Kratom

Described by FDA researchers as a natural opioid, this leaf-derived drug has both supporters and detractors.

Kratom … it sounds like something that Superman would have brought with him from his home planet. No doubt Lex Luthor would be in hot pursuit of this strange substance for his own nefarious purposes.

But the truth is both far more terrestrial, as well as infinitely more complicated.

The leaves of the kratom tree have found their way across the Pacific and into the American economy, as well as alternative medical practices, and the lifestyles of many who believe that it helps them with everything from sleep problems, to chronic pain, to kicking an addiction. Currently, some 10 to 15 million Americans are believed to be enjoying the effects of kratom.

The first reported use of the substance in the United States was in the 1980s. Considering all the other drugs that have been used here since before the Constitution was ratified in 1788, kratom is brand spankin’ new to our nation.

“Kratom may have been used much longer than we think,” says Dr. Oliver Grundmann, clinical associate professor with the University of Florida’s College of Pharmacy. “But attention to the research has significantly increased in recent years.”

Before you can decide if these leaves are something you should try, you may want to dig down to the roots. What the heck is kratom? How do you use it? Is it good for you? What are the possible side effects?

To answer those questions, we interviewed an expert in kratom research, as well as several Tucsonans who have had experiences — positive and negative — with this ancient, yet newly popular plant.

LEAVES LIKE GRASS

Southeast Asia’s tropical Mitragyna speciosa tree, found in Indonesia, Malaysia and Thailand, is the source for kratom. The deep green, ribbed leaves of kratom are perched peacefully on the thin branches nearing the top of the tree. Each individual leaf has either a green, white, or red stem that flows into the veins, dispersed throughout the leaf.

Reportedly, each of these colored stems brings a different effect to the person ingesting them. The red vein strain is for those who need to sit back and relax. People use them for sleeping, anxiety, mental health, pain, and opiate withdrawal. The white stem, which also is known as the most powerful strain of kratom, is typically used like one would use coffee — as a stimulant. Green vein strain kratom could be compared to a “hybrid” in marijuana, which is the mix between cannabis sativa and indica. This strain has the capability to both calm and give energy to someone.

If it sounds like kratom has some parallels to marijuana, it’s because it does. For starters, there are a number of ways to get the leaves into your system. In the United States, one of the most common ways is in a liquid form. Another that has been on the rise is taking it as a powder (stirred into a beverage, or loaded into a capsule). It’s understandable that users prefer not to taste it: it’s often compared to dirt, or tea that has been sitting for far too long.

And like pot, the legality of kratom (on a state level) depends upon where you live. It’s currently banned in Alabama, Arkansas, Indiana, Rhode Island, Vermont, Wisconsin, along with cities such as Denver, Colorado; San Diego, California; Sarasota, Florida; Alton and Jerseyville, Illinois; and Columbus, Massachusetts. Where it is legal to buy, you often can find it at head shops, smoke shops, herbal shops and, of course, on the internet.

TO SCHEDULE, OR NOT TO SCHEDULE

Considered an “opium substitute” by some, discussion on the safety of kratom continues on the legal and medical fronts. “The reason why physicians and other health care providers are not necessarily as engaged with kratom,” explains Grundmann, “is because the Food and Drug Administration does not endorse its use. Actually, up until very recently at least, the FDA was trying to force it into the Controlled Substances Act under Schedule 1 — basically on the same level as heroin or marijuana.”

The FDA and the Drug Enforcement Administration (DEA) have both concluded that they do not see any justifiable medical use for kratom. The FDA has even put out a warning that claims kratom, “should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids.”

The DEA has played a significant role in all this, too. According to Grundmann, they planned to place kratom and its primary psychoactive alkaloids (mitragynine and 7-hydroxymitragynine) into Schedule 1. “Based on public comments in 2016-2017, as well as members of Congress voicing their opposition to it, the DEA actually withdrew that scheduling attempt. That doesn’t happen very often.”

What the DEA and the FDA were concerned about with kratom was the possibility — demonstrated in computer models — for two alkaloids contained in kratom to act in the human body the way an opiate would. Mitragynine isn’t of special concern, but 7-hydroxymitragynine has been associated with dependency and increased use.

