Kratom gets a lot of attention in the media as it gains popularity and notoriety among Americans. Unfortunately, a lot of misinformation has been mixed in with the facts and it can be difficult to separate fact from fiction when it comes to this unusual drug.
While kratom appears to be a potential opioid alternative, there are significant toxicities associated with the drug and a number of deaths have been linked to its use. At this point, there is very little quality, researched evidence supporting its use in humans. Thus, there is a lot of controversy regarding its use.
Kratom, which is currently in legal limbo in the United States, is marketed as an herbal remedy for pain and for assisting people with detoxing from opioid use. It is legal in most states in the country and can be purchased online, as well as in head shops, gas stations, and kava bars.
What is Kratom?
Kratom is the common name for Mitragyna speciosa, which is a type of evergreen tree related to coffee. Kratom is native to Southeast Asia (specifically Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea), where its leaves have been used for over a century as a sort of opium substitute. The kratom drug is made by grinding up the tree leaves or brewing them in a tea.
Is kratom an opiate? No, kratom is not an opiate (i.e., a drug that grows naturally in the opium poppy), nor is it an opioid (a drug derived from an opiate). However, kratom is considered to be an opioid-like drug in that it activates opioid receptors in the brain. It also acts as a stimulant, similar to cocaine. As such, kratom is an unusual drug because it does not fit into any specific drug category.
Kratom in Florida
Is kratom legal in Florida? Yes, at the moment. Due to increasing reports of kratom poisonings and deaths, the FDA arranged to have kratom imports seized beginning in 2014. In 2016, the DEA made kratom a Schedule I controlled substance (unsafe, with no medical uses and a high potential for abuse). However, groups of kratom enthusiasts, backed by a group of U.S. senators, lobbied for stopping this measure and the DEA took the unusual step of withdrawing their intent.
At the present time, kratom is illegal in six states and D.C., but remains legal in Florida, although it is banned in Sarasota County. At the federal level, it remains in limbo while the public debate about the issue continues. The FDA is warning people to not use kratom because there is no researched evidence to support any therapeutic uses, and there is a high potential for harm. The DEA placed kratom on its list of “chemicals of concern,” and remains intent on making kratom illegal.
What Does Kratom Do?
Any information on what benefits or effects that kratom may have is based largely on anecdotal information. The drug has received little attention from the research community, with only a few published studies.
What is kratom used for? In the absence of hard evidence of any kratom benefits, the drug is used without FDA approval for:
- Pain Relief. In Southeast Asia, where kratom is indigenous, the drug has been used since the 19th century for treating pain. There have not been any human studies of kratom used for pain relief, but animal studies seem to support this indication.
- Anxiety. Studies in mice have suggested that there may be a role for kratom for treating anxiety. This information requires a lot more study before any conclusions may be made for its use for treating anxiety in humans.
- Depression. Studies in mice have likewise suggested that there may be a role for kratom for depression but, as with anxiety, there is insufficient evidence at this time to support its use for treating depression in humans.
- Energy. The native population of Southeast Asia has used kratom for energy as they go about their workday for more than a century. This is presumably based on the stimulant effect that the drug gives in low doses.
- Sleep. Kratom is a stimulant at low doses but at higher doses, it has a paradoxical sedating effect, so some people use kratom for sleep.
- Heroin Withdrawal. People use kratom for heroin withdrawal, and the drug is known to have activity at the opioid receptors. However, kratom itself causes a withdrawal syndrome of its own. Based on animal studies, researchers saw physical dependence and withdrawal similar to opioids develop after five days of use. As such, people who use kratom for heroin withdrawal may be replacing one addiction with another.
- Fibromyalgia. Kratom’s purported pain relief and energy properties may suggest the use of kratom for fibromyalgia (FM). However, opioids and stimulants are ineffective for treating FM, and there are no studies supporting the use of kratom for this indication.
