Imagine an all-natural treatment that works like opioids for chronic pain but without the risk of dependence and resistance. This treatment promises a feeling of euphoria in smaller doses or a feeling of pain-free calm in larger amounts. This medicine can be taken in pill form; as a powder mixed into juice, yogurt, or applesauce; or as hot or iced tea. It is widely available at the corner store and does not require a prescription. Insurance does not cover this treatment, but it is affordable, about the cost of a venti coffee drink. The recommended frequency of dosing is just a few times a month.
This miracle treatment is called kratom.
Its use is as controversial as you would expect for a natural treatment that promises these benefits. Before making up your mind, it’s important to start with the facts.
Mitragyna speciose, also known as kratom, is either an evergreen or deciduous tree (depending on the climate of cultivation) and is classified in the same family as coffee plants. Cultivated mostly in Southeast Asia and indigenous specifically to Thailand, the leaves of the tree contain psychoactive properties that can induce reactions depending on the quantity consumed and type of preparation.
The chemical properties of kratom are similar to the chemical properties of opioids.
Kratom binds to some of the same receptors as opioids, which would explain the sedative and pain-relieving properties of the plant. Each leaf of kratom contains more than 40 chemical compounds, including calcium channel blockers that are present in larger or smaller amounts, again depending on where the tree is cultivated.
The effects of this substance vary depending on dosage, type of preparation, and properties of the individual plants. In small doses, effects reported range from the positive (mental clarity and alertness and sexual stamina) to the negative (on-edge, touchy, upset).
Positive testimonials emphasize kratom’s help with social situations as well:
“A little over a year ago I began taking low doses of a plant that I feel is a gift. Prior to this, I had just moved to a new city for school, and I knew no one. As a person who suffers from crippling social anxiety, low doses of Kratom helps ease myself into social situations and assist in empathy… After over a year of use, I have found no negative side effects from Kratom.”
Large doses can produce a more relaxed feeling and can be used successfully as a treatment for both acute and chronic pain. Negative side effects reported include nausea, vomiting, itching, and sweating.
Users of higher doses (and some doctors) believe that kratom has helped them break free from their addition to opioids:
“I’m 28 this month and have been off and on opiates since I was 16. I had a bad accident and had a major surgery and that’s when my addiction began…I’m constantly on my feet so I always try to take pain meds so I can function the best I can …finding kratom has let me break free from the chains of opiate addiction…It has helped my life tremendously and I’m so much happier with myself and my life!”
Because of kratom’s complex chemical make-up, it is difficult to pinpoint exactly how it acts in the body (or what other medicines it might interact with). Its most prominent use in Asia has been as a substitute for opium when it was not available or to help ease the symptoms of opium withdrawal. Kratom has been used by workers spending long hours in factories to keep their energy and mental focus up, as well as an anti-diarrheal, a remedy for erectile dysfunction or low libido, and a treatment for addiction to opium. Everyday Thai people do not stigmatize the use of this substance. The majority grow into adulthood chewing kratom leaves that proliferate throughout the country.
In 1943, the Thai government banned cultivation of kratom and ordered all existing trees be cut down.
Those opposed to the use and cultivation of kratom in other countries argue that even indigenous cultures believe it is dangerous, but there is another side to the story. If the Thai people can freely obtain a natural substance that mimics some of the properties of opium without the side effect of addiction or resistance (needing more and more to get the same high), then this would impact the Thai government’s ability to collect taxes on opium distribution. Kratom is currently still illegal in Thailand but laws against its use are rarely enforced.
In the U.S., kratom is, at this point, legal in all but four states and officially unregulated. The DEA has issued a statement that kratom is a “drug of concern,” and as of June 2015 the U.S. Food and Drug Administration authorized seizure of all imports of kratom because there is no evidence that kratom does not pose a threat to people.
The general policy appears to be a combination of “wait and see” and to take it off the streets until it is proven harmless.
Proponents of this approach would argue that kratom use offers benefits beyond the risks and that seizing the leaves or banning their use causes more harm. Paul Kemp of the American Kratom Association, an advocacy group for the use of kratom, believes that those who are reporting negative side effects are not utilizing it in the manner in which it should be used, saying:
“The DEA and [others] have a different perspective than the folks I know who use kratom for chronic pain, anxiety, depression, diabetes, and simply for an energy boost. There is no need for increasing doses, no need to suffer the side-effects that are described here, no need for withdrawals if one doesn’t pursue kratom in massive quantities as if it were the opiate a person used to be addicted to.”
Based on the current lack of scientifically valid research, it is impossible to know whether kratom is a safe breakthrough or just another empty promise. What is certain is that there is enough anecdotal evidence to warrant further study. Ask your doctor what she knows about this controversial plant.