Kratom is a drug which has generated interest by consumers in the US over the past couple of years. Consumed in a similar way to coffee, it has now been used in several products to ease anxiety, improve energy levels, and in some cases provide psychoactive effects.
This article will contextualise kratom, and examine whether this drug is as harmful as the media has indicated.
History
Originating from Southeast Asia, kratom has a history of being used for pain relief, addiction withdrawal, and to fight fatigue. Kratom was used by those working in strenuous conditions such as farming to remain focussed and avoid exhaustion.
The most common way of consuming kratom was to crush the leaves then either chew or drink it in a tea. Kratom can also be smoked, however this was a less common form of consumption.
Effects
Kratom is made up of mitragynine and 7-hydroxymitragynine, compounds which bind to the opioid receptors in our body. This means that while it fits into the opioid family consisting of drugs such as morphine and heroin, it is a far less potent form of opioid which has different effects depending on the dose.
Kratom fits into a unique chemical profile when compared to other substances. While kratom provides stimulant effects in small doses which will give similar effects to caffeine (increased heart rate, focus, and energy), in higher doses it produces sedative and narcotic symptoms, which mimic the effects of drugs like cocaine and morphine (euphoria, drowsiness, pain relief).
Legality
While kratom is federally legal in the US, the sale of it is banned in six states (Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin). There are also some forms of legislation regarding its sale in a further 30 states.
The FDA has warned that kratom is a drug that has potential for abuse, dependence, and addiction. Therefore, the FDA advises against its use and has labelled kratom as a substance of concern.
Polydrug use
One of the key dangers of kratom is its use alongside other drugs, where it can worsen or amplify the effects of other substances.
The primary example of this relationship is with alcohol. Similarly to cocaine, when kratom is consumed alongside alcohol there is an increased risk due to the opposing effects of each substance.
As a depressant, alcohol reduces the brain’s control over the body which can result in reduced inhibitions, a lower heart rate and slowed breathing in higher doses. Whereas stimulants like kratom can increase heart rate and alertness.
This means that alcohol and kratom may minimise the effects of each other, which could encourage higher levels of consumption and therefore increase the risk for more serious side effects such as addiction and heart and liver issues.
If combined with other stimulants such as cocaine, there is also an increased risk due to the amplifying effects that kratom can have on other stimulants and opioids.
The bottom line
While there are a number of health concerns which relate to kratom consumption, it is important to articulate that these issues depend on the set and setting in which it is consumed.
The use of kratom as a painkiller or as a substitute for opioids does not appear to be the best use, due to a lack of evidence on its efficacy in both situations. While there is an emerging body of evidence indicating that it is significantly less addictive than traditional opioids, and can be used as a viable solution to alcohol or opioid withdrawal, there is still no conclusive data on whether kratom is a better solution to these issues than existing treatment methods such as methadone. Generally speaking, there appears to be better substances or avenues which can resolve these issues more effectively.
The more recent case of kratom being used as a social drug to alleviate anxiety and improve focus appears to be more suitable, provided it is not combined with alcohol or stimulants. While products using kratom such as New Brew should not be incorrectly stigmatised as the “new opioid epidemic”, it is important to recognise the problematic aspects of the drug, and the ways in which it could cause relapse in ex-opioid users, induce addiction for new users, or become particularly dangerous when consuming in excess with other drugs. New Brew has taken steps in this direction, with clear labelling on each can warning of the risks particularly for those with a history of substance abuse, and a self-imposed age restriction of 21+.
It is also worth noting that products like New Brew often use kava root as an ingredient alongside kratom, which is a depressant which could produce somewhat similar effects to alcohol, which is a harmful interaction.
Overall, it is important to be aware of the substances you are putting into your body, and ensure that you remain vigilant to the signs of dependence or addiction which could occur should you choose to consume these products.
The piece was written by Oliver Callaghan, intern at Volteface. X @Oliver1331556