Traditional uses of kratom

A herbal medicine, benefits of kratom is used as an opioid replacement in the US and as a stimulant. It is also reported to have mood-enhancing properties, though research is limited on this use. The drug can cause side effects including nausea, drowsiness, constipation and changes in heart rate and blood pressure. It is also possible to overdose from kratom, with symptoms including seizures, respiratory problems and death. Reports of kratom overdoses mostly involve combining it with other substances, especially opioids like heroin and fentanyl. People who take kratom should be aware of the potential for these life-threatening side effects and should never use it with any other substance or medication.

The US Food and Drug Administration hasn’t approved kratom, but it is available in a variety of forms including powders, tablets, capsules and raw leaves (mostly dried) and concentrated extracts (mostly liquid). Currently, kratom is unregulated, which can result in inconsistent concentrations of the putative active ingredients mitragynine and 7-hydroxymitragynine. The quality of kratom products is highly variable, which has been linked to hallucinations and liver damage.

Researchers say more rigorous clinical research needs to be done to test kratom’s therapeutic benefits and for adverse side effects like behavioral intoxication and addiction. “Because of the lack of safety data and the herb’s widespread availability, it is important that individuals err on the side of caution, always use kratom with a sober friend nearby and carry fentanyl test strips and naloxone in case of an overdose,” says Garcia-Romeu.

Studies of kratom show that it has pain-relieving properties, but many users seek out the drug for nonprescription treatment of depression or anxiety, reports and surveys suggest. One recent survey of 2,798 kratom users found that 91% reported using kratom to relieve pain, on average, several times per day for back, shoulder and knee pain. In addition, 35% of kratom users reported using the drug to help with opioid withdrawal or as an alternative to prescription opioids and heroin.

A lawsuit filed against the vendor of kratom in Krystal Talavera’s Father’s Day overdose death cites acute kratom intoxication as the cause of her overdose and subsequent death. The lawsuit is seeking more than $4 million in damages for her family.

The DEA and FDA have considered criminalizing kratom, but they’ve been met with public and supplement industry pushback. The federal agencies should continue to do their work on this issue, but they must avoid drug hysteria and focus on evidence from controlled scientific studies.