Kratom has opiate-like effects and can lead to addiction. It is unregulated and can be laced with other drugs, including opioids. Some people have died from kratom overdose.
Calls to poison centers involving kratom have included agitation, hallucinations and seizures. It can also cause liver toxicity. It can interact with certain medications and cause side effects such as tachycardia, depressed breathing and nausea.
While some people report positive effects of kratom, such as pain relief and mood elevation, others have reported experiencing side effects like nausea, vomiting, tremors, the inability to sleep or hallucinations. More research is needed to understand kratom’s safety and risks, particularly since mitragynine and 7-hydroxymitraginine have psychoactive properties similar to opioids.
The FDA has also warned that kratom may contain dangerous contaminants, including salmonella. In 2018, the CDC linked a multistate outbreak of salmonella illness to kratom products, including pills, powder and tea.
Despite the DEA’s recent decision to put kratom in schedule 1, the FDA is continuing to support sound scientific research on kratom. Until more is known, it’s important that people use kratom only under a doctor’s supervision and avoid combining it with other drugs, especially those that cause sedation or slow breathing.
Until more is known about kratom’s effects, health care professionals can’t recommend it as a treatment for any condition. Instead, experts suggest that people who want to address pain, anxiety or drug withdrawal symptoms explore other alternatives, such as exercise, yoga, acupuncture and meditation. They can also talk to their health care provider about effective, FDA-approved medications for these conditions. These include buprenorphine and naloxone (Suboxone), which are used to treat opioid use disorder. Taking these drugs under a doctor’s supervision can help reduce cravings and withdrawal symptoms.
A person’s body chemistry, the type and dosage of kratom, and other factors influence how it affects them. A typical kratom dose is 5 to 10 grams, and effects begin within minutes and last for one to five hours. Stimulant effects include increased alertness, boosted physical energy, talkativeness, and sociability. At higher doses, opioid and CNS depressant side effects can predominate.
The most common use of kratom is for pain relief. It can also be used to treat anxiety or depression, diarrhea, hypertension or high blood pressure, diabetes, and coughing. It is also popular among those who are battling opioid addiction as it can help them avoid withdrawal symptoms and cravings for other drugs. However, it is important to remember that kratom functions like an opioid, so it can still lead to dependence and addiction.
People who take kratom should start with the lowest possible dose and increase it gradually. They should also experiment with different routines, such as taking it on an empty stomach some days and on a full one other times. This will give them a better idea of how much kratom is needed to get the desired effect. It is recommended that they avoid taking kratom more than twice a day because the drug’s half-life is 24 hours. This means that it takes about 24 hours for the body to digest, absorb, and eliminate the entire dose.
A doctor who is treating a patient with addiction issues may decide to recommend kratom. However, he or she should first ask why the patient wants to use it. If the answer is pain relief or to mitigate withdrawal symptoms, the physician may be able to prescribe a drug that is safe and effective.
The Food and Drug Administration has not approved kratom, so there is no way to know what’s actually in it. In one study, researchers purchased 15 different products advertised as kratom online and found that most contained the stimulant mitragynine, but only five of them had 7-hydroxymitraginine, which has narcotic properties. The researchers also found high levels of heavy metals, such as nickel and lead, in some of the kratom products.
One of the most dangerous side effects of kratom is seizures. A 23-year-old man who took 85 g of a powdered kratom product experienced tonic-clonic seizures and an abnormal brain MRI with white matter microvascular ischemic changes, according to a report published in the Journal of the American Medical Association. Another case involved a woman who had focal epilepsy after taking kratom for 10 days. She also had rhinorrhea, insomnia, poor concentration and constricted affect, the researchers reported.
Many deadly risks associated with kratom come from how it interacts with other drugs, especially opioids. The CDC recently issued a warning about kratom, citing 660 calls to poison centers and 44 deaths related to its use. These deaths often occurred when kratom was taken in combination with other illegal drugs, prescription drugs or over-the-counter medications such as acetaminophen.
Kratom has affinity for opioid receptors, and it is used as an alternative to opioid medications for pain relief. However, it is also known to produce stimulant and CNS depressant effects at higher doses. These effects vary between users. Stimulant effects are reported as increased alertness, boosted physical energy, talkativeness, and social behavior. CNS depressant effects are experienced as sedation, relaxation, and pain relief.
Kratom is a potent inhibitor of the CYP450 2D6 and 3A4 enzymes, which can cause drug interactions with many common medications. It is recommended to avoid kratom products if you take any prescription medications, including opioid painkillers, antidepressants, and sedatives. Seizures have been reported when kratom is combined with modafinil.
The long-term use of kratom has been associated with addiction and withdrawal symptoms. It is also possible to develop a tolerance to the herb, which requires higher and higher doses to produce the same effect. Long-term users are often unable to quit taking the drug without assistance, and they can experience withdrawal symptoms if they discontinue it.
A recent case report in The Oncologist describes a 23-year-old man who had severe liver toxicity after using 85 grams of kratom per day for 6 weeks. The patient had a history of misusing nonprescription opioids and intravenous heroin, and he had received treatment for buprenorphine/naloxone at an addictions clinic. He was amenable to medication therapy for kratom withdrawal and completed an at-home induction with buprenorphine/naloxone. Kratom capsules