This is where location plays a major role in the properties of a drug. The fresh kratom leaf, which is what people in Southeast Asia use, has a lower percentage of 7-hydroxymitragynine than the dried leaf form, which is more common in the U.S. since it has to be shipped here and packaged for consumers.

THE KRATOM DIARIES

An anonymous survey of 8,000 people conducted by Dr. Grundmann found that the average U.S. kratom user is an employed, college-educated, white male, married or with a significant other, earning an average household income of $35,000.

Participants noted that kratom increased their energy and focus, decreased pain, and contributed to a less depressed mood, lower anxiety, and also assisted in halting their opioid addictions.

Several individual users reached for this story reported both positive results, and bad experiences. Dustin Clevenger, 39, and a former user of kratom, took the substance steadily from 2016 to 2020 after hearing good things about it from friends. Initially, his reason for using was to ease his addiction to opiates.

“I then started taking kratom to deal with my back pain because I didn’t have insurance,” Clevenger says. He explains that it did relieve the pain, although the price he had to pay was tasting the less-than-pleasant substance. “I’d shake it up in some lemonade and drink it as fast as possible. It tastes like grass clippings,” he adds.

Most of his experience with kratom was more helpful than anything, but there were times when it made his stomach turn. “If I took too much, I’d get really shaky and feel kind of uncomfortable. I’d throw up and then I’d feel fine,” he says.

Clevenger decided after four years that it was simply time for him to disassociate himself with kratom. Day by day, he decreased the frequency of the dosage. “I was taking it six to 12 times a day and I was just tired of it,” he reflects.

According to users of the drug, the number of doses will result in different effects. Between one to three grams will provide energy. A three to six gram dose will impart even more energy and start to relieve pain. If anxiety and pain relief are the goal, six to eight grams is considered the sweet spot.

Frequency of use is typically two to three times a day.

Jacob Kolt, 23, has been using kratom for two years, initially to wean off from opiates. He now uses it for a burst of stamina. “It’s a slight high — like an opioid — without the relaxation, and then it gives me energy,” he observes.

As with any drug, there are those who simply cannot tolerate it. “I used it once for sleep and hated the effects,” remarks Kalon Blumentritt, 30. “It made me uncomfortable even at a low dose of white vein kratom.”

MAKING A WITHDRAWAL

Quitting kratom can be a bit like giving up Oxycodone, heroin or other opiate. The symptoms include muscle spasms, limited appetite, fever, diarrhea, runny nose and eyes, and pain.

The psychological withdrawal symptoms are mood swings, anger, nervousness, restlessness, disrupted sleep, tension, and sadness. Participants in Dr. Grundmann’s survey said that even though the symptoms of easing off the drug were very similar to opioids, they were not as intense and did not last for as long.

Kolt describes the withdrawal feelings as “like a super mild hangover.”

As the cliché goes, however, actual results — whether taking the drug or stopping it — may vary. Numerous health organizations have concluded that there are risks (up to and including death from overdose — though that is rare) in taking kratom. Consult your physician before you decide to include kratom, or any supplements containing it, in your routine.

A WORLD

AWAY Although America has been late to the party, the first documented use of kratom in Southeast Asia was as early as 1836. The tree that produces kratom is indigenous to several countries in that region, so it’s common to see it in various forms.

Like in the States, many people in Southeast Asia also use kratom either in place of opioids, or to wean off them. This may mean trading one dependency for another. Based on two different surveys, one conducted in Malaysia in 2009 and another in Thailand several years later, it’s common for users to develop a dependency on kratom, since a lot of them previously had been addicted to other drugs.

Aside from being a substitute for hard drugs, kratom is mostly used in Southeast Asia by men to boost their energy while working in manual labor jobs. For an energizing effect, they often chew the leaves. To partake of its calming properties, they drink tea (often diluted with water) made from kratom.

Men using kratom, especially as part of completing a day’s work, are not stigmatized the way people using opiates are. Though statistics say that men are more likely to use kratom, there is increasing evidence that women are becoming regular consumers of the drug, too. There is evidence to suggest that women who use it during pregnancy may give birth to infants who experience withdrawal symptoms.