability at Pinney Associates. He is currently a consultant to the American Kratom Association and had previously provided pro bono support to the same group in their efforts to prevent the Drug Enforcement Administration from banning kratom.
Henningfield also worked on dietary supplement notifications for kratom products in an effort to get FDA to regulate kratom as a dietary supplement. For example, Narcan, which is used to treat opioid poisoning binds to opioid receptors, but no one calls Narcan an opioid.
Prozialeck was one of the first to recognize that interest in kratom was growing. He co-authored a paper in the Journal of the American Osteopathic Association on kratom. The article also provided an overview of usage for the substance such as fatigue, diarrhea and cough.
He also provided information on its legal status and additional potential medical uses of kratom including fighting off fatigue and managing coughs. In so doing, kratom would be put in the same category as substances such as marijuana, LSD and heroin. However, The Washington Post reported that the DEA yielded to protests from the public and lawmakers and withdrew the plan. Griffin added he was not in favor of placing kratom in Schedule 1, saying that doing so would effectively ends research into the substance.
All but one of those kratom deaths had other factors such as existing diseases or conditions like CVD, epilepsy or multiple drug use such as stimulants and alcohol. Though those are only anecdotal, it is difficult to ignore that volume of information. Secondly, there are animal studies that show the chemicals isolated from kratom can alleviate pain and the symptoms of opioid withdrawal.
Those studies, even though there are not a lot of them, should not be completely ignored. Other clinicians and professionals who have researched kratom told Healio Family Medicine the polar opposite views being expressed in the debate pose their own set of dangers to people, and that a common ground must be found. This is madness. This is also dangerous because it denies a therapy that many people are currently using for opioid maintenance therapy or chronic pain that they rely on or to which they are addicted.
Making it illegal or shutting off the legal supply by forcing recalls will push some law abiding citizens to use illegally smuggled kratom or even worse, use heroin or illicit fentanyl. White authored a paper that appeared in the American Journal of Health System Pharmacy that underscored the need for more research on kratom, saying the existing clinical, pharmacokinetic, and pharmacologic data is inadequate.
There has to be a middle road that allows kratom to be available while the serious research that needs to be done can be completed. Access should be restricted for recreational use and to children but allowed for chronic pain and opioid addicted people. Others, such as Kirk L. A FDA official told Healio Family Medicine established federal and scientific processes mean the door has not completely closed on kratom use. Before it can be legally marketed for therapeutic uses in the U.
Both mitragynine and 7-hydroxymitraginine are substances with opioid effects whose use may result in serious negative outcomes and accordingly, DEA would advise anyone against using this substance for its psychoactive properties.
The FDA spokesperson said patients needing treatment for opioid use disorder already have viable legal options , and more such therapies could be forthcoming. We understand that patients suffering from opioid addiction need access to effective treatment options.
Creating an efficient pathway for the development of these treatments is a very high priority for Commissioner Gottlieb. Primary care providers must help their patients make informed decisions when it comes to kratom, Cumpston said, and even then, may want to encourage patients to think twice about recommending it, especially when it comes to opioid addiction. In my opinion, the combination of FDA-approved drugs to treat addiction and therapy from addiction specialists is known to be safe and effective, so kratom users are taking unnecessary risks.
White said that despite the benefits of kratom, there are many things to be considered before suggesting it to patients.
If a person has had bad experiences with prescription opioids before and its either opioids or kratom as treatment options, then I would bring kratom into the discussion. He and his colleagues found all of the products contained the stimulant mitragynine on their label, but the narcotic 7-hydroxymitraginine was not found. Proponents of kratom suggest that the herb could serve as a solution to the opioid crisis , both by offering another option for pain relief and by aiding those struggling to overcome opioid addiction.
Other experts say that it's not the magic solution some people claim it is. The available research includes a report published in the International Journal on Drug Policy in , for which scientists surveyed people who actively used kratom and found that the herb was "described as affordable, easily available, and having no serious side effects despite prolonged use.
However, in a report published in Drug and Alcohol Dependence , researchers surveyed people who regularly used kratom and determined that more than half had developed severe dependence problems, including kratom withdrawal symptoms like muscle spasms, sleep disruption, anger, and tension. A mouse-based study published in the Journal of Medicinal Chemistry in suggested that kratom may not slow breathing to the same extent as other pain-relieving drugs like morphine.
Given that deaths due to opioid overdose are usually the result of respiratory depression, the study's finding suggests that further research on the compounds in kratom is warranted. A review concluded that kratom offers some potential benefits but has a high potential for abuse, interactions, and adverse side effects. The review also suggested that placing it behind the pharmacy counter could be a potential middle ground between banning the drug and allowing its sale unrestricted.
The future legal status of the drug remains unclear, although the DEA's past statements on the subject give some indications of what might be expected. Mitragynine and 7-hydroxymitragynine are the kratom constituents that would be classified as Schedule I drugs, making possession or sale of the herb illegal. Kratom would remain on the Schedule I list for at least two years. In mid-September , for instance, protesters held a march and rally at Lafayette Park in Washington, D.
According to those opposing the ban, placing kratom's alkaloids on the Schedule I drug list would also stifle further research on the compounds. In these cases, people had also taken fentanyl and heroin. As of , federal regulation remains on hold as the debate over the substance continues. The FDA has issued warnings to companies that sell kratom in the U. Only FDA-approved drugs can make such claims. The future legal status of the drug remains to be seen.
Although case reports have reported drowsiness, irritability, palpitations, high blood pressure, poor concentration, insomnia, hypothyroidism, seizures, psychosis, hepatitis, and coma in people using kratom, it's unclear how much is directly attributable to kratom.
Risks appear to be higher when it's taken in concentrated extracts which have a higher potency , mixed with other psychoactive substances, drugs, or adulterants, or when it's taken by people with alcohol use disorders, a history of heroin use, or certain health conditions. Potential health effects include:. According to reports by U. In most cases, the kratom was laced with other drugs.
If you or someone you love are experiencing any signs of overdose, call or the Poison Control helpline immediately. If someone you love is using kratom, it's important to be on the lookout for the common side effects such as talkativeness, increased social behavior, itching, changes in appetite, sweating as well as any unusual or extreme shifts in mood, behavior, appearance, and overall health.
Many people believe that because kratom is an herbal supplement, it's safe to use. Contamination and adulteration with other drugs, herbs, and substances are possible. For instance, in at least Americans became sick after taking kratom tainted with salmonella. Kratom comes with a risk of tolerance, dependence, and withdrawal. People who use kratom can build a tolerance , or the need to use more to achieve the desired effect, and experience symptoms of withdrawal when they stop taking the drug.
More research is needed to determine the exact half-life of kratom. Like other substances, how long kratom stays in your system will depend on the following factors:. The DEA states that kratom abuse can lead to addiction and can result in psychotic symptoms, including hallucinations, delusion, and confusion. Not everyone will experience addiction in the same way, but there are several hallmark signs and symptoms, including tolerance, dependence, and withdrawal.
Other common signs of addiction include:. People who take large doses of kratom several times per day have an increased risk of moderate to severe withdrawal symptoms. In general, however, withdrawal symptoms are milder in comparison to opioid withdrawal and may include:.
Living with pain isn't easy. If you live with pain, you may already be all too familiar with the profound effect it can have on your quality of life. For more mental health resources, see our National Helpline Database. If you are considering trying kratom, you should speak with your healthcare provider first.
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