There are substances that are generally used to help people from suffering from chronic pain. Most of these substances, however, are prescription drugs. Although these prescription drugs have been proven to be effective, its adverse effects after long time use make it a bit on a dangerous side.
Some individuals who are recommended to take pain medications on a long-term basis have found an alternative to hopefully help them financially and to prevent them from having to endure all the bad side effects. One of the popular pain relief substitutes is kratom.
What is Kratom?
Kratom is an herbal leaf from a tree of the Rubiaceae family. It was first documented by Pieter Korthals, a Dutch colonial botanist. Korthal gave the genus Mitragyna due to the similarity of the stigma of the plant to a bishop's miter.
The Mitragyna speciosa or kratom trees grow as tall as 12-30 feet and 15 ft wide. Its dark green colored leaves can grow up to 7 inches long and 4 inches wide. All throughout its flowering stage, the growing florets are completely surrounded and covered by copious overlapping bracteoles. The leaves fall or grow depending on the season. During the rainy season, the leaves grow abundantly while in the dry season, the leaves fall.
Kratom contains alkaloids including mitraphylline, mitragynine, and 7-hydroxymitragynine. These alkaloids act as a mu-opioid receptor antagonist. Due to this function, the kratom is used as an alternative to opiates for those people suffering from opium dependence. The therapy starts at a low dosage then gradually decreasing and then finally withdrawn. Symptoms of withdrawal from kratom are milder compared to opium.
Mitragyna is also used as stimulant and depressant. It is used as a sexual enhancer to improve sexual activity. It is also used as a treatment for some illness such as diarrhea and pain. The kratom leaves are either boiled or used as a tea or chewed and smoke. It can cause calmness of mind.
Due to its effects, kratom is a controlled substance in some countries including Thailand, Australia, Bhutan, Denmark, Finland, Poland, Lithuania, Myanmar, and Malaysia. There are some countries that are still studying the properties of the plant and its effects. Some include Kratom in their laws such as the Regulation Laws. According to Thai books, kratom is a milder substance compared to morphine and less harmful than cocaine.
Kratom is also known by the following names: Kakuam, Ithang, Thom, Ketum
Uses of Kratom
Kratom is characterized by its alkaloid content mitragynine and 7-hydroxymitragynine. These two alkaloids are the primary contributors to the effects of the plant.
Due to its narcotic effects and its function to the opioid receptors, the kratom plant is used as an alternative to opiates to people suffering from opium addiction. The kratom plant can minimize and control the withdrawal symptoms in opiate-dependent individuals.
In the United States and Europe, kratom is used as a treatment for certain ailments particularly pain, anxiety, depression, and withdrawal of drugs. In Southern Thailand, kratom is used as a substitute for heroin to stop the dependence on the said drug.
In 2005, some individuals tried to create a cocktail using kratom leaves as its base. They boiled the leaves and created a tea base and added cola, cough syrup, and ice. This was used for recreational purposes.
In other cultures, kratom is used as a sexual enhancer, improving sexual intercourse and increasing libido. Some use the leaves to treat diarrhea. Some also use kratom as a sedative by using a low, controlled dose.
The effects of the plant can cause calmness of mind. Reports show that kratom can provide euphoria, a feeling of happiness, activeness, strength, and desire to work. That is why it has a history that the main users of kratom are laborers and workers.
The use of low dosage kratom has no reported side-effects although certain side-effects were reported if taken in a frequent, regular, high dose in a long period of time.
Scientific Studies of Kratom
A lot of people have been giving a lot of attention to kratom leaves. Certain companies including scientific groups and pharmaceuticals have started to conduct studies on the composition, properties, and effects of kratom in humans.
Until now, the effects of kratom are not yet fully understood. Recent studies revealed that the kratom leaves have alkaloids that can affect the mu-opioid receptor of the brain. Alkaloids like mitragynine can give certain effects such as stimulating and depressing traits. However, the process of how these alkaloids work and affect one's behavior is yet to discover.
It has been proven that kratom can be a great pain killing agent although there are no commercially available pills or preparations that are made from kratom leaves. It has also been established that kratom can lessen the withdrawal symptoms of those people with opiate and morphine dependence.
