Posted by: Chris Maloney | February 17, 2016

How Dangerous Is Kratom?

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 the220px-mitragyna_speciosa111 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 [41], impaired cognition and behaviour [42, 43], dependence potential [42], 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 [58]. 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 [1].” (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.

 

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Responses

  1. […] How Dangerous Is Kratom? […]

  2. Kratom is amazing – best thing iv ever tried for withdrawal symptoms.

  3. I think it’s a HUGE stretch to say kratom is anything like heroin. I’ve tried heroin. Kratom doesn’t kill you and the side effects are nothing like heroin. Also, I was an alcoholic for 10 years and kratom help me quit over night. Kratom doesn’t make you wreck your car, or sleep walk and piss on the floor, or sleep with someone you shouldn’t sleep with. I’ll take kratom over heroin or alcohol any day. I’m glad it’s there and I’m thankful that it saved my life. And the idea that people like you want to get rid of it cause you get high off feeling self righteous about something (anything), is upsetting.

  4. Thanks for your comment! I think your circumstances were a far cry from someone trying kratom on a whim. If you look at the article again, I’m just quoting from medical studies when I look at the kratom/heroin picture. My opinion is that kratom is powerful, and likely addictive for people who try it off the street. I’m glad you found it a less addictive and better alternative than heroin. I have no interest in its legal status. My goal is to clarify that it is powerful and has side effects for people who are considering it a safe high.

  5. I am not one of those users of kratom that flies off the handle at any criticism of it. I don’t want it Schedule 1’d because I want more studies as to both its benefits and risks. While it has personally replaced anti-depressants and anti-anxiety medications for me, I do believe it can be misused and perhaps both psychologically addictive and physically addictive.

    But I do object to you equating a plant that could potentially help rid the country of our deadly opioid addiction to heroin. And most users of kratom aren’t buying it at smoke shops for a safe high. They’re using it to stop relying on or abusing presciption medications, recreational drugs, or alcohol. I know moms using it to help with fibromyalgia pain. Grandparents using it to help with arthritis pain.

    I personally add 2 grams to my Kefir and blueberry protein shake in the morning and then consume another 2 grams as a tea at night. I get a stimulant effect akin to coffee (the plant is in that same family) but with a euphoric calm if that even makes sense. It helps me focus and work. It has also enabled me to stop taking the anti-depressants and anti-anxiety medications I had been on since high school. All while feeling better with less side effects than I had on those medications.

    Yes, you definitely have to look at medical studies, but you also have to take into account the real actual human stories behind kratom. I am cautious. I take Milk Thistle and drink beet juice to help prevent any detrimental effect it may have on my liver. I stay hydrated because it can dehydrate you. I’ve monitored my blood pressure (it’s rise is again similar to that of a cup of coffee) and I also take 2 days off each week to prevent developing a toloerance that would lead to me needing more. And I also only buy from reputable botanical companies. Not the crap at head shops or gas stations. Kratom CAN help if used responsibly.

  6. Thanks for your thoughtful comment. I want to be clear that any substance can be used responsibly and it sounds like you’re doing that. You’re not someone I would have issues with. I’m writing for the kids who are looking for fun, and see kratom as harmless because it’s natural. Serious consequences do happen, as evidenced by the level of Thai addiction.

    I’m glad it’s served to help you off other medications. At the same time, I see it as a possibly useful transitioning agent rather than something I’d want someone on for life. It is addictive, and it does cause serious problems.

    On the heroin comparison, I worked in Oregon, where many people consider heroin addiction to be manageable. Arguably, some of them were able to handle it. But many others fell into dysfunction as soon as life threw them a curve ball and they weren’t able to cope. So, having dealt with them, the experience of Thai users of Kratom does sound similar to me. I never met an addict of any kind who set out to be an addict. And I’m all for people using what they need to transition away from addiction. But when we deal with something like Kratom, we should be aware of just how powerful it can be.

