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Originally Posted On: https://www.alternativetomeds.com/blog/kratom-use-and-side-effects/

 

If you’ve never heard of kratom, then maybe you’ve heard of some of its alternative names. kakuam, krathom, and neithum are the ‘street’ names for the traditional cultures from which kratom originates.

Long used for medicinal and ritual purposes, kratom has recently been used in the United States both as alternative medicine and recreationally.

What Is Kratom?

What is Kratom? Kratom is an herb that has been acquired by cultures around the world for its use as a substance, both as a recreational drug and medicinally. Kratom is the powdered form of the leaves of a native Southeast Asian evergreen tree called Mitragyna speciosa (a tree in the coffee family related to the coffee tree). This tree is found specifically in Thailand, Papua New Guinea, Malaysia, and Indonesia.

Other names for kratom products include Biak, Ketum, Ithang, Thom, and Kauam. The traditional uses of kratom include adding it during cooking, chewing, or brewing into tea. Today it is being ground and smoked, similar to tobacco, or put into pill form. The active chemical in kratom that gives the substance its well known stimulant (effects in small doses), is mitragynine 1. In larger doses mitragynine acts more closely to a sedative, which is why it is akin to opioid drugs such as codeine and morphine. Individuals take kratom for a range of purposes—most famously to mitigate opiate withdrawal symptoms. Kratom is also widely used for pain management, depression, and anxiety, but it is not supported by the United States Food and Drug Administration.

 

In traditional cultures, kratom has been used as a medicine to treat pain, as well as increasing appetite, energy levels, and sex drive. Extracts of the plant are often used as a local anesthetic, or even to heal wounds. In Thailand, the leaves are used for deworming.

A few other common traditional uses of kratom is to treat fever, diabetes, and diarrhea. This was typically in connection with more rural peoples self-treating these minor health concerns.

Kratom has also been used in ritual worship in traditional cultures.

Research Regarding Kratom

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The effects of kratom use are diverse and depend highly on dosage. Research from the Food and Drug Administration 2 indicates that kratom binds to mu-opioid receptors in the brain (the same receptors which are activated by other opioids, whether recreational or medicinal). Mitragynine provides some relief from the body’s perception of pain, in attaching to these receptors, and thus higher doses of kratom are used in attempts to assist in pain management.

For the majority of information regarding kratom, unbiased and well supported research is functionally non-existent, leaving claims regarding the positive and negative effects of using kratom to be interpreted only from the compilation of anecdotes from those who have used the herb for medicinal and recreational purposes. Within these accounts, results vary widely on a case-to-case basis, with different positive and negative information accumulating.

The only federally approved study that has been published was conducted by the FDA in 2018, using internally produced computerized algorithms under the PHASE model (Public Health Assessment via Structural Evaluation). This particular study is considered to be biased against kratom by proponents for its use, as the PHASE model was developed by the FDA for use in its own research study.

In one document published in 2015 3, users describe their minds as calm. They state that five to ten minutes after using kratom, they feel strong, active, and happy. This was especially true in the agricultural industry. They also go on to mention that “their mind is calm.” While this isn’t so a much a clinical study, and is instead anecdotal evidence, the reports from traditional cultures are important to Western research.

What Is Kratom Used For?

There are a variety of applications for kratom in the modern world, and it is widely available for use in the states in which it is not banned or heavily regulated. Many individuals provide anecdotal evidence that kratom is used as a treatment for pain, anxiety, depression, and managing symptoms of withdrawal from opiates, such as heroin, morphine, and other pharmaceutical opiates. Others claim that using kratom in smaller doses provides effects more similar to a stimulant, improving mood, increasing physical endurance, and elevating sexual performance.