Kratom serves as an alternative to opiates in the rehabilitation therapy and provides milder withdrawal symptoms compared to those of opiates. For this, scientists see kratom as a future drug that can be utilized as a substance to combat drug addiction and dependence.
It has also been proven that kratom is a good stimulant. Future efforts are being formulated to produce strong and effective kratom-based antidepressants. But this plan is still going to take a long way for we still need to have an in-depth study and understanding of the mood and behavioral activities of the brain and its receptors.
There are also some efforts in creating kratom-based cosmetics. Aside from the fact that kratom can affect the mind, studies show that it can also affect the body if applied topically. Future skin rejuvenating creams and lotions are looking forward to the future.
Benefits of Kratom
The plant has been used for over centuries by the natives of South East Asian countries such as Thailand, Indonesia, and Malaysia. Today, the health and medical world is giving attention to kratom.
Based on some studies, kratom contains alkaloids that have effects on the human mind. It has stimulating, depressing and intoxicating effects. Pharmaceuticals are exerting some efforts in creating kratom-based medicines such as topicals and pain relievers. The leaves are smoked, chewed and prepared as teas by boiling.
Taking kratom in a controlled low dose, certain benefits are said to be acquired. Kratom was used by jungle people to restore their lost energy. They say that kratom can restore energy, making you active and stronger.
The native Thai used the leaves of kratom to treat diarrhea and muscle pain. Others say that it can lower blood pressure suitable for people with hypertension. It also contains a substance called epicatechin, a substance found in dark chocolates that can promote good health.
Some people also use kratom to protect them from extreme effects of the sun by stimulating the production of melanin. Some users of kratom say that they use the plant as tea in order to lose weight.
Kratom can be beneficial in the following ways:
Aids in relaxation
Contains Antioxidant properties
Helps in pain management
Helps to reduce anxiety and depression
Helps to have a restful sleep
Induces prolonged sex
May help with losing weight
Provides a calm effect
Provides a sense of well-being
Reported to be an herbal alternative to prescriptions
Dangers of Kratom Use
Kratom has both positive and negative effects. More often than not, people overlook the side effects as they are more focused on the positive effects that kratom can provide. Kratom users should be warned of the dangers that kratom may possess, most especially to those who are regularly using this kind of substance.
Kratom use within a regulated amount may provide beneficial effects to an individual. It has a natural stimulant effect, which is very helpful in adding focus and increasing energy and alertness. However, larger doses may produce a euphoric feeling similar to opioids and may affect a person’s decision-making.
Frequent and progressive kratom use may lead to addiction because it can trigger the “happy center” of the brain. When the user takes the substance, it comes to a point where the individual may no longer feel the same intensity with the same dose. As a result, the user would then take larger doses to achieve the desired result, which in turn may lead to dependence.
Undesirable Drug Interactions
Mixing kratom with other psychoactive substances may put a person at high risk of having seizures. One of the most popular kratom concoctions is 4×100, a cocktail composed of kratom and codeine-based cough syrup or caffeinated beverage. This mixture can provide a similar effect as alcohol.
Several reports of kratom use mixed with other drugs have led to serious health conditions. When kratom is used along with another mind-altering drug, it can lead to a fatal drug interaction.
Side Effects of Kratom Use
Kratom use can lead to different effects – from stimulant-like to opiate-like effects depending on the dose taken by an individual.
At low doses of 1-5 g, kratom may produce a mild stimulant effect. An individual may feel the effect 10 minutes after taking kratom, and this feeling may last for up to 1.5 hours. The effects are less intense as amphetamine use, and may include the following:
At moderate to high doses of 5-15 g, kratom may provide an opioid-like effect that may last for several hours. Such effects include:
Decreased in opioid withdrawal symptoms
Unfavorable side effects may range from uncomfortable to lethal symptoms such as:
Doses of more than 15 grams are reported to cause seizures. A potent form of kratom known as Krypton is believed to be the cause of several deaths in the U.S. Krypton is a combination of kratom and O-desmethyltramadol, which causes an increase in the depressive effects on the central nervous system.
