Has anyone heard of Kratom or tried it?

@stuckonu Kratom has been discussed here in the past. There are many reasons why it is not FDA approved, not least among them that as an unregulated substance, usually imported and with no standardized testing, the customer has no idea what they are buying in terms of strength or purity.

Here is the latest opinion from Mayo Clinic with many references to other studies and sources:
https://accurateclinic.com/wp-content/uploads/2022/06/Kratom-Unsafe-and-ineffective-Mayo-Clinic-2022.pdf
Although it is technically legal in the US, due to concerns about addiction and abuse many states are taking steps to ban or regulate Kratom.
Sue

Yes, you have to be super careful with it because you can become dependent on it rapidly, develop a tolerance and then it takes a long time to get off of it.

Here are a couple of discussions on the forum related to Kratom
- Kratom warning: https://connect.mayoclinic.org/discussion/kratom-warning/
- Kratom for PN pain in feet?: https://connect.mayoclinic.org/discussion/kratom-for-pn-pain-in-feet/

Kratom is an unregulated substance, so I consulted a Mayo Clinic pharmacist on the posts. She offered the following information.

|Kratom is a natural product but it does have significant risks and side effects. Because of these risks the FDA banned import of Kratom in August 2016 and issued a notice of intent to classify 2 chemicals in Kratom as Schedule 1 drugs (the same category as heroin). There are no FDA-approved uses for kratom, and the agency has received concerning reports about the safety of kratom. FDA is actively evaluating all available scientific information on this issue. (2019) https://www.fda.gov/news-events/public-health-focus/fda-and-kratom

Kratom can cause dependence and withdrawal symptoms including aggression, anxiety and other negative psychiatric effects, muscle aches, spasms, tremors, insomnia, fever and upset stomach. It can also cause dangerous slowed breathing and seizures. It can worsen psychiatric disease and may increase the risk of suicide. Kratom can impair liver function. Kratom interacts with other herbal medications including Jimson Weed. It interacts with sedating medications. It has the potential for many other drug interactions because of the way it is metabolized."

For more information see:
– National Institute of Health: Drug Facts, Kratom https://www.drugabuse.gov/publications/drugfacts/kratom
– Center for Disease Control https://www.webmd.com/mental-health/addiction/news/20190411/cdc-americans-are-dying-from-kratom-overdoses#1

Here are additional articles from Mayo Clinic on Kratom:
– Kratom: Unsafe and ineffective https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171
– Kratom for opioid withdrawal: Does it work? https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/kratom-opioid-withdrawal/art-20402170

A lot of people swear by it. I have no interest in it, myself. What I use now works for me. But it would be a bad move to ban it, as this would only drive it underground, where quality would suffer even more and more people would become criminals by law. Is it healthy and effective? The experts say no; many people who use it swear by it. Your body; your choice. But if you decide to try it, follow harm reduction guidelines: Start low and go slow. That is, take the smallest amount possible at first and increase slowly over time until you know how it affects you. Don't leave it around where children can find it-- this goes for ALL drugs. And be honest with your doctor if you're using it.

Good luck. Be careful.

It’s important to note the DRAMATIC difference between adulterated vs non adulterated.

Issues are when the 7-OH alkaloid is artificially inflated by 500%. In the plain leaf it’s only 2%

Mother nature got it right but you know we humans always feel that we are so superior that we have to try and improve on everything

World Health Organization
WHO was asked to do a critical 1 year review in Oct of 2021. In a 4 day hearing they couldn’t find any reason for a review

Expect Committee in Drug Dependsnce from the WHO World Health Organization has determined there’s insufficient information to even review KRATOM further. The concluded to leave it at the same level of surveillance as it had been for years.

“Is Kratom addictive?

Is coffee addictive? Are you addicted to chocolate?

Asking questions like this is a bit misguided. In none of these examples we ask whether plants themselves are addictive. Instead, we question the potential for abuse of active alkaloids in each plant.

Alkaloids: one of a class of nitrogenous organic compounds derived from plants that have been pronounced physiological actions in humans.

In simple English, alkaloids are any chemicals in plants that cause real effects when consumed by humans. Caffeine, for example, is an active alkaloid in coffee beans that is responsible for the stimulating effect of coffee. Nicotine is an alkaloid in tobacco, and theobromine & caffeine are alkaloids in chocolate (chocolate).

There are about 20 active alkaloids in the Kratom plant. The two dominant alkaloids responsible for plant effects are Mitragynine (MG) and 7-hydroxymitragynine (7-HMG). Of all the alkaloids in Kratom, MG is the most common, making up about 60% of all alkaloid profiles. In contrast, 7-HMG only makes up 2% of the alkaloid profile. Therefore, it is believed that MG is the alkaloid responsible for most of the effects reported by Kratom users; such as relieving anxiety, relieving pain and regulating moods.

"The main effect of kratom is most likely produced by MG with the possible contribution of 7-OH-MG.

(from Pinney Associates's 8-factor analysis of potential kratom abuse)

With this in mind, we should reframe a little the original question: Is Mitragynine addictive?

According to a study conducted by the Society for the Study of Addiction published in June '18 in the Journal of Addiction Biology (a peer-reviewed academic journal), "These findings indicate that MG has no potential for abuse and reduces morphine intake, a desirable characteristic of pharmacotherapy candidates for opiate addiction and withdrawal ... "So, in other words, MG does not match the potential abuse profile assigned to addictive substances, such as heroin and Oxycontin. More about that here. In fact, in the study, they gave mice with Morphine for several days in a row, and then turned it into MG for several days. After their time with MG, Morphine was again available to them, and they showed a reduced likelihood of returning to using Morphine. This is what is referred to in the quote above when they show that it "reduces morphine intake". Which, as the authors say, makes it a very promising potential therapy for opiate & withdrawal addiction.

In addition, when looking at potential drug abuse, the main factor considered is the effect that the substance has on the daily lives of users. For example, the majority of cocaine or heroin users report a drastic negative impact on their ability to engage with work, friends, and life in general. The use of kratom does not fit this description at all. In fact, according to Pinney Associates 8-factor analysis, "Consumption usually does not interfere with work or social activities and commitments, and in fact kratom is widely reported in the US, as in Southeast Asia, to contribute to work productivity, quality of life, and social relations. "So, unlike abuse drugs, kratom seems to improve the quality of life for many users, as opposed to reducing it. It is interesting to read this description as presented by scientific research.”

NIDA affirmed that, "Kratom by itself is not associated with fatal overdose," explaining only when the natural ingredient is contaminated “laced with other compounds" has it been associated death.‬

‬
‪*(Post et al, 2019. Clinical Toxicology).‬

“mitragynine is not structurally similar to traditional opioid medications.”

difference between kratom and traditional opioids…lack beta-arrestin-2 recruitment, which may explain reduced side effects and risk of respiratory depression seen with kratom”

Volume 20, Issue 5
A Kratom Primer: Miracle Medicine or Herb of Abuse
Sept 2020

According to a study conducted by the Society for the Study of Addiction published in June '18 in the Journal of Addiction Biology (a peer-reviewed academic journal), "These findings indicate that MG has no potential for abuse and reduces morphine intake, a desirable characteristic of pharmacotherapy candidates for opiate addiction and withdrawal ... "So, in other words, MG does not match the potential abuse profile assigned to addictive substances, such as heroin and Oxycontin. More about that here. In fact, in the study, they gave mice with Morphine for several days in a row, and then turned it into MG for several days. After their time with MG, Morphine was again available to them, and they showed a reduced likelihood of returning to using Morphine. This is what is referred to in the quote above when they show that it "reduces morphine intake".