Kratom is a tropical deciduous and evergreen tree in the coffee family native to Southeast Asia in the Indochina and Malisia floristic regions. Its leaves are used for medicinal properties. It is psychoactive, and leaves are chewed to uplift mood and to treat health problems.
Kratom is indigenous to Thailand yet it has been outlawed for 70 years. It was originally banned because it was reducing the Thai government’s tax revenue from opium distribution. Kratom and its derivatives have been used as a substitute for opium as well as an aid for the management of opium withdrawal.
Data on the incidence and prevalence of its use are lacking, as physicians are generally unfamiliar with it and its use is not detected by typical drug screening tests. Kratom metabolites can be detected by specialized mass spectrometer tests. Incidence of Kratom use appears to be on the rise among those who have been self-managing chronic pain with opioids purchased without a prescription and are cycling (but not quitting) their use.
As of 2011, there have been no formal trials performed to study the efficacy or safety of Kratom to treat opioid addiction. The pharmacological effects of Kratom on humans are not well studied. Its metabolic half-life protein binding and elimination characteristics are all unknown. Kratom behaves as a u-opioid receptor agonist, similar to opiates like morphine, although its effects differ significantly from those of opiates.
Kratom does not appear to have significant adverse effects, and in particular appears not to cause the hypoventilation typical of other opioids. Compulsive use has been reported among drug users who inject opioids, and those who use opioids to manage pain without direction from medical professionals.
The DEA warns the leaves from Kratom trees are widely available on the internet and sold as crushed leaves that can be smoked or steeped in tea. The kratom leaf is native to Southeast Asia. However, it’s banned there but it’s legal in the US, leaving several wondering why.
The DEA says Kratom can lead to addiction. At low doses users report alertness and energy and at high doses, the drug produces sedative effects. According to the DEA, there is no legitimate use for Kratom but they’re still conducting research on the possible dangers of using the drug.
Side effects associated with chronic Kratom use include constipation, loss of appetite and weight loss and darkening of the skin color on the face. Chronic use has been associated with bowel obstruction. Chronic users have also reported withdrawal symptoms including irritability, runny nose and diarrhea. Withdrawal is generally mild and short-lived, and may be treated with dihydrocodeine and lofexidine.
Three cases reported documented deaths involving kratom. Other drugs were used in all cases and in one, Kratom was speculated to possibly be the primary cause of death. In 1975, there was an isolated report of serious adverse effects such as psychosis, hallucinations, convulsions and confusion among five individuals who had used kratom daily for 10-35 years.