KRATOM -Harmless Herbal or Substance of Abuse?
Feeling a little depressed or anxious? Low energy? Perhaps you just “want to feel a little less crappy in general.” A rapidly growing number of people in the U.S. are turning to Kratom, a largely unregulated and poorly studied supplement often perceived to be “safe and natural.” Some estimates suggest more than 10 million people in the U.S. are users with retail sales in excess of $2 billion. As usage skyrockets and the sort unfolds, it’s clear krater is not a simple and safe natural herbal burt a complex mix of compounds with a myriad of potential side effects as well as real addictive potential. Currently krater is considered a “drug of concern” by the U.S. Food and Drug Administration.
What is kratom?
Kratom is derived from the leaf of a tree (Mitragyna species) native to Southeast Asia from Myanmar to the Phillipines where it has long be used (chewed) for its energizing and stimulant effects, particularly among manual laborers. Kratom actually contains more than 50 different substances but two are believed to be most important in producing kratom”s effects, mitragynine (MG) and 7-hydroxymitragynine (7-OHMG). In natural krater extracts, MG accounts for about 60% and 7-OHMG for less than 2% of total content. Both compounds act at multiple receptors in the brain with potential for psychoactive effects including those for dopamine and serotonin. It’s also fair to say krater is an opioid like drug as well since both MG and 7-OHMG activate the mu opioid receptor.
The effects of krater are dose-related. At low doses it’s a stimulant but at higher doses produces opioid-like effects including analgesia and sedation. 7-OHMG is more than 40 times more potent at the opioid receptor than MG. Some kratom products are now marketed as 7-OH, “7-Hydro,” or even “legal morphine and contain a greater, enriched concentration of 7-OHMG. While all kratom products have abuse potential and may be associated with a withdrawal syndrome similar to opioid drugs, the risk is much higher with increased concentrations of 7-OHMG. Since production of kratom is not regulated or standardized, the user doesn’t know the actual kratom content, particularly the concentration of the more potent 7-OHMG. Also, contamination of kratom products with salmonella and potentially toxic heavy metals has been reported.
Kratom in North America is ingested via a capsule or in powdered form mixed in a beverage. Smoking or injecting kratom is rare.
WHO USES KRATOM AND WHY
A recent survey of kratom users found an average age of initiation of use of 29.9 years and significant history of other substance use including non-medical cannabis (72.1%), non medical prescription opioids (31.8%) and psychedelics (25.4%). Users identified multiple reasons for using kratom:
“Just to feel less crappy in general” 67%
Self treat anxiety 53%
Low energy 50%
Pain 50%
Recreation 49%
Reduce social anxiety 47%
Self treat depression 42%
Relieve opioid withdrawal 19%
Fully a third of users described krater as “safer than other substances,” though a quarter admitted it was “addictive or habit forming” Most reported multiple sources for kratom, including gas stations, vitamin/herbal shops or online vendors.