Kratom is an increasingly popular drug of abuse and readily available on the “recreational” drug market. Between 3 million and 5 million people in the U.S. use kratom, and reported poisonings from people taking it have soared.
The U.S. Food and Drug Administration (FDA) has warned against using Mitragyna Speciosa, commonly known as kratom, a tree in the coffee family which grows naturally in Thailand, Malaysia, Indonesia, Philippines, Vietnam, Myanmar, and Papua New Guinea. The concern is that kratom leaves, which affect the same opioid brain receptors as morphine, appear to have properties that expose users to the risks of addiction, abuse, and dependence.
There are no FDA-approved uses for kratom because there is no scientific evidence to support its medical use, and the FDA urges consumers to report any adverse reactions to the FDA’s MedWatch program.
Because kratom is still legal in the U.S., it has become a go-to drug for individuals with chronic pain, promoted anecdotally by some psychiatrists both to mitigate pain and to ease withdrawal from other opioids.
Some other psychiatrists are convinced of kratom’s mental health benefits as a potential therapeutic agent.
Similar to the dose-dependent characteristics of any drug, in relatively small amounts kratom acts as a stimulant; in relatively larger amounts it causes sedation; and when overdosed it can cause death.
Kratom’s psychoactive compounds, mitragynine and 7-hydroxymitragynine, are opioid-receptor agonists, which means they are chemicals that bind to the same receptors in the brain to which opioids bind, thus acting in the brain similar to other opioids like morphine and codeine.
Side effects of taking (or withdrawing from) kratom may include dependence, nausea, vomiting, aggression, hallucinations, delusions, psychosis, seizures, thyroid problems, increased risk of suicide, trouble breathing, brain swelling, seizures, liver damage, or death.
In spite of the American Kratom Association’s lobbying efforts to promote this harmful substance, and its repeated references to the American Psychiatric Association for support, we find that there is sufficient reason to be highly skeptical.
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