  7. Thanks for the response. May I ask the source you’re referencing regarding Thai teens and Kratom experimentation? The main reason it was banned in Thailand, where it’s native to, was because opium addicts turned to Kratom when the government began taxing opium users and shops. They made it illegal for no other reason than it was cutting into opium revenue. You aren’t permitted to grow the plant and any plant found is destroyed. From everything I’ve read, it is still primarily older generations that continue to grow the plant and discreetly chew the leaves to combat aches, pains, and fatigue. Traditionally, it had been used for decades by workers in the fields for that reason, so while illegal now, the practice is still accepted and overlooked in villages there. Word is they are actually considering lifting the ban and taxing Kratom to help combat the methamphetamine problem there.

    I’ve read about teens abusing Kratom in Bangkok. Young people there are boiling two dozen or so leaves and then mixing it with cough syrup + Coca Cola and ice for a cheap drink called 4×100. It’s popular among the Muslim population in Bangkok because it’s a substitution for alcohol. There are however several reported deaths attributed to 40×100 intoxication. Drinking several of those one after another – just like we knock down beers here – is a high Kratom dosage that will put you in a sedated stupor. Combine that with the dextromethorphan and it’s easy to see how that can be a problem whether it’s respiratory distress or whatever.

    The problem is the FDA – despite the fact that dietary supplements sold here are not subject to premarket approval – has determined kratom is a new dietary ingredient (NDI) subject to a safety-related notification despite its history. Research Big Pharma’s patents on Kratom alkaloids and I think the reason for this is obvious. Drug companies are looking for a means to patent and market it. Meanwhile, we need to get it out of gas stations and smoke shops, where manufacturers often add caffeine and synthetic tramadol to it, and get it on the shelves at health food stores from GMP facilities with proper dosing info and warnings.

    Anything that makes you feel good can lead to an addiction. I don’t like the days I force myself to skip Kratom. I don’t feel as good, I don’t work as well, and my mood changes. While some may look at that as some kind of indicator that I’m at risk for a type of opioid dependency, I see it as no different than what happens to my wife when she skips coffee in the morning. And caffeine is a dangerous stimulant that can contribute to heart arrhythmias and even death that we’ve normalized to the point where you see 10 year olds getting Venti’s at Starbucks or kids drinking Monster drinks at the bus stop.

    I guess my point with all of this is yes Kratom is something we should use with caution. But it’s also something we need to study as more people use it for longer periods of time. Banning it is the wrong move. If it was truly like heroin, there wouldn’t be so many people championing it. Nobody ever says, “Heroin saved my life” or “My life was miserable and just one dangerous pill after another until I found heroin!” I ran six miles today with Kratom added to my protein drink. No heroin addicts are running six miles or even one.

    Anyway, thanks again for reading and replying.

  8. Hi Brian,

    Thanks for all the thought you’ve put into this. The information about Thai Kratom use is from the medical review of Kratom which is the basis of my post (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657101/). About half-way down, under Kratom Use In Southeast Asia, third paragraph, they cite Thai surveys that show young Thai are experimenting (between 4 and 10% have tried it).

    What we’re seeing nationwide is a prescription drug addiction epidemic that has branched out into heroin use as patients are taken off their prescription opiates and left without care. Some of them are able to detox, but others seek out heroin as a substitute. Since it’s illegal, the suppliers of heroin are very dangerous folks. Dealing with opioid addiction is a huge issue that cuts across all social and political boundaries.

    Recently I wrote a book on Healing Chronic Back Pain specifically because back pain sufferers are no longer supposed to receive opiates for pain relief. I did not mention Kratom as a possible replacement because in my practice I’ve found habitual pain response can be altered by a combination of physical and mental exercises in combination. Sort of Dr. Sarno meets McKenzie exercises with an emotional twist. That’s where I’d send people if they’re using Kratom to transition. (http://naturopathicmaine.com/books/healing-your-back-of-chronic-pain-reversing-habitual-responses/)

    I’m taking an internet holiday for the holidays starting tomorrow. Feel free to comment, but I won’t be responding until the New Year. Happy Holidays!

  9. Happy holidays and happy New Year to you as well. Thanks for the source link and for understanding that I’m not coming at you in a confrontational way. Just offering a different perspective. Appreciate your time.


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