Understanding Kratom: History, Research & Advocacy
Kratom, scientifically known as Mitragyna speciosa, is a tropical tree native to Southeast Asia (SEA), particularly in countries like Thailand, Indonesia, Malaysia, and Papua New Guinea. For centuries, the indigenous people of these regions have consumed kratom leaves for a variety of benefits, primarily for enhancing energy, increasing focus, and promoting a general sense of well-being. In recent decades, kratom has gained popularity in Western countries, particularly the U.S., as a natural herbal remedy. This guide offers an in-depth look into what kratom is, how it’s been traditionally used, its benefits, potential risks, and the legal landscape surrounding it.
What is Kratom?
Kratom is a member of the coffee family and, much like coffee, is known for its stimulating effects. Traditionally, kratom leaves were either chewed or brewed into tea by workers in Southeast Asia to help boost energy and alleviate fatigue during long days of labor. Today, kratom is available in various forms, including powders, capsules, and liquid tinctures, used not only for energy and fatigue but also for relief from discomfort.
Kratom leaves are harvested at different stages of growth, and these stages are often marketed as different “vein colors.” The three most common vein types are white, green, and red. These colors represent the stage at which the leaf is harvested:
- White Vein: Harvested early in the plant’s growth cycle, these leaves are often associated with increased energy and focus.
- Green Vein: Harvested at the mid-point of maturity, green vein kratom is known for providing a balance between energy and discomfort relief.
- Red Vein: Harvested later in the growth cycle, red vein kratom is typically used for its calming and soothing properties, especially for discomfort relief.
The primary active compounds in kratom are two alkaloids: mitragynine (MG) and 7-hydroxymitragynine (7-HMG). These alkaloids are responsible for kratom’s stimulating, relieving, and calming effects.
How is Kratom Historically Used?
In its native regions, kratom has long been consumed by agricultural workers and laborers who chewed the fresh or dried leaves, primarily for an energy boost. In recent years, it has expanded beyond these traditional uses, particularly in Western countries, where users consume kratom for various reasons, including:
- Energy and Focus: In smaller doses, kratom acts as a mild stimulant, enhancing focus and energy levels, similar to the effects of coffee but without the jitteriness.
- Discomfort Relief: At higher levels, kratom’s alkaloids have been reported to provide relief for acute and chronic discomfort. According to the American Kratom Association, many users find it effective for managing conditions like arthritis, back pain, and fibromyalgia as a safer alternative to addictive opioids (AKA Policy Brief No. 1001).
- Opioid Withdrawal and Addiction Treatment: Kratom has gained attention as a natural alternative for those seeking to reduce or eliminate their use of opioids. Its alkaloids have been reported to alleviate withdrawal symptoms and reduce cravings. However, it’s important to understand that kratom works differently than conventional opioids. Kratom’s alkaloids interact with the body in unique ways, reducing the risk of severe respiratory depression—a common danger associated with opioid use.
Debunking the “Kratom is an Opioid” Myth
One common misconception about kratom is that it is an opioid. While it is true that kratom’s alkaloids, particularly mitragynine and 7-hydroxymitragynine, do bind to some of the same receptors in the brain as opioids, the way kratom works is fundamentally different.
The U.S. Food and Drug Administration (FDA) has classified kratom as a “drug of concern,” but their efforts to label kratom as an opioid have been met with resistance from both scientists and the Drug Enforcement Administration (DEA). Recent studies have shown that kratom’s alkaloids are partial agonists, which means they do not fully activate the opioid receptors like traditional opiods. (Hemby et al., 2018; Yue et al., 2018). This significantly reduces the risk of the respiratory suppression that makes opioids so dangerous. Additionally, research has shown that kratom does not create the euphoric high typically associated with opioid use, which is why kratom has a much lower potential for abuse. (Hemby, Addiction Biology, 27 June 2018)(i)
A recent peer-reviewed published article (Henningfield, Grundmann, Babin, Fant, Wang, & Conei)(ii) found that opioids have at least a 1,000 times greater risk of overdose deaths than using kratom. The study emphasizes that more research on kratom safety and risks is needed, and regulation of commercial kratom products to ensure that consumers are informed by FDA labeling and that kratom products are not contaminated or adulterated with other substances. (AKA Policy Brief No. 1001)
Safety Profile of Kratom
One of the most important factors that make kratom appealing to millions of people is its relatively low risk of serious side effects compared to opioids. According to reports from Southeast Asia, where kratom has been used for centuries, there have been no reported overdose deaths from kratom alone. However, in the United States, there have been cases where kratom-related deaths were reported, but further investigation revealed that these cases involved polydrug use.
