Kratom is a potent but completely natural plant substance that produces powerful analgesic and psychoactive effects. Despite its growing status as a drug of abuse in the United States, kratom is widely available and can be purchased online by just about anyone with a credit card. Consequently, understanding kratom is critical in determining its future place in our society, as numerous calls have been made to ban the substance.What is Kratom?
Kratom generally consists of the whole or prepared leaves of the Mitragyna Speciosa tree that is native to parts of Southeast Asia; most notably Thailand. The tree was first documented in the 1830’s by Pieter Willem Korthals; a botanist with the powerful Dutch East India Company. (1)
The most common methods of kratom consumption are to chew the leaves directly or to prepare them as a tea. However, tinctures and capsule versions of kratom are available as well.
But despite the fact that the plant is sold openly on the internet, many websites feature troubling disclaimers that are similar to those on websites that sell bath salts and other dangerous chemicals.
For instance, KratomHerbs.com claims that the kratom they sell is not intended for human consumption, despite clear references that this is exactly what the product is for. (2)Kratom is historically similar to Coca
When the Spaniards came to the New World, they discovered that the native peoples in some regions constantly had a wad of leaves stuffed in their cheeks. It turns out that these were coca leaves – the sole source of today’s cocaine production. People who lived in the Andes had been chewing these leaves for their stimulant and anti-hunger properties for centuries. (3)
While a specific time frame of ancient use has not been established, we can assume that people in Southeast Asia were probably chewing kratom leaves as early as the indigenous peoples of South America were chewing coca leaves. However, few records of kratom-eating exist and it wasn’t until the 1960’s and 1970’s – decades after the Thai government banned the possession of kratom and ordered the trees cut down – that credible studies were conducted on the use of this natural psychoactive substance.Traditional Use of Kratom
Kratom is considered a cultural drug in that it is primarily used in Thailand among specific demographics. Traditional use of the plant almost exclusively centers around the stimulation of better work habits; by eating the kratom leaf, laborers are able to fend off hunger, exhaustion and depression and as a result are more productive.
Unfortunately, years of use of this plant often leads to addiction requiring medical treatment, (4) but for many Thai laborers and farmers, treatment is not an option.
Interestingly, these are the same reasons that indigenous peoples in the Andes chew the coca leaf: increased productivity, direct treatment of hunger and weariness, and improved sense of well-being despite difficult living and working conditions.Recreational Use of Kratom
Today kratom is becoming more widely known as a result of growing recreational use of the plant. Users report that the plant causes euphoria, relaxation, stimulation, increased awareness, hallucinations and other effects that many drug users compare to the effects of opiates like heroin and morphine.
According to Maya Ethnobotanicals, kratom causes stimulant effects – much like that of cocaine – at low doses and opiate-like effects at higher doses. (5)(6) Anecdotal evidence and comments on various drug forums and websites support this theory.Medical Use of Kratom
Despite the US Department of Justice stance that kratom has no legitimate medical use, a number of studies indicate that this is not the case. In fact, the same US DOJ report that condemns the plant as having no medical value precedes this claim by stating the following:
“It has also been used to manage opioid withdrawal symptoms by chronic opioid users” and “Through actions on centrally located opioid receptor, it inhibits gastric secretion and reduces pain response,” clearly contradicting the report’s later statement that there is “. . .no legitimate medical use for kratom in the US” (6)
The claim that kratom has no medical value is undermined by the fact that a University of Massachusetts study reported that kratom: “has additional receptor affinities that might augment its effectiveness at mitigating opioid withdrawal,” (7) and a prominent study out of Malaysia that documented the antidepressant properties of the plant. (8) These and other data and research on the subject echo anecdotal evidence that kratom has a significant amount of potential as a psychiatric, analgesic and addiction treatment tool.Potential for Abuse and Addiction
Unfortunately, because kratom has euphoric and other pleasurable effects that impact the “reward center,” dopaminergic and other neurotransmission systems in the brain and central nervous system, it has potential for abuse and addiction. Consequently the plant has been placed on the DEA “Drugs and Chemicals of Concern” list; a possible precursor to its reclassification as an illegal substance.
In fact, in a 2012 article for NBC News, Kari Huus indicates that emergency rooms in the US are beginning to see an increase in the number of urgent care and ER visits related to kratom. In some cases these patients include teens that are too young to buy alcohol and so turn to kratom as a legal means to get high. (9)
In general patients seek treatment for symptoms of withdrawal related to kratom addiction (and addiction to other drugs and/or alcohol in some cases), but in other instances patients seek treatment for respiratory depression, anxiety, paranoia and agitation caused by ingestion of the plant. (9)Current Legal Status
Kratom is currently legal for sale and consumption in the United States, with the exception of the state of Indiana. It is also legal in many other countries around the world and can be purchased online at hundreds of shops that aggressively market the plant. Most shops that advertise kratom require that purchasers be at least 18 years of age, but other than this there are almost no restrictions involved with obtaining the plant.
Consequently, more study into the potential medical value and risks of kratom is needed before a definitive statement can be made about the plant’s future in the United States. Based on the fact that the plant has a huge following of supporters and lobbyists, it’s likely that a battle could play out between the US DOJ and those who wish to keep the plant legal and unregulated. In the meantime, poison control centers and hospitals are the best source of information about the potential effects this drug could have if it continues to become more widely used.
(1) Pieter Willem Korthals Wikipedia http://en.wikipedia.org/wiki/Pieter_Willem_Korthals
(2) KratomHerbs FAQ KratomHerbs.com http://www.kratomherbs.com/help_answer.asp?ID=12#254
(3) Angela C Springfield, Larry W Cartmell, Arthur C Aufderheide, Jane Buikstra, Joyce Ho Cocaine and Metabolites in the Hair of Ancient Peruvian Coca Leaf Chewers Forensic Science International, Volume 63, Issues 1–3, December 1993, Pages 269-275
(4) Suwanlert, Sangun A Study of Kratom Eaters in Thailand Bulletin on Narcotics, 1975; Vol 27(3): 21-27 The Vaults of Erowid http://www.erowid.org/plants/kratom/kratom_journal3.shtml
(5) Mitragyna speciosa (Kratom) Maya Ethnobotanicals http://www.maya-ethnobotanicals.com/product_browse.phtml/catid/subid/herbid_351
(6) Kratom (Mitragyna speciosa korth) Drug Enforcement Administration Office of Diversion Control Drug & Chemical Evaluation Section January 2013 http://www.deadiversion.usdoj.gov/drugs_concern/kratom.pdf
(7) Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth) Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA Addiction. 2008 Jun;103(6):1048-50. doi: 10.1111/j.1360-0443.2008.02209.x. http://www.ncbi.nlm.nih.gov/pubmed/18482427
(8) Idayu NF, Hidayat MT, Moklas MA, Sharida F, Raudzah AR, Shamima AR, Apryani E Antidepressant-like effect of mitragynine isolated from Mitragyna speciosa Korth in mice model of depression Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia Source Phytomedicine Volume 18, Issue 5, 15 March 2011, Pages 402-407
(9) Huss, Kari Asian Leaf Kratom Making Presence Felt in US Emergency Rooms 03/19/2012 NBC News http://usnews.nbcnews.com/_news/2012/03/19/10760892-asian-leaf-kratom-making-presence-felt-in-us-emergency-rooms?lite