Kratom: Alternative Pain Reliever or Dangerous, Addictive Drug?

There’s a false narrative floating around about kratom that suggests it is a legitimate alternative to opioid painkillers. Yet, in practice, most people who use kratom are using it alongside other opioid drugs. Kratom IS addictive, though it is still fully legal on the federal level and in most states.

Kratom Defined

“Kratom” refers to a tropical tree native to Southeast Asia. The leaves of the tree contain compounds that have mind-altering effects. Though kratom is not illegal, it is not safe by any means and should not be consumed.

Yet because it is legal, kratom is relatively easy to find and purchase. Some people buy it online, others shop for it in convenience stores and head shops. Most people take kratom as a pill, capsule, or extract. Some chew the kratom leaves or brew dried or powdered leaves as tea. Sometimes the leaves are smoked or eaten in food.

Kratom is sought after primarily because it can cause effects similar to both opioids and stimulants. Kratom is said to have a pain-relieving effect, hence why some claim that it is a safe alternative to opioid pain relievers. According to the National Institute on Drug Abuse, “Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain, especially when users consume large amounts of the plant. Mitragynine also interacts with other receptor systems in the brain to produce stimulant effects.” That explains the physiological and psychological effects of the drug.

Most users report that they feel increased energy, sociability, and alertness when they take kratom in small amounts. However, they also report that kratom can cause uncomfortable and sometimes dangerous side effects.

Some of the side effects of kratom include:

• Nausea and vomiting
• Uncontrollable itching
• Sweating
• Dry mouth
• Constipation
• Increased urination
• A loss of appetite
• Seizures
• Intense hallucinations

Kratom use is not yet widely common in the United States. It’s likely that if more people begin using the drug, more side effects from its use will become apparent.

Recent Findings Shed Light on How Kratom is Used

Kratom is often promoted as a safe alternative to opioid painkillers. There are at least two untrue aspects of this narrative.

1). Kratom is not safe.

2). Kratom is not an alternative to opioid painkillers, at least not in practice. A new study shows that most people who use kratom use it alongside other drugs (meaning they never replace other drug use with kratom, they use other drugs and kratom).

People who struggle with physical pain often take opioid painkillers to relieve their pain. Then, when they determine that the risks of the harmful side effects of such drugs outweigh the relative benefits of pain relief, they seek alternatives.

Kratom has been promoted as such an alternative. But according to the study authors of an American Journal of Preventive Medicine study, “Kratom use is particularly prevalent among those with prescription opioid use disorder, but it is also prevalent among people who use other drugs. This study adds to previous literature linking kratom use with opioid misuse, because results suggest that, whereas those proxy diagnosed with opioid use disorder are at high odds for use, those who misuse prescription opioids but do not have use disorder are not at increased odds for use.” In layman’s terms, the study indicates that people who misuse opioids are much more likely to use kratom than those who use prescription opioids for pain relief but who want an alternative. The talk around kratom suggests that it is the latter who are seeking out kratom, but the study suggests the former are the ones who use kratom the most.

The researchers concluded that kratom use is prevalent among people who use other drugs but not as prevalent among those with legitimate pain concerns who are simply seeking a safe method to relieve pain without taking opioid painkillers. The researchers found that kratom use is only present in 0.7% of the general population, but its use is present among 10.3% of people who use opioids.

More research needs to be done, but there seems to be compelling evidence that kratom is not the “safe alternative” that some are saying it is. Quoting study author Joseph Palamar, Ph.D., MPH, an associate professor of population health at NYU Grossman School of Medicine, “Few national studies have examined kratom use among the general population, and such studies can give us a better idea regarding who has been using the substance. ... This study adds to our understanding of kratom’s prevalence and its connection to opioid misuse.”

Kratom Addiction and Overdoses

Kratom is addictive, and it can even cause fatal overdoses. There have been multiple reports of deaths in people who had ingested kratom. While many of the toxicology reports of such deaths revealed that victims also had other drugs in their systems, there have been several kratom deaths in the U.S. where kratom was the only drug found in the user’s body.

Kratom is not an FDA-approved substance, yet there have been several reports of people taking kratom as a dietary supplement, dying from it, and their toxicology reports revealing that the kratom had been laced with other toxic compounds. When users experiment with kratom, they have no clear way of knowing if the drug they’re taking is actually kratom or a mixture of kratom with other, unknown substances.

Like other drugs with opioid-like effects, kratom can cause both chemical dependence and psychological reliance in the user. That means users will feel both physical withdrawal symptoms and psychological cravings for kratom when they stop taking the drug. Withdrawal symptoms are said to include, but are not limited to:

1) Muscle aches

2) Insomnia

3) Irritability

4) Hostility

5) Aggression

6) Sudden emotional changes

7) Runny nose

8) Jerky movements

Kratom: May Be Legal, Definitely Not Safe

Kratom should not be legal as it is addictive, dangerous, and potentially lethal. If people seek out kratom for its alleged pain relief benefits, they should instead find safer and less risky treatments for their pain.

If someone you know becomes addicted to kratom, make sure they get help as soon as possible. Kratom can be fatal, especially when it is consumed with other drugs. Help them get off kratom once and for all, then assist them in finding healthier alternatives for pain relief. There are safe and effective ways to overcome physical pain without taking addictive, mind-altering drugs that cause more harm than benefit.

Sources:

• https://doi.org/10.1016/j.amepre.2021.02.004
• https://www.eurekalert.org/pub_releases/2021-04/nyu-kur042321.php
• https://www.drugabuse.gov/publications/drugfacts/kratom

Reviewed by Matt Hawk, BS, CADC-II, ICADC