“He had been drinking it as a tea to help with anxiety and ultimately ended up in the school’s student health center in acute opioid withdrawal”
-Marianne Chai M.D.

Dr. Chai first encountered kratom when treating a teenage boy for addiction. Like many therapists and addiction medicine clinicians, Dr. Chai was surprised to learn about this legal substance that has been increasingly popular among teenagers and adolescents.

An herbal supplement that is deemed dangerous

Kratom, commonly known as biak, ketum, kakuam, ithang, and thom is a green psychotropic substance made from a tropical tree that originates in Southeast Asia. This psychoactive substance can be easily ordered on the Internet and is a popular substance because it has opioid and stimulant-like properties. It is an unregulated herbal supplement that the DEA considers a “drug of concern.” Since kratom is legal and does not require a prescription, it is easily attainable and is often falsely advertised as “safe”. It can be found in powder and capsule form and is commonly used to make tea.

Mitragynine is one of the active ingredients found in kratom leaves. This ingredient interacts with receptor systems in the brain to produce stimulant effects. Mitragynine and another compound, 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing the pleasurable, pain-reducing effects of opioids, especially when users consume large amounts of the plant. The combination of stimulant and opioid-like effects is what makes this drug so attractive to many users.

Kratom use among students and middle-aged adults

Young high school and college-aged students are turning to Kratom to help cram for exams, help lower anxiety, and help relieve pain. Many news stories have appeared in recent years, falsely highlighting safe uses for kratom such as relieving anxiety, eliminating chronic pain, and curing long-standing medical illnesses such as diabetes. Kratom is also advertised as a means to reduce opioid withdrawals; however, to date, there have been no well-controlled scientific studies showing that kratom is effective for opioid abuse withdrawal or any other condition in humans.

Kratom is not just a popular drug among high school and college-aged students. It is also becoming increasingly popular among middle-aged adults living with chronic pain and are seeking relief.

Since kratom is legal, deemed as all-natural, and easily attainable, many young people assume it is safe. The major challenge associated with kratom is a perceptual one. Many individuals do not consider the dangers of this drug until they get into trouble.

Is kratom addictive?

Since kratom has both opioid and stimulant effects, it can be both physically and psychologically addictive. Many users admit to taking kratom to help relieve opioid withdrawals, but longer-term use of kratom can result in dependence and withdrawal. Withdrawal from kratom is not always easy and often mirrors the effects of opioid withdrawals.

Withdrawal side effects include the following:

  • Muscle aches and pains
  • Irritability
  • Insomnia
  • Aggressive behavior
  • Hostility
  • Runny nose
  • Watery eyes
  • Diarrhea
  • Nausea and vomiting
  • Food cravings
  • Anxiety
  • Depression
  • Hot flashes

Can I overdose on kratom?

“In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances…”

As with many other addictive substances, it is possible to overdose on kratom, especially when under the influence of other drugs such as opioids, benzodiazepines, cocaine, and alcohol. Although kratom is legal and can be obtained without a prescription, this does not necessarily imply that it is safe for consumption.

What are the side effects of kratom intoxication?

When kratom is taken in small amounts; users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects, including the following:

  • Sweating
  • Increased urination
  • Elevated heart rate
  • Nausea
  • Itching
  • Vomiting
  • Weight loss
  • Insomnia
  • Hallucinations
  • Loss of appetite
  • Seizures
  • Liver damage
  • Cardiac arrest

Since there are many active ingredients that have not been studied in kratom, the safety profile, addiction potential, and long-term effects are still widely unknown.

Seeking help

Although kratom withdrawal is not life-threatening, the addictive behavior associated with kratom can be dangerous. Since kratom has both opioid and stimulant-like properties, many individuals may also be physically dependent on other classes of drugs that have harmful profiles. There are no medications used to treat kraton dependence; however, a wide array of psychotherapy approaches can help individuals overcome behaviors and lifestyle choices that coincide with substance use disorders.

ARC is a full-service addiction treatment center located in the Los Angeles area that has remained open throughout the COVID-19 pandemic. The treatment staff at ARC ensures that your detox, treatment, and recovery are tailored to your individual needs. Our goal is to provide individualized treatment in a safe and secure environment in hopes that you can live a happier, healthier, and prosperous future.

Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases, including mental health disorders and the stigma associated with them.