Because the majority of claims regarding the medicinal properties of kratom are largely anecdotal, it is not officially considered effective for the treatment of any condition. However, the list of things that kratom has been claimed to benefit include 4:

• Acute pain
• Anxiety
• Athletic performance
• Chronic pain
• Cough
• Depression
• Diabetes

• Diarrhea
• Fatigue
• Fever
• High blood pressure
• Sexual performance
• Opiate Withdrawal

In reality we do know that the active ingredient in kratom, mitragynine, acts similarly to an opioid and likely stimulates similar receptors in the brain as opiate-based medicine and other more popular or widely-used drugs. There is not a diverse and trustworthy base of evidence (beyond anecdotes) as to whether kratom is a safe or healthy alternative to more mainstream medicines or even other natural, holistic alternatives. Advocates of kratom use cite the lack of relevant, unbiased research into the use and effects of the herb for its unkind reputation amongst organizations such as the FDA. They believe that with more research, kratom use could be respected for its positive contributions to pain management and other applications.

Why Use Kratom?

The most common reasons for using kratom are for pain management, the stimulant affects you can get from low doses, mood improvement, and assistance in easing the effects of withdrawal from opiates. For the majority of places across the United States, it is easier to access kratom than to access pharmaceutical medication for the same purposes. It does not require the advice or support of a medical professional and, compared to both pharmaceutical and other natural medicinal products, it is relatively affordable too. In fact, there are a number of places online which provide easy access to kratom products and ship them to locations in which the purchase and consumption of kratom are not regulated by local law.

In an article published in 2020 5, it was said that preclinical trials showed a reduction in opiate withdrawal, significant pain reduction, and a nominal amount of hypoventilation.

Dr. Chris McCurdy suggests that this study is one of the most important for revealing that Kratom could be a potential treatment for those recovering from opioid dependency. Currently, buprenorphine and methadone are the pharmaceuticals used to treat opioid withdrawal, but each of these has their own side effects and limitations.

Methadone, the more recognized of the two can have somewhat serious side effects, including:

• Mood Changes
• Vision Problems
• Constipation
• Vomiting or Upset Stomach

• Trouble Breathing
• Seizures
• Severe Drowsiness

Like any other substance, methadone can be addictive, and may lead to taking more for the same effects.

Long term use of methadone has been linked to changes in the brain. With the potential affect to nerve cells, there’s a change in memory, cognitive function, and learning. In research conducted, there was a substantial reduction in functions that support learning and memory in the hippocampus and frontal lobe. This deterioration in cognitive function is significant, and alarming.

Buprenorphine can also be used to treat opioid addiction, however can also have somewhat uncomfortable or severe side effects:

• Muscle Aches
• Irritability
• Inability to Sleep
• Fever

While the possibility of abuse is significantly lower for buprenorphine, the high cost and potential lack of success with those who require high levels of methadone make this a non-ideal pharmaceutical for opioid addiction treatment.

Reprieve From Pharmaceuticals

Many people who seek to use large doses of kratom for its sedative effects are the same who are currently habituated to using opiate based pharmaceuticals or other widely distributed pain medications. For some, the side-effects and dependency on these substances is unbearable. Thus, they seek reprieve via natural alternatives, including kratom. Anecdotes of individuals using kratom in the short term for chronic pain, after leaving the pain medications prescribed to them for a variety of conditions, tend to include statements that kratom use has left them feeling pain free, happy, and more energetic.

The addition of pharmaceuticals often leads to more pain and trauma to a body’s functions. And the potential for addiction to these new substances is still high for those suffering from addiction disorder.

In today’s medicinal climate, many are unhappy with the widespread prescription of opiate based pharmaceuticals, and there are a number of ethical reasons regarding personal safety and economic interests. There are many reasons to seek natural alternatives to pharmaceutical medication, ranging from personal beliefs, effectiveness, availability and affordability. The usage of a natural substance is often less traumatic on the body. Kratom is that solution for some individuals, but when addressing issues of chronic pain and extended use, it is always recommended to consult a healthcare professional.

Kratom Use For Pain Management

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Although there are a number of situations in which kratom has been used for both acute and chronic pain management, the majority of these were not overseen by a medical professional; their validity is thereby in question. They may remain widely unsupported, but the positivity that supposed kratom users have in their experience remains. Some conditions that Kratom has been claimed to treat are arthritis and fibromyalgia 6 as well as other chronic pain disorders and acute pain from injury or means.

