What is Kratom?

Kratom (Mitragyna Speciosa/Korth) is a leaf on trees that are native to Myanmar, Thailand, Indonesia, Phillipine, Papua New Guinea and other various parts of Southeast Asia. This tree is a member of the coffee family. Kratom can come in powder, pill or tea form in most cases and depending on the dosage that one takes, Kratom can have either a stimulant-like or an opioid-like impact on the brain. Originally, Kratom was used to increase productivity in workers by reducing fatigue. Workers would either chew or chop the leaves into a tea in order to get a quick boost of energy.

However, in recent years, Kratom has become sort of a niche substance used by individuals for a variety of reasons. Some use it for energy. Others for pain. There are even those who claim that Kratom has helped them to abstain from harder drugs such as opioids, heroin, methamphetamine and bath salts. (It is important to remember that Kratom can have an “opioid-like” or “stimulant-like” impact depending on dose.) Kratom is sometimes sold with other names such as: biak, ketum, kakuam, ithang, thom, etc. It comes in varieties that are mainly named after the regions that they are sold in. Some common strains include Malay, Maeng Da, Sumatra, Vein Kratom and Borneo. Some are also referred to by colors like Bali Green or Red Borneo or White Vein.

Each strain has different effects on the body. Some have mood-enhancing effects. Some have relaxation, sleep-inducing and pain-relieving properties. I ask that you read on before making a decision on whether Kratom is right for you.

 

How Does Kratom Work?

Kratom contains various phytochemicals or chemicals that are active in a plant. Phytochemicals have been credited with things such as immune boosts, reduction of inflammation, cellular repair and more. In Kratom, there are so many phytochemicals that scientists struggle to separate and identify each one. This makes studying the true long-term effects of Kratom very difficult. The majority of Kratom (approximately 66%) contains a phytochemical called mitragynine. This is an alkaloid that is found in many psycho-active substances. Mitragynene is known to contain analgesic properties or simply, pain relieving properties. The effect on the body in higher doses is similar to a sedative or an opioid. This is because mitragynine binds to opioid receptors that naturally occur in our brain. This is also the same receptors that fentanyl, methadone, morphine, codeine and other opioids bind to. When a person takes Kratom, they are simply replacing a drug that comes from the poppy plant (which produces heroin, oxycontin, Vicodin, etc.) with Kratom that comes from the Korth tree. Like cannabis, you will find other names on Kratom products such as “Space Dust” to distinguish the product from another seller.

 

Does Kratom Actually Work?

The simple answer is yes, Kratom works. However, the more accurate answer is that Kratom is simply a plant that mimics the opioids that are already available. It acts the same way on the brain. So yes, it will work to relieve pain. It will help you sleep. But…and this is a BIG but, you are not gaining anything more or less healthy than you would with a Vicodin or anything else. These substances will still metabolize in your system the same way and long-term use in either substance can and will increase the risk of dependency.

 

But Is Kratom Dangerous or Are You Just Trying to Scare Me?

The purpose of these blogs is never to scare you. The hope is that these blogs will educate you and give you more information so that you can make the best choices for you. Kratom, like any other plant, including cannabis, can be contaminated by naturally occurring things such as yeast, mold, pesticides, etc. Salmonella is one of the most common things seen in Kratom. (Yes, the same Salmonella that you get if you touch or consume raw chicken!) These contaminants can create serious health problems. The true dangers lie in the processing of Kratom. Think of Kratom like any other pill (if you take it in pill form.) The pill has to be made of something and you never get a pill that is 100% Kratom, Vitamin D or anything else. There are fillers and binders that give the pills their form and materials that make the capsules hold their shape. Like diet pills and other supplements, Kratom is not FDA approved and has no known medical benefit. (Full disclosure: this does not mean that it does not have benefits. It just means that there is not enough information available to make a scientifically sound decision about whether the benefits outweigh the risks of abuse, dependency and addiction.)