Loss of motor coordination
Nausea and vomiting
Long-term effects of kratom may cause:
Psychological Effects of taking Kratom
The effects differ depending on the type of strain and one’s own personal chemistry. Kratom may be used in treating depression, but not all strains are fit for this purpose.
Strains that are effective in treating depression are:
Kratom is also known to treat anxiety and insomnia. Strains that can be used for such conditions are:
Kratom dependence occurs after progressive intake of larger doses to achieve the desired effects. This is one of the reasons why many people are clamoring for this substance to be listed among the controlled substances in the U.S. Such dependency may lead to serious health hazards.
Kratom addiction will need treatment the same as any other opioid addiction. Treatment may involve rehabilitation and detoxification, as well as management of withdrawal symptoms.
Withdrawal symptoms can also be experienced when kratom intake is suddenly stopped. Such effects are similar to opiate withdrawal, including the following:
Abdominal and muscle pain
Cravings for kratom
High blood pressure
Kratom Strains Based on Veins and Stems
Kratom can be categorized according to different strains, as well as the varieties of the color of veins and stems. The differences of these strains provide varying effects. The strength of kratom may be identified based either on the location or its color strain.
Here are the kratom strains based on stem and vein color:
White And Green Strains
These strains induce energy and productivity. Leaves from white stem kratom produce more stimulating effects than the red vein variety. The green leaves varieties are believed to provide clearer thinking and endurance. This is the type of strain that most athletes prefer to use.
A number of studies showed that the green vein variety aids in treating anxiety and depression.
This kind induces calmness, sedation, and relaxation, which is the opposite of the two other strains. After the initial rush of energy, the calming effect takes place. This variety is often used to provide pain relief and as a substitute for opiate detoxification. It is said to provide a euphoric feeling to users.
Kratom Strains Based on Location
Kratom strains based on location are as follows:
This is one of the most well-known forms of kratom. Maeng Da literally means “The Pimp”, and was named almost 20 years ago. It was believed that this strain was genetically modified to be able to provide its effects.
It is a popular choice among working men. It has forced growers to produce exceptionally potent and stimulating kratom to be able to provide for the demanding needs of laborers. Grafting became a popular technique in some Indonesian plantations, with the goal of producing the strongest kratom.
This type of kratom has white, green and red varieties, wherein the white and green are more popular. Maeng Da is popular with those two varieties because it provides powerful mind-boosting and energy boosting effects accompanied by an analgesic effect.
This strain has mood-lifting effects. Unfortunately, individuals may develop tolerance easily because its effect builds up quickly.
A large part of kratom supply comes from this island, second to Maeng Da in popularity. It has four strains where the red and green strains are the most popular.
Red Borneo: This strain has a sedating and soothing effect. It is a popular choice for pain management.
White Borneo: This is fairly popular to alleviate feelings of lethargy, depression, and lack of focus.
Green Borneo: This is the most popular of all Borneo strains because it helps enhance over-all mood to a euphoric level. It is known to remove aches and pains in chronic conditions.
Blended Borneo: This is a combination of all three strains. The individual effects of each strain complement one another.
This is commonly confused with Borneo kratom, which is more popular. It has three kratom varieties, with the red and green being more popular.
It is one of the most potent and cheapest strains of kratom, which makes it widespread. Some Borneo strains are shipped from the southern or western Borneo and are labeled as Bali as it would refer to the shipping hub of the strain.
Red Vein: This is the most popular of all Bali strains because of its effects, including analgesia, relaxation and anxiety relief, which is very similar to the Borneo strain.
Green Vein: Its effect is similar to the red vein variety but with less potency. This is good for those who want pain relief without wanting to have such high level of sedation.
White Vein: It is the least popular because of its low potency.
The White Indo Kratom is the most popular among the three strains of Indo Kratom. This type of kratom can be found in Indonesia and some parts of Bali and Borneo.
There are different strains that grow in various regions with varying effects.
Super Indo: It is a unique strain because it seems to retain the painkilling and relaxing effects of a red vein, as well as providing some very mild energetic effects.
Red Vein Indo: It has a very powerful analgesic, sedating and mood-lifting properties.
