Opioid Withdrawal

The herbal supplement kratom is used recreationally and for pain relief. It is available in many forms: dried or powdered leaves, kratom resin (dried and pulverized plant matter), tinctures, capsules and extracts. It is also sold as a remedy for several medical conditions, including anxiety and depression.

The kratom plant is from the Mitragyna speciosa family of plants. It is native to Southeast Asia where it has been used traditionally as a psychostimulant at small doses and an opioid at higher dosages. It is reported to have sedative and analgesic effects and has been used by some people with chronic pain, to relieve withdrawal symptoms from opioid and other drug addiction, as well as for mood or attention deficit/hyperactivity disorders, or for weight loss. Kratom is currently popular in the United States, where it is sold as a legal herbal supplement.

Researchers are still learning more about kratom. In a study of its pain-relieving properties, scientists found that two chemicals in the plant, mitragynine and 7-hydroxymitragynine, bind to receptors in the brain. The compounds seem to block the transmission of nerve impulses, causing pain relief. These effects may explain why so many people find kratom helpful for pain and other conditions.

Kratom is not regulated at the federal level, and it can be difficult to find a reliable source of the herb. The plant is unstandardized and can be mixed with other drugs, which increases the risk of side effects, such as hallucinations and liver damage. A recent salmonella contamination in kratom supplements has further raised safety concerns.

Research has shown that kratom contains alkaloids that have opioid-like properties and may cause psychological and physical dependence. However, the compounds do not act on receptors that suppress breathing in the same way as stronger opioids such as morphine and fentanyl. This is an important difference, since respiratory depression is the leading cause of overdose deaths from opioids in the United States.

Despite these risks, people continue to report using kratom. A survey of kratom users found that they reported beneficial effects such as increased energy, lessened or stopped opioid painkiller use, lowered anxiety, improved mood and reduced symptoms of posttraumatic stress disorder (PTSD), and fewer negative side effects such as nausea, constipation or dizziness when they consumed a moderate amount of kratom (3 g or more).

Although kratom appears to be relatively safe, further clinical studies are needed to evaluate the long-term health effects of its use. The results of these studies are expected to inform regulatory decisions about kratom's future in the U.S.