With Kratom, it’s hard to have it both ways. Either Kratom is a dangerous drug, and should be banned. Or Kratom is a weak herb and shouldn’t be. Which is it?
The New York Times came down on the side of Kratom being addictive. But they fail to make the claim stick, and even when looking for places that want to ban it, there doesn’t seem to be any proof of danger. The best anecdotal report that the NYT found in the U.S. is one person who might have committed suicide due to addiction yet was also being treated for depression?
Leaving the popular press, what do the medical journals have to say about Kratom?
Kratom (Mitragyna speciosa) is a tree in Southeast Asia. The fresh or dried leaves are chewed by farm laborers to increase energy and productivity. It’s also been used to help treat opiate addiction in Malaysia and Thailand. The difference is in the dosage, as a small dose can be very stimulating while a large dose can make someone feel like they are on opiates. Reports of the subjective effects of Kratom can vary from stimulating (1-5g) to sedating (5-15g) The length of effect ranges around four hours, and can vary depending on absorption and how rapidly the liver can clear the alkaloids.
But generalizing dosages and times can be very dangerous, as the chemical structure of Kratom varies widely. Thai Kratom is almost 66% purely of one alkaloid while Malaysian Kratom contains only 12% of that alkaloid (mitragynine).
The side effect picture of Kratom can be serious. Reported side effects can include: “elevated blood pressure, nephrotoxic effects , impaired cognition and behaviour [42, 43], dependence potential , and hepatic failure [41, 44]. The onset of liver injury is described to occur within 2 to 8 weeks of starting regular use of kratom powder or tablets.” (complete review here).
While Kratom is currently legal in the United States, it’s banned in Thailand and Malaysia, (though one in ten Thai teens has tried it). The high rates of abuse in these countries makes it possible to study the long term effects of Kratom. “Many regular users declare their difficulty to abstain from kratom use and experiencing sharp unpleasant symptoms during abstinence periods . Physical withdrawal symptoms include anorexia, weight loss, decreased sexual drive, insomnia, muscle spasms and pain, aching in the muscles and bones, jerky movement of the limbs, watery eyes/nose, hot flushes, fever, decreased appetite, and diarrhoea [48, 54]. Psychological withdrawal symptoms commonly reported are nervousness, restlessness, tension, anger, hostility, aggression, and sadness [1, 54]. Long-term addicts are described to become thin and have skin pigmentation on their cheeks, due to the capacity of mitragynine to increase the production of melanocytes-stimulating substance [1, 46]. Regular ketum use is also reported to cause psychotic symptoms such as mental confusion, delusion, and hallucination .” (see review above)
It doesn’t sound to me like Kratom is safe or weak. Kratom sounds a lot like heroin, though heroin typically uses much lower doses to get the same effects (and withdrawal). I wouldn’t want anyone trying Kratom at a smoothie bar? Really? Would you like an opium pipe with that? Yes, I realize that it’s perfectly legal, and I also recall when Coke contained cocaine. Just because you can doesn’t mean you should.