White Vein Indo: It is known for its “clean” analgesic effect, which helps in dealing with mentally strenuous tasks easier.
Malaysian strains are not as popular as the Indonesian strain because it is illegal in the country. The Super Green Malay strain is very popular for its bright green appearance as well as for proving energetic and mind-boosting effects.
Super Green Malaysian: It has a variety of effects and well-balanced properties such as anxiety relief, mood-lifting property, focus, pain relief, and energy boost.
Red Vein Malaysian: This strain provides more pain relief and sedating properties than the Super Green Malaysian variety.
White Vein Malaysian: It has the most stimulating and energetic effect among all Malaysian strains.
This is the less popular strain of Kratom because it is illegal in Thailand. Most of the Thai-labeled kratom comes from Indonesia. The banning of kratom has nothing to do with its use but rather as a competition to opium business in the 1940s.
Red Vein Thai: This is most popular strain among all Thai strains because of its analgesic effect.
White and Green Vein Thai: These are helpful in treating depression.
This type of strain is less well-known among all strains. It is often a difficult strain to characterize by effects due to the differences in vein-type effects. Among its uses are pain relief, insomnia treatment, anti-stress and mood-lifting properties.
Red Vein Sumatra: This variety has anti-stress properties, pain relief, insomnia relief, relaxation and a more sedating effect than the white variety.
White Vein Sumatra: A smaller dose of this variety will provide a stimulating and energetic effect. At large doses, it provides relaxation and pain-killing effect.
It is a province located in Borneo. The difference of this strain from the Borneo kratom is not well-known.
Red Vein Kalimantan: This can provide a calming effect that can last for a few hours even with just a low dosage. It is one of the well-known strains that provide a very relaxing effect.
Green Vein Kalimantan: It is becoming a widely accepted recreational sedative, and analgesic by users in the U.S. It aids in muscle relaxation and provides energy-boosting properties.
White Vein Kalimantan: This is the least well-known of all Kalimantan varieties.
This type of kratom is processed in a different way and because of this, it provides a different kind of flavor and an increased in alkaloid percentage. This is a very rare strain of all varieties but is slowly gaining popularity in the market.
It is also known as the “Tropical Blend” for its calming and relaxing characteristics. It is also helping in improving sleep. Its length of efficacy is much longer compared to other strains.
Kratom extracts are produced to improve the potency of kratom in order to produce a stronger effect in relieving chronic pain. Kratom extracts are available in different types, differing in the level of potency and method used in the extraction of kratom.
Water-Based Kratom Extract
The process of extraction starts from extracting the alkaloids from the leaves by dissolving them in water. It is then strained and ground to produce the powder form. Water should completely evaporate, and a brownish material that is more rich and concentrated should remain.
This type of extract can be used in combination with plain leaves to increase the potency. It can be dissolved in water easily.
The downside of this type is that it is more expensive than plain leaves and that the high potency that a person may desire can only be achieved if used in combination with plain leaves.
The strongest concentrate of the kratom extract comes in the form of kratom resin. In this type of kratom extract, the leaf undergoes condensation process wherein it is cooked at a certain temperature. After condensation, it leaves a dark mixture that is considered to be lower in quality but much richer in active alkaloids and with a higher potency.
Kratom resin has a higher potency and concentration power, which means it also has more side effects compared to plain leaves.
Kratom tincture is achieved by extracting the concentrated essence of the active alkaloids from kratom leaves and then diluted with alcohol to produce a solution that can be used topically.
It can be easily used and conveniently stored. However, this is more expensive than other extracts and may not be able to deliver a wide range of effects.
This type of extract is more improved and refined and generates more powerful effects. It is produced by carefully choosing a very potent extract of kratom that is mixed with a solution and allowed to dry in order to form a powder.
Enhanced kratom has a lower tendency for side effects compared to other types of kratom extracts, and is said to be effective for pain relief. The disadvantage of using enhanced kratom is that it can lead to adverse conditions once using the extract has been stopped. This is also more expensive than plain leaves.
How is Kratom Consumed?