Users experiencing conditions with high chronic pain claim that kratom is an effective, but gentle substance for chronic pain management. Many typically state that there is a relaxing feeling that doesn’t keep you from feeling energized enough to maintain your state of mind. Some will also claim kratom works better than some medications that their doctors had been prescribing for their condition in the past. Though some also cite experiencing long-term side effects after one year of use.

Kratom Use For Withdrawal

As discussed, because the mitragynine chemical in kratom mimics the effects of opioids and bonds to opiate receptors in the brain, there is a population of individuals who self-administer kratom to assist in coping with the effects of withdrawal from opiate based drugs and medications. Whether they’re seeking freedom from prescription opiates (such as vicodin, Ohydrocodone, oxycontin, oxycodone, codeine, or morphine), or detaching from their addiction to recreational opiate use, including heroin, Kratom has been used. The FDA made an announcement that no substantial studies have shown that kratom can help with opiate withdrawal symptoms.

Due to its legality and ease in acquiring, individuals who are breaking their relationship with use of other recreational drugs also turn to kratom as a safer alternative to assist in the mitigation of withdrawal effects. As a cheaper alternative to participating in a rehabilitation program and acquiring prescription drugs such as methadone, which is only available through approved outpatient treatment programs. As a lightly processed herbal alternative to other substances, many drug users favor kratom not only for its availability but for its ease in administration and pleasant effects in both low and medium-high doses.

As with treating addiction to any substance, there is a fear that, rather than break the addiction and return to sobriety in life, the initial addictive substance will instead be replaced with another substance use addiction. Dependence on kratom can occur when taken regularly may also result in adverse side effects, ranging from physical effects, such as diarrhea, to psychosomatic effects like anxiety 7.

Regular use of kratom has been said to increase the tolerance, and therefore, effective dosage of the herb. Routine consumption of high doses of kratom may have adverse side effects, with anecdotal evidence of trouble breathing, brain swelling, seizure, liver damage, and death.

Whether or not these side effects can be attributed to the consumption of large doses of kratom without a doubt is questionable, as the evidence provided is strictly anecdotal and could be associated with the administration of other substances, or underlying medical conditions. What are the side effects of Kratom use?

Side Effects of Kratom Use

There are numerous side effects to using kratom, and their regularity and severity are debated between groups who advocate for kratom use and the polarized dissenting groups who believe kratom is an unsafe substance, and has potential for recreational abuse, including the FDA 8 and Mayo Clinic 9.

Administration of kratom ranges from smoking, eating, and drinking, but all capitalize on the fact that kratom is an orally active drug. When taken through the mouth, kratom can cause numbness of the tongue, dry mouth, vomiting, and nausea. Other side effects associated with the use of kratom include constipation, aggression, hallucination, delusions, and potentially thyroid issues.

When taken in larger doses, which typically indicates the goal of getting to the point where the mitragynine provides an effect described more closely to that of a sedative, kratom is associated with side effects including trouble breathing, brain swelling, seizure, liver damage, and death. When dependent on kratom due to regular usage, other side effects can present themselves, including a decrease in appetite, diarrhea, muscle pain, twitches, water eyes, trouble sleeping, hot flashes, fever, and anxiety—which many claim is also something which kratom use can treat.

Claims from an actual kratom user state that, while they prefer taking kratom more than their prescribed pain medication, they developed the presence of a slew of side effects after a year of use. These include some of the above listed side effects, but also say that, when they don’t use it, they feel nervous and depressed, and that kratom use causes frequent urination and irritation to the bladder and prostate.

Is Kratom Hard on the Liver?

Kratom is processed in the body as a toxin. Experiences for individuals will differ depending on how long the substance is used, the size of your body, and range of other factors.  In cases of using kratom as well as other recreational or medicinal drugs, the combination may result in liver damage, even in low-dose usage 10.