Kratom is not regulated or standardized and may be cut with other plant species additives. As such, it may be difficult to know what dose one is taking. The effects of kratom, particularly the stimulant and opioid-like effects, are dose-dependent:
- Low to moderate dosages (1 g to 5 g of raw leaves) usually, produce a stimulant effect that is described as pleasant but not intense like other stimulants (such as cocaine or methamphetamines)
- Moderate to high dosages (5 g to 15 g) result in effects similar to opioids, such as analgesia and euphoria. The euphoric effects are described as less intense than those of opioids
- High doses (above 15 g) are toxic and may involve serious side effects and overdose
People usually take between one and three doses per day.
How to Take Kratom
Kratom is sometimes smoked but is usually taken orally. Locals in Southeast Asia sometimes chew the leaves fresh from the trees or eat them in food. In the United States, kratom is available in several formats, all based on M. speciosa leaves, and comes either whole or ground up:
- Powder. Kratom powder is made by grinding the dried leaves, and is usually sold in packets labeled, “not for human consumption.”
- Capsules, pills or tablets. The powder is packaged into kratom capsules or pressed into kratom pills or kratom tablets.
- Tea. Kratom tea is made by brewing the dried or powdered leaves.
What Does Kratom Look Like?
The kratom plant (M. speciosa) is an evergreen tree but is not coniferous (like pine or spruce trees). Rather, it produces broad aspen-shaped dark green glossy leaves that contain the active ingredients. The tree can grow up to 80 feet high with a trunk up to three feet thick.
Once dried and shredded, the leaves are a light olive-green. Capsules are usually clear and filled with dried and shredded or powdered leaves. Likewise, the tablets and tea are olive-green.
Some subspecies of kratom have white-veined or red-veined leaves so that the color of the drug preparations will have a white or reddish hue.
Kratom Street Names
Kratom is available under a wide array of brand names and names of the specific strains of the plant. However, general kratom street names include:
- Herbal speedball
- Biak, biak-biak
Kratom Side Effects
Kratom’s side effects mimic those of opioids:
- Dry mouth
- Respiratory suppression
- Withdrawal symptoms
The stimulant effects of kratom are uncomfortable for some people, and can produce:
- Aggressive behavior
Long-term or high-dose use of kratom has also been associated with:
- Dark discoloration of the skin on the cheeks
- Anorexia and weight loss
How Long Does Kratom Stay in Your System?
Lab detection methods are based on detecting mitragynine, the main active ingredient in kratom. This compound is believed to have a half-life of about 24 hours.
Kratom is not tested as part of routine drug screens (such as the NIDA-5 and the SAMHSA-5), and laboratory tests to detect the drug are not in widespread use. It can, however, be detected by specialized lab testing:
- Blood: depending on the amount ingested, blood tests can detect use for several days.
- Urine: can detect use for up to a week for heavy users.
- Hair: these tests are not yet commercially available for kratom use.
- Breast milk: the safety of kratom in breastfeeding has not been established, but the main psychoactive ingredients of kratom appear to be present in breast milk.
Kratom produces physical and psychological dependence, as well as the tolerance and withdrawal symptoms that are characteristic of addiction. Kratom has the typical characteristics of an addictive substance:
- Withdrawal symptoms
- Obsessive thoughts about using the drug
- Psychoactive effects that provide temporary relief from mental health symptoms and negative emotions or feelings or a temporary escape from life stressors
Key Points: Understanding Kratom
Some key points about kratom are:
- Kratom is a drug derived from the leaves of a tree indigenous to Southeast Asia
- Kratom has opioid-like and stimulant effects that vary depending on the dose
- The FDA has issued a warning to consumers not to use kratom and the DEA has listed it as a chemical of concern
- Kratom is in legal limbo at present but is currently legal in most states in the United States
- Kratom is addictive and produces tolerance, dependence and withdrawal effects
If you struggle with kratom use, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how addiction treatment can help. You deserve a healthier future, call today.
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