Kratom: Treating Addiction With Addiction

By Drs. David Niesel and Norbert Herzog, Medical Discovery News

Some who use kratom to ease their withdrawal symptoms from heroin addiction are discovering that this is also an addictive drug that can reignite the cravings for the heroin they are trying hard to conquer. The use of kratom as a painkiller or to treat depression or for the mild high it provides is gaining in popularity, but its potential dangers are not well understood.

Kratom is legal in most states and is sold under a variety of names. It is available in powdered form at head shops, convenience stores and online. There are even bars that sell beverages made with kratom in Colorado, Florida, New York and North Carolina. Reports suggest that 40 million Americans have purchased kratom online for the management of chronic pain or to mitigate opioid withdrawal.

The U.S. Food and Drug Administration banned the importation of kratom in 2014 due to the strong suspicion that it was harmful, but the laws concerning the drug are so bizarre that it was sold legally in Chicago at the same time. Although the FDA considers kratom to be a somewhat safe dietary ingredient, the U.S. Drug Enforcement Administration lists it as a "drug of concern" but not a controlled substance. Some states have banned it, and the Army forbids its use by soldiers.

Kratom comes from a tropical tree in the coffee family, Mitragyna speciosa, which is indigenous to Southeast Asia. The name kratom comes from the term for the tree and the preparation of its leaves in Thailand. The use of kratom has been outlawed there, although now there is a movement to legalize it. Traditionally kratom leaves are chewed or used to brew tea. Low doses of it have cocaine-like stimulatory effects and are used to overcome fatigue. Higher doses have opium-like sedative effects used in traditional medicines as a substitute for opium. It is also used to treat pain, diarrhea, coughs and premature ejaculation. The symptoms of the drug appear 5-10 minutes after consumption and can last for up to an hour. Side effects of long-term kratom use include weight loss, tiredness, constipation and hyperpigmentation of the cheeks.

The active ingredients in kratom bind to the same cellular receptors as heroin or morphine, but it also binds to two other receptors, accounting for its different effects. And like heroin or morphine, kratom produces dependence. Withdrawal symptoms are relatively mild but include craving, weakness, lethargy, anxiety, restlessness, runny nose, muscle pain, nausea, sweating, jerky movements of limbs, tremors, sleep disturbances and hallucinations. It looks like taking kratom comes with a price of it's own.

Since some opioid addicts use kratom to overcome their addiction, advocates of it state that it is useful for reducing dependence on more dangerous opiates and has the advantage of not being detected by drug tests for now. But some former opiate addicts report becoming addicted to kratom and ending up back in rehabilitation. It is both a way of overcoming addiction and an addiction itself.

The scientific study of kratom requires more research into its physiological effects. It's one of many drugs wading through a murky legal environment and challenging law enforcement's ability to keep people safe.

Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at