While the cases of acute liver injury are rare with the usage of kratom, the limited data shows that it is a possibility. The onset of nausea, fatigue, pruritus (itchy skin) and finally dark urine followed by jaundice, or a yellowing of the whites of the eyes or skin, are the results of extreme cases of acute liver injury.

The most concerning issue is the lack of scientific study and clinical trials of the substance, resulting in somewhat skewed data, and biased reporting of effects.

The Experience of Taking Kratom

Kratom is an orally active substance, and it is injected in a handful of different ways. Most commonly, kratom is found in powdered form and may be put into capsules akin to those used in dietary supplements—in fact, some dietary supplements do include kratom as a primary or periphery component of the product. It is also widely consumed in the form of a tea, where the powder (crushed, dried leaves of the tree) is brewed with boiling water and drunk over time. There is also the traditional usage, where it is crushed and smoked like tobacco. Kratom is commonly found as tinctures, extracts, and resins.

Tradition

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Traditionally, individuals indigenous to the same southeast Asian regions as the kratom tree either brewed tea in this way, or chewed the tree’s leaves. Kratom was consumed recreationally in Thailand and other tropical countries, with the intention of fighting fatigue and improving work productivity. There is also evidence for the appearance of kratom in indigenous religious ceremonies. Local traditions also employ the use of kratom for the mitigation of pain, treatment of diarrhea and, eventually, as a substitute for opium.

It appears that there’s not a stigma of addiction in Malaysia, where the substance is most widely used. Specifically for men, there’s no taboo regarding dependence on Kratom. The story for women, however, is different, as the culture accepts men who provide their family’s livelihood and are addicted to kratom, but not women who are addicts of the same substance.

Flavor

Those who take kratom orally are met with a bitter, earthy, and herbal flavor that some enjoy, but many find the flavor a bit repulsive until they become accustomed or find a way to improve it. Some mix the kratom into milk or yogurt in attempts to neutralize the taste and may even add sweeteners like honey. Others choose to dissolve powdered kratom into liquids including fruit juices and may even include kratom as a supplement in smoothies. Some websites online offer kratom powder intended for these concoctions 11.

Effects

The effects of kratom will start to be felt by the consumer usually in 5-10 minutes, maybe closer to 30-45 minutes, depending on the individual and the method of consumption. The effects typically last from one hour up to five hours, depending on dosage and tolerance.

In lower doses, someone taking kratom will experience effects similar to a mild stimulant, and such effects are typically described as pleasant, relatively mild, and non-hallucinogenic. Those who use kratom regularly to mitigate pain will likely experience less overall pain, and some relief to acute pain within the body as well. Those who use kratom in larger doses will experience effects closer to a sedative, and these effects will pervade for up to multiple hours 12.

Dependence

Those who use kratom over an extended period of time are at risk of dependence on the substance. Because the mitragynine in kratom bonds to opiate receptors in the brain, the brain will become accustomed to this action taking place in coordination with administration of the substance. Kratom is easily substituted for opiates, but dependence to the herb has been reported, and those transitioning from other opiates can potentially transfer their addiction from the previous drug to kratom instead.

Is Kratom Considered a Controlled Substance?

Kratom is not regulated on the federal level like substances such as cannabis or other recreational drugs, but it is illegal in some states in the United States of America. The substance is not immune to nationwide regulation or ban in the future, and the Food and Drug Administration does not seem to have much respect for the substance and its medical applications 13. Currently, the FDA has labeled kratom as a drug with no known medical benefits and considers kratom alkaloids to be psychoactive substances. Further, the FDA advises against the purchase of kratom in any form, including powder and as an ingredient in dietary supplements. While kratom is legal and unregulated in the majority of states in the U.S., Kratom is banned in the following states:

• Alabama
• Arkansas
• Indiana
• Rhode Island
• Vermont
• Wisconsin

There is also pending legislation in Connecticut, Hawaii, Kansas, Michigan, Missouri, New Hampshire, Ohio, Oklahoma, Oregon, Tennessee, and Texas—which, in the event that it passes, will limit, restrict, or ban the use, purchase, or sale of kratom in any form 14.