This highlights the importance of not mixing kratom with alchohol or perscription drugs and purchasing kratom from reputable and trusted sources that follow proper testing and handling guidelines as spearheaded by the American Kratom Association. Proper regulation in the kratom market, particularly in the U.S., is crucial, as adulterated products can pose serious risks to consumers. Ensuring that kratom products are pure and unadulterated is essential for maintaining safety and consumer trust.
The Science Behind Kratom
Several studies have been conducted to better understand kratom’s potential for addiction and its role in opioid withdrawal treatment. In 2020, Johns Hopkins University published a study on adult kratom users, revealing that 87% of those using kratom for opioid dependence found relief from withdrawal symptoms, and 35% of these users were able to stay opioid-free for more than a year.(iii)
Moreover, the U.S. National Institutes of Health (NIH) and the National Institute on Drug Abuse (NIDA) have funded multiple studies to investigate kratom’s safety and its potential role in treating opioid addiction, including a recent ongoing study at the University of Florida that will further investigate the potential for kratom’s alkaloids to treat opioid withdrawal.(iv) The University of Florida research team supported in their grant submissions affirming that “studies indicate that mitragynine does not exhibit abuse-related effects and can attenuate opioid intake”(v), making it a potentially valuable tool in addressing the opioid crisis in the U.S.
Legal Status and the Regulatory Debate
Currently, kratom is legal in most U.S. states, although it faces ongoing scrutiny from the FDA, which has pushed for its regulation or scheduling under the Controlled Substances Act. However, the DEA has not followed through on these recommendations, citing insufficient evidence of public health risks that would justify banning kratom. The agency typically acts quickly on scheduling drugs when there is clear evidence of danger to public health, but in kratom’s case, no such action has been taken.
Several states have implemented their own laws regulating kratom sales, while others have banned it altogether. The Kratom Consumer Protection Act (KCPA) has been introduced in various states to ensure that kratom products are properly labeled, unadulterated, and only sold to individuals of legal age.
Additionally, the U.S. House of Representatives has urged the National Institutes of Health (NIH) to broaden research on kratom, as highlighted in the 2020 House Committee on Appropriations report (House Committee on Appropriations LHHS, 2020xiv)(vi). The committee specifically opposed any efforts to ban kratom, stating that such a move would hinder valuable ongoing research. The House Report also acknowledged the promising potential of kratom for patients dealing with acute and chronic pain, particularly those seeking safer alternatives to highly addictive and potentially lethal prescription opioids.
Conclusion: Kratom as a Safe, Natural Option
According to the American Kratom Association, millions of Americans, kratom is a safer alternative to dangerous, addictive prescription medications. Used responsibly, pure kratom has the potential to manage pain, reduce opioid dependency, and provide relief from withdrawal symptoms. However, consumers must be cautious about where they purchase kratom, as the unregulated market has allowed adulterated products to enter the supply chain.
Advocates, including the American Kratom Association, continue to push for the regulation of kratom products to ensure that consumers have access to safe, pure, and properly labeled kratom. While more research is necessary to fully understand its long-term effects, kratom holds promise as a natural, plant-based remedy for various conditions, particularly in the context of the ongoing opioid crisis.
If you’re considering kratom, it’s crucial to purchase it from reputable sources and consult with healthcare providers to ensure it’s right for your needs. With the right knowledge and care, kratom can be a valuable addition to the world of natural health and wellness.
================
(i)Hemby et al. “Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine,” Addiction Biology, 27 June 2018, doi: 10.1111/adb.12639.
(ii)Risk of Death associated with kratom use compared to opioids; Henningfield, Grundmann, Babin, Fant, Wang, Cone, Preventative Medicine, Nov. 2019, https://www.ncbi.nlm.nih.gov/pubmed/31647958
(iii) Garcia-Romeu A, Cox DJ, Smith KE, Dunn KE, Griffiths RR. Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic. Drug Alcohol Depend. 2020;208:107849. doi:10.1016/j.drugalcdep.2020.107849
(v) https://addictionresearch.health.ufl.edu/2019/08/30/research-kratom/
(vi) U.S. House of Representatives, Departments of Labor, Health And Human Services, and Education, and Related Agencies Appropriations Bill, 2020, pages 100 and 102. https://www.congress.gov/116/crpt/hrpt62/CRPT-116hrpt62.pdf.