Kratom is distributed in many forms. For those using them in their native regions, the central vein of kratom leaves is removed and freshly chewed. Dry leaves can also be used but should be crushed into powder so they can easily be swallowed. Kratom is also prepared as a tea, which is strained and then ingested.
Kratom powder is another way of preparing the substance, which can be mixed with water and other kinds of liquids such as milk or fruit juice. Some would prefer mixing it with chocolate milk to minimize the bitter taste. Sugar and honey may be added to the mixture to make it more palatable.
Some individuals would make a paste out of powdered leaves and mixed with yogurt to mask the unpleasant taste.
Other kratom users, meanwhile, would smoke the leaves. It is also possible to produce kratom extract by evaporating the water from a prepared kratom tea. The kratom extract may be swallowed pure or dissolved in water.
A dose of kratom may vary depending on the strain. A substantial amount of 2-4 grams of kratom or ½ to 1 full teaspoon of kratom powder may be enough to provide the effects needed by an individual. Kratom extract as little as 0.5 gram can provide the same relaxing effect.
Kratom is widely used to treat various kinds of pain and is believed to be more effective than over-the-counter medications. Because of this, patients suffering from chronic pain have become pharmaceutical-free because of the benefits of kratom.
Kratom has become the alternative medication to effectively reduce pain from conditions such as:
Minor injuries such as burns, broken bones and scrapes
Neck pain and soreness
What are “wobbles”?
"Wobbles" is the term often used by kratom users referring to the difficulty to focus the eyes at a certain point without strain. This may lead to a headache and nausea.
According to kratom users, the only way to prevent from having the “wobbles” is to keep the dosage low.
The Bali strain has the highest “wobble” factor, while the True Borneo strain has the least.
Is Kratom Safe?
The federal government has not banned Kratom use, but knowing how its long-term use can lead to undesirable effects should be of concern. Scientists are continuously finding ways to ensure that kratom can be the best alternative medication to opiate users. Weighing between the benefits of kratom over its ill effects may take a while.
For anyone’s safety, it is still best to consult your physician if you feel that you need any help. It may also be safer to stick to prescribed medication. You should also take responsibility for taking kratom, in order to avoid unnecessary intake and eventually addiction and tolerance.
In short, every patient or individual who is under such pain management should carry complete responsibility, regardless of whether the substance in question is kratom or not.
Legality of Kratom
Although the use of Kratom has been accepted to be part of Thailand’s culture and traditional practices, it has actually been outlawed since 1943 when the Kratom Act was passed. The law criminalized possession of Kratom leaves, planting, and cultivating Kratom plants.
However, implementing the law posed an enormous challenge to the Thai government because eradication efforts included setting fire to rainforests where the trees naturally flourish. The results were detrimental to the wildlife and ecosystems of the country.
In 1979, Kratom was included in the Narcotics Act and was classified as a Category 5 substance. Regulatory efforts continue to persist in Thailand where the use of the substance is most prevalent.
Kratom is illegal in other countries such as Malaysia, Myanmar, Australia, and Denmark.
In the United States, Kratom has not been declared illegal by the Federal Government. According to the Drug Enforcement Administration (DEA), Kratom is currently not included in any of the categories under the Controlled Substances Act. However, DEA cited kratom as an “imminent hazard to the public” because of its potential for abuse. Back in August 2016, the agency announced that it would make kratom a Schedule 1 substance, the same as LSD, marijuana, heroin, and ecstasy.
The decision has been recanted by the DEA in November 2016.
Some states, nevertheless, have passed legislation prohibiting use and possession of Kratom. Here is a list of states categorized according to the legality of kratom use:
Kratom use is legal: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Iowa, Kansas, Kentucky, Louisiana, Maine. Maryland, Massachusetts, Michigan, Minnesota, Missouri, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Virginia, Washington, and Wyoming.
Kratom use is legal, but legislation to ban the substance has been initiated: Florida, Illinois, New York, North Carolina, Oregon, Utah and West Virginia.
Kratom use is banned: Alabama, Arkansas, Indiana, Tennessee, Vermont and Wisconsin.
