Addictive Potential: Medium
Emergency Room Visits Yearly: No recorded hospital visits
Mandatory Minimum Sentence: Unknown
Mechanism of Action: mu-opioid receptor agonist
Kratom (Mitragyna speciosa) is a medicinal leaf harvested from a large tree native to Southeast Asia in the Rubiaceae family, first documented by Dutch colonial botanist Korthals. It is botanically related to the Corynanthe, Cinchona and Uncaria genera and shares some similar biochemistry. It is in the same family as coffee and the psychoactive plant Psychotria viridis. Other species in the Mitragyna genus are used medicinally in Africa, and also used for their wood.
Kratom contains many alkaloids including mitragynine (once thought to be the primary active), mitraphylline, and 7-hydroxymitragynine (which is currently the most likely candidate for the primary active chemical in the plant). Although structurally related to yohimbine and other tryptamines, its pharmacology is quite different, acting primarily as a mu-opioid receptor agonist. It also shares some adrenergic receptor activity similar to that of yohimbine. Kratom also contains alkaloids found in uña de gato, which are thought to play a beneficial role on the immune system and lower blood pressure, as well as epicatechin, a powerful antioxidant also found in dark chocolate and closely related to the EGCG that gives green tea its beneficial effects. Other active chemicals in kratom include raubasine (best known from Rauwolfia serpentina) and some yohimbe alkaloids such as corynantheidine.
Kratom is currently being researched for its potential use in the treatment of addiction to, and withdrawal from, opiates. While this has been a well known street remedy for a long time, its efficaciousness has recently been taken more seriously as a possible future treatment for issues surrounding opiate abuse. Early research seems to indicate that the alkaloids in Kratom effect the same areas and receptors of the brain as many opiate based compounds, and are effective in replacing opiates during withdrawal. Research continues into this potentially useful alkaloid.
Kratom is a controlled substance in Thailand, Bhutan, Australia, Finland, Lithuania, Malaysia and Myanmar (Burma). A handful of people in Malaysia and possibly other countries are lobbying their governments to allow medical research into kratom as a potential prescription substance.
The DEA has added Kratom to their list of “drugs and chemicals of concern”.
Dosage and Effects:
Oral dosages range from 2-5 grams of the dried leaves. Within 15-30 minutes initial effects are felt. The effects usually last 4-6 hours. Some people report euphoria and energy at low dosages, while higher dosages evoke more depressant and opiate-like effects.
Side Effects and Adverse Reactions:
According to Erowid (2014), the negative effects of kratom include:
- Bitter taste
- Dizziness, nausea, and/or vomiting (at higher doses)
- Mild depression during or after use
- Users may feel hot and sweaty
- Hangover similar to alcohol, including headaches and nausea (at higher doses)
- Desire to repeat experience more frequently than intended
- Tolerance develops after a few days of repeated use
Kratom Addiction. It’s important to emphasize that, because of Kratom’s action on the mu-opioid receptors, it may be addictive.
- A case report of inpatient detoxification after kratom (Mitragyna speciosa) dependence
- A coincidence of addiction to “Kratom” and severe primary hypothyroidism
Deaths and Overdoses:
- A drug fatality involving Kratom
- A drug toxicity death involving propylhexedrine and mitragynine
- Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton
- Murple’s Kratom Guide
- Kratom: Possible Cure for Drug Addiction
- The Alkaloids of Mitragyna
- A Study of Kratom Eaters in Thailand
- Self-Treatment of Opioid Withdrawal with a Dietary Supplement, Kratom
- Herbal Medicines for the Management of Opioid Addiction