If you’ve spent any time in your neighborhood smoke shop or bodega, you may have seen kratom and heard that the herbal substance is an effective and natural alternative to other drugs. The truth is a little more complicated—even though kratom is easy to get, there’s very little clinical research on it, meaning doctors don’t always know how dangerous it can be. Picking up kratom as a replacement for other drugs can still lead to addiction, which is both physically and financially costly. At Ophelia, we want our patients to fully understand their options and how they compare to evidence-based, medication-assisted treatment (MAT). We’re here to explore everything you should know about kratom.
What is kratom?
Kratom is a tree native to Southeast Asia and parts of Africa. Its leaves are traditionally used as medicine, with low doses producing stimulating effects and high doses resulting in a sedative effect. These effects come from two psychoactive compounds contained within the plant: mitragynine and 7-hydroxymitragynine, which interact with the opioid receptors in the brain.
Currently, it is legal in the U.S. and not considered a controlled substance. The DEA warns that kratom is a Drug and Chemical of Concern, and agencies like the FDA are still reviewing evidence of its safety and addictive properties.
Kratom’s status has been the subject of significant debate in Washington, DC. In 2016, the DEA proposed a ban on the substance but reversed course in 2018 after the Office of Health and Human Services (HHS) recommended making it a Schedule I substance. These restrictions would make kratom extremely difficult to obtain—which is good for the general public—but also virtually impossible for scientists to research.
What are the benefits?
Kratom benefits typically vary between individuals and depend on the dosage. In low doses of 5 grams or less, stimulant effects include increased alertness, energy, and sociability. Higher doses, between 5 and 15 grams, may result in feelings of calmness, relaxation, and euphoria. Many people use it to manage pain and mental health problems.
It’s often considered a “safer” and “natural” alternative to opioids, used to self-manage pain and help with opioid withdrawal. However, not enough clinical studies have been conducted to consistently and definitively prove the benefits or harm. There have been some rare but serious side effects seen from kratom use, such as hallucinations, difficulty breathing, cardiac problems, and seizures.
How can kratom be used?
The herbal drug kratom comes from the crushed leaves of the plant, which can then be smoked, brewed in tea, packed in capsules, or chewed directly. They also come in pastes and tablet form.
Some people with OUD use it to handle symptoms of drug withdrawal, but kratom itself has some addictive qualities. Kratom withdrawal may cause pain, muscle spasms, tremors, seizures, and rhabdomyolysis (a condition in which the muscles disintegrate and release protein into the blood, causing kidney damage). Withdrawal can also produce psychological symptoms, including restlessness, depressed mood, and anger.
When people become addicted to kratom and can no longer control their use or safely taper off, they’re typically eligible for Suboxone maintenance treatment due to kratom’s opioid effects. Someone seeking treatment for kratom addiction should find a specialist who is licensed to provide Suboxone to ensure access to evidence-based care.
Finding a true evidence-based solution
As evidence continues to emerge about kratom’s effects and risks, it’s important to turn to safer and better-researched alternatives. At Ophelia, we’re dedicated to making evidence-based solutions for OUD more accessible. Our clinicians are well-versed in the latest research and provide personalized support through a telehealth-based program. Find out if you’re a candidate with a quick questionnaire and 15-minute welcome call.
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