Kratom continues to be available for purchase whether over the counter at various shops, or over the internet. No license or prescription is required to buy, possess or use the drug. Some users previously imported the leaves from some Asian Pacific countries until 2015, when the Food and Drug Administration (FDA) regulated this practice by issuing directives for the immediate seizure of such shipments from listed vendors.
Below is a list of kratom’s status in several countries.
It is currently listed as Schedule 9 of the SUSDP. Their decision was made in October 2003 during the National Drugs and Poisons Schedule Committee meeting.
Kratom is legal wherein leaves of the plant, as well as kratom extracts, are sold in local markets.
Kratom is not a controlled substance in this country.
Kratom is a legal substance in Canada where it can be purchased, sold and used without limitations.
In 2009, kratom was declared a controlled substance.
A prescription is required to be able to purchase kratom. Kratom importation is illegal.
It is classified as a controlled substance under Section 73 of the Medicines Act. Penalties are imposed on individuals found to purchase kratom online.
Kratom use is legal and the plant is not considered to be a controlled substance.
Kratom is sold as incense which can be purchased at head shops.
Kratom is not regulated by the country’s Misuse of Drugs Act.
Kratom may be used legally and is not considered as a controlled substance.
Anyone caught in possession of kratom is subject to a criminal offense.
Kratom is illegal to be sold in Malaysia unless a government license can be provided by the seller/trader.
It is illegal to grow and sell kratom in this country.
This country is one of the largest suppliers of kratom in Europe. Kratom is legal and can be purchased from smart shops and from online Dutch vendors.
It is classified under the same Schedule 1 of the Medicines Amendment Regulations Act of 2009. It is illegal to sell kratom without prescription. Importing and possessing is not illegal.
This is classified as a medicinal drug, which can only be accessed with a recommendation by doctors or government officials.
Kratom and its by-products are controlled substances in Poland.
Kratom ban has been implemented since 2010.
Kratom was illegal until its status was changed in 2011.
It is currently illegal in Sweden but is not listed in any drug schedules. There are, however, some indications that the status may change in the future.
Kratom is illegal and is strictly regulated.
It is classified as Level 5 Narcotic, which makes it illegal to grow, possess, sell, or purchase in Thailand despite being used in the past as alternative pain relief medication.
There have been increasing reports of emergency room visits resulting from Kratom use. The patients either complained of adverse reactions to the substance or of withdrawal symptoms. But more statistical data and scientific information are needed before the drug can be appropriately classified. The same information will validly determine whether regulatory or criminal legislation must be passed and enforced.
In the meantime, medical practitioners are rushing to find whatever resources they could to enable them to manage and treat patients who may present signs of Kratom tolerance, dependence, or withdrawal.
Kratom was marketed in the past as a nutritional or dietary supplement. It was in 2014 when there had been numerous reports to the U.S. Food and Drug Authority (FDA) about health concerns and toxicity of kratom. This resulted in a move to completely ban the importation of kratom to the US.
Despite this measure, kratom is continuously being sold at headshops where it is labeled as “incense”. It can also be purchased online. Some bars even offer this as a cocktail drink called “ketum”.
Currently, it is an unregulated substance, which is why it continues to be available in the market. No official labels are used for selling; therefore, the potential health hazards and the level of potency may be unknown to buyers.
Banning of Kratom in Thailand
In the 1940’s, the opium was very popularly shipped from Thailand to other countries. But since Kratom was inexpensive than opium, people have opted to buy opium instead. When opium sales fell, this alarmed the local businesses involved with opium, which then became the reason for banning kratom.
Kratom was not banned because of its effect but because of it being in competition with opium.
Statistics on Kratom Use
The popularity of kratom has been increasing as the availability of the substance online continues to rise and more people are openly discussing their kratom experiences.
A 2013 study showed that there is an increase in kratom-related cases as reported by the Texas Poison Control Database.
The exact number of teen kratom users may not have been determined as drug surveys do not include questions relating to kratom use. However, there are emergency room reports where teens were said to have taken kratom to get high. This is causing a major concern among authorities because kratom can become more appealing to teenagers. The availability of kratom has made it easier to purchase the substance than any other drug, and it costs much less than other drugs.