However, there are proven documented risks. CNS (Central Nervous System) drugs such as benzos, barbiturates, alcohol, opioids, anti-depressants and more can interact with Kratom. These drugs can create an additive effect like when you see Tylenol or Aspirin mixed with caffeine to treat headaches. Both Tylenol and Aspirin can treat a headache, but together, they work a little better. Too much of this mixture, however, can cause severe health issues. CNS drugs can also create what is known as a synergistic effect, meaning that the addition of Kratom to the drug can amplify the impact of the CNS drug to the point that overdose and adverse reactions are much more likely.

 

Can I Overdose or Die on Kratom?

Yes and YES! Kratom overdose can happen at any time and can cause symptoms similar to any other drug overdose. Rapid heartbeat, nausea, slowed breathing, incoherence, loss of consciousness, etc. The actual cause of death is called “acute mitragynine intoxication.” Currently, there are multiple deaths attributed to Kratom and lawsuits alleging that the companies sold these products without proper dosing and usage instructions. I will include those links down below and include the CDC’s take on unintentional Kratom overdose. The summary of these deaths is that they have happened in very healthy people. Nurses, in-shape fathers, young adults, etc. These are not people with a history of medical problems. In some cases, there is no history of addiction. These are simply people who thought Kratom could help them.

In one study “152 of those people were found to have kratom in their system, and the drug was a cause of death for 91 of them”

 

What Is The Truth?

The truth is that we have a long way to go before we understand the true impact of Kratom on our bodies. There are diehard proponents who say that Kratom has worked wonders for them. However, critics point out that Kratom works exactly like the drugs that Kratom users claim they stop using. Kratom is no different than heroin or other prescription opioids. It acts the same exact way in our brain. It metabolizes in our body and can result in side-effects like liver and kidney issues. There are no approved forms of Kratom being sold in the United States. It is legal at the federal level because we have not studied it enough to decide if it should be on the list of Scheduled drugs. Some states have outright banned Kratom. Sellers in those states are simply skirting the law until they get caught.

In 2016, the UK banned the sale, import and export of Kratom. Ireland has declared that the phytochemicals mitragynine and 7-hydroxymitragynine are Schedule 1 drugs. Who knows where the United States will stand when it comes to Kratom? Kratom is legal in Canada as long as it is not “for human consumption.” It is sold for “aromatherapy, education and research purposes.” We saw similar disclaimers on bath salt packages. The biggest problem that I see in Kratom is something similar to what we see in cannabis. No one knows the precise dose of Kratom. They do not know how much or how often one should take it based on age, height, weight, other medications, etc. The labels on powder packages do not tell you how much Kratom to mix into a cup of tea. Some labels are as vague as “Take 1-2 pills” but do not mention how often, with or without food, etc. There are no warnings of the potential side effects if you get it wrong.

To be honest, the number of Kratom deaths is most likely much higher. Testing for mitragynine or 7-hydroxymitragynine is a very specific test. It is not one that would be run as part of a normal blood panel during an autopsy. Most are probably not tested unless Kratom use is admitted by a patient or their family members, or unless it is found at the scene of a suspected overdose. Some of these deaths could be attributed to unknown causes or things that are completely unrelated to the Kratom use. This should serve as a tale of caution for those of you using or considering the use of Kratom. This is not technically something that we know how to treat. So use is definitely an at your own risk situation.

 

RESOURCES

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657101/

https://www.fda.gov/news-events/press-announcements/fda-issues-warnings-companies-selling-illegal-unapproved-kratom-drug-products-marketed-opioid

 

Kratom Deaths

https://www.kiro7.com/news/trending/family-files-lawsuit-over-florida-womans-kratom-related-death/SNXMAWS6RNGU5LPCY3RQR6N6EE/

https://www.miamiherald.com/news/nation-world/national/article269902902.html

https://apnews.com/article/health-business-lawsuits-georgia-us-food-and-drug-administration-46027961c11d27c3cee56c547a4a1664

https://www.cnn.com/2019/04/12/health/kratom-deaths-cdc-study/index.html

https://www.cdc.gov/mmwr/volumes/68/wr/mm6814a2.htm