In Australia, kratom is considered a controlled substance. Canada has prohibited the promotion of ingested use of kratom, but it can be marketed for other purposes.

The European countries of Romania, Poland, Sweden, Denmark, Lithuania, and Latvia have marked it as a controlled substance since 2011. The UK has disallowed the import, export, and sale of the substance since 2016 under the Pyschoactive Substances Act.

In 2017, The Republic of Ireland listed kratom as an illegal substance under the names mitragynine and 7-hydroxymitragynine.

In the traditional countries of production, there have been some recent changes to status as well. Indonesia will see it listed as an illegal substance in 2024. The timing was pushed back after the widespread banning in 2019 to give farmers more time to change to alternative crops.

Thailand fully legalized kratom and eliminated its classification as a narcotic, and also issued pardons to upwards of 12,000 individuals who had been detained when it was still considered a narcotic.

Does Kratom Affect Mood?

There are a number of things which contribute to our overall mood as individuals, as there is complexity and many facets to our existence. Kratom use as a natural alternative to other medicine, may address particular aspects of our life in different ways and affect our mood accordingly.

Individuals who use kratom for managing pain may find that their overall mood is more positive after beginning their kratom use, as they will hopefully be experiencing less pain overall. If you are using kratom to manage the symptoms of withdrawal from opiates, your mood may be affected in adverse ways depending on your state in the process of withdrawal and how your body reacts to kratom. Overall, your mood may improve on a personal level as you are distancing yourself from the use of opiates, but the use of kratom could develop some adverse negative effects as well depending on your body and your situation.

Others may use kratom in small doses for its supposed stimulant effects, as it is popularly believed to improve mood. In fact, a survey of 8,000 individuals included a population which said that their primary use for kratom was to improve their mood 15.

Does Kratom Use Cause Depression?

The data to make an outright determination on the long- and short-term psychosomatic effects of kratom use is insufficient. As with many other substances, initial usage may result in positive effects on overall mental, physical, and emotional qualities. But, as use becomes habitual, tolerance builds, dosage increases, and potential dependence on the substance can take place. At this point, depression is more likely to be a result of the use of kratom, for numerous reasons. It is also suggested that like any drug that can change or add to your neurochemistry, there could be a negative effect from the usage of kratom.

Does kratom affect serotonin levels?

There is currently insufficient research available to determine whether serotonin levels are affected by kratom dosage, but it is likely that, because the mitragynine in kratom acts similarly in the brain to an opioid, the production and transmission of neurotransmitters of all kinds are affected in some way or another. Especially in cases of long-term use, high dosages, or a combination of the two, kratom use has some anecdotal evidence of causing depression and anxiety. Though, these effects will differ between different individuals and may be a combination of different factors, rather than solely attributed to the use of kratom.

Closing Thoughts

At the end of the day, different substances affect individuals in different ways depending on a slew of different factors that can come into play. Body chemistry typically affects the results certain substances will have on the body and mind, and kratom is no different. Kratom unfortunately lacks the research we need in the present day to make any widespread claims which would be accepted by the masses as well as the scientific community. Studying the substance, rather than an outright ban, by scientific means would create a better opportunity to regulate kratom so its chemical levels can be maintained, and unpredictable amounts of the active chemicals aren’t being imposed upon the body systems. Instead, the resulting studies could show the potential therapeutic uses for the natural substance for opioid addiction treatment and pain management, among other uses.

As with any substance use, recreational or medicinal, it is better to use the drug with the end goal of remaining sober, without the need or dependence to continue to consume it.

Leading a sober and healthy life is the end goal for the Alternative to Meds Center. We strive to give you the tools to take control of your life. We believe in creating a program that is individual to you and you alone. Education is the first step in achieving the naturally restored and balanced life you deserve on your journey toward true holistic healing