What is Keratom?

Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects. It has been used a traditional medicine to treat medical conditions such as musculoskeletal pain.

Kratom is not currently an illegal substance and has been easy to order on the internet. It is sometimes sold as a green powder in packets labeled “not for human consumption.” It is also sometimes sold as an extract or gum. Keratom is being advertised as a natural supplement for treatment of chronic pain and fibromyalgia and others uses it to get energy or to improve their general well-being. It is also being advertised and used by some people for treatment of opioid dependence.

What are some of the other names of kratom?

Kratom sometimes goes by the following names:

  • Biak
  • Ketum
  • Kakuam
  • Ithang
  • Thom

How do people use kratom?

Most people take kratom as a pill, capsule, or extract. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.

How does kratom affect the brain?

Kratom can cause effects similar to both opioids and stimulants. 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. When kratom is taken in small amounts, users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects.

What are the health effects of kratom?

Reported health effects of kratom use include:

  • nausea
  • itching
  • sweating
  • dry mouth
  • constipation
  • increased urination
  • lack of sexual desire
  • loss of appetite
  • seizures
  • hallucinations
  • psychosis
  • hallucination
  • paranoia

Can a person overdose on kratom?

Kratom by itself is not associated with fatal overdose, but some forms of the drug packaged as dietary supplements or dietary ingredients can be laced with other compounds that have caused deaths.

Is kratom addictive?

Like other drugs with opioid-like effects, kratom might cause dependence, which means users will feel physical withdrawal symptoms when they stop taking the drug. Some users have reported becoming addicted to kratom. Withdrawal symptoms include:

  • muscle aches
  • Loos stool
  • difficulty sleeping
  • irritability
  • hostility
  • aggression
  • emotional changes
  • runny nose
  • Fearfulness
  • jerky muscle movements
  • Restlessness and sleeplessness
  • Severe depression

How is kratom addiction treated?

There are case reports of successfully treating keratom dependence with Suboxone.

Adverse Effects

Regular use of large amounts of keratom could result in:

  1. Liver toxicity
  2. Seizure
  3. Respiratory depression
  4. Psychosis
  5. Anorexia
  6. Drug interaction (SSRIs)
  7. Death

Warning

Taking kratom with other suppressant medications or drugs such as alcohol, benzodiaepines, and opioids could increase the risk of toxicity and death.

References:

  • Anwar, Mehruba; Law, Royal; Schier, Josh (2016-01-01). “Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers – United States, 2010–2015”. MMWR. Morbidity and Mortality Weekly Report65 (29): 748–49.
  • Import Alert 54-15; Detention without physical examination of dietary supplements and bulk dietary ingredients that are or contain Mitragyna speciosa or kratom. U.S. Food and Drug Administration. 20 December 2016. Retrieved 7 March 2018. 
  • Hassan Z, Muzaimi M, Navaratnam V, et al. From kratom to mitragynine and its derivatives: physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev 2013; 37:138-151.
  • Rech MA, Donahey E, Cappiello Dziedzic JM, et al. New drugs of abuse. Pharmacotherapy 2015; 35:189-197.
  • Sheleg SV, Collins GB. A coincidence of addiction to “Kratom” and severe primary hypothyroidism. J Addict Med 2011; 5:300-301.
  • Khazaeli, Azin MD; Jerry, Jason M. MD; Vazirian, Mohsen MD. Treatment of Kratom Withdrawal and Addiction With Buprenorphine. Journal of Addiction Medicine. olume 12(6), November/December 2018, p 493-495.
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