What Is Kratom?
Kratom is a tropical tree in the coffee family that is native to Southeast Asia. The leaves that grow on this tree contain properties that can have mind altering or psychotropic effects. For centuries, people in countries like Thailand, Indonesia, Malaysia, and Papua New Guinea have chewed on these leaves to fight fatigue, manage pain, increase productivity, and replace Opium. Kratom was brought to the Western Hemisphere in the 19th century when Pieter Willem Korthals, a botanist with the Dutch East India Trading Service, discovered its existence. Today, Kratom is controversially sold for recreational use to boost energy, enhance mood, and treat Opioid addiction.
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The leaves from Kratom are also referred to as Herbal Speedball, Biak, Ketum, Gratom, Kakuam, Maeng Da Leaf, Krathom, Madat Thang, and Thom. The scientific name for this substance is Mitragyna speciosa. The 2 compounds in these leaves, mitragynine and 7-hydroxymitragynine, interact with Opioid centers in the brain to produce, depending on the amount, either Opioid or Stimulant effects. Higher doses can result in sedation, feelings of pleasure, and decreased pain, much like Opioids. Smaller amounts can increase energy, sociability, and awareness, like Stimulants. Kratom is an illegal substance in only 6 US states. Because of this, there is a vast market for this substance, especially online, where it is sold as extract, gum, powder, capsules, or as just the leaves for tea.
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Many believe Kratom is safe to use because it is plant-based, but use can have uncomfortable or dangerous side effects. Adverse health effects can include:
- Chills, nausea, and vomiting
- Dry mouth
- Changes in urination
- Loss of appetite and weight loss
- Liver damage
From 2011-2017, poison control centers in the US received about 1,800 Kratom associated reports. Of these reports, around half resulted in serious harm to the user such as seizures, high blood pressure, and even death. In 2017, the FDA recognized 44 Kratom-related deaths, although most involved other substances such as alcohol, Benzodiazepines, Fentanyl, and Cocaine.
Addiction To Kratom
Many in support of Kratom will argue that its ability to be an herbal alternative to medical treatments used to control Opioid withdrawal symptoms is the drug’s most useful function. There has not been enough scientific evidence to support this claim, as studies show many possible safety concerns and no clear benefits to using Kratom. In fact, it is possible that the herbal substance can be just as addictive as Opioids are. A study followed people struggling with an Opioid addiction who took Kratom for 6 months as a form of treatment. At end of the study the withdrawal symptoms were essentially the same as those associated with an Opioid addiction, and many subjects required additional treatment to reduce their symptoms. These symptoms include hostility, aggression, excessive tearing, aching of muscles and bones, and jerky limb movements. At this point, there is not enough research to determine a safe and effective treatment approach for a Kratom addiction. Some have found success with behavioral therapy.
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The Legality Of Kratom
Currently, Kratom is not an illegal substance in the United States, apart from Alabama, Arkansas, Washington DC, Indiana, Rhode Island, Tennessee, Vermont, and Wisconsin. In 2016, the Drug Enforcement Administration (DEA) announced that they intended to place Kratom’s main active ingredients in Schedule I of the Controlled Substances Act (CSA), which is for substances with a high potential for abuse that currently have no accepted medical use. Later that year, the DEA withdrew their statement citing backlash from the public as their motivation to do more research and reconsider their position. Currently, the DEA has Kratom listed as a drug of concern.
Consistent with the DEA, the US Food And Drug Administration (FDA) does not regulate Kratom and currently has not approved it for any medical uses. This causes more opportunity for the substance to be cut with other drugs, therefore making it more unsafe and sometimes fatal. Despite lack of regulation, the FDA has issued numerous warnings about Kratom since 2014 and has the substance on import alert. This means the FDA can seize and detain shipments of Kratom without inspection, examination, or sampling. In May 2021, US Marshals, on the FDA’s behalf, confiscated more than 207,000 bulk dietary supplements and ingredients that contained Kratom in Fort Myers, Florida. Some of the brand names of these seized products were Boosted Kratom, The Devil’s Kratom, Terra Kratom, Sembuh, Bio Botanical, and El Diablo. In response to this, the FDA released a statement detailing substantial concerns about the substance’s safety, risk to public health, and potential for abuse. They plan to continue exercising their authority under the law to act against Kratom to protect the health of the American people.
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Additionally, substances that are made with Kratom are at risk of being contaminated with salmonella. In 2018, 130 people in 38 states became ill with salmonella after Kratom use. The FDA has linked more than 35 deaths to this salmonella contamination. Salmonella cannot be detected with the naked eye as signs of contamination are not obvious or visible.
Kratom enthusiasts are pushing for more regulations to be put in place. They would like to see a set of standards across all US states with more restrictions on the adding of other dangerous substances, proper labels on packaging, and minimum age requirements. These regulations would help to limit any potential harm that could come from mislabeled or unsafe Kratom products. If you or a loved one is struggling with an addiction to Kratom or another substance, contact a treatment provider today.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience