Disclaimer: None of the information in this article constitutes medical advice. This article is the opinion of the writer(s), and is presented for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to psychoactive botanicals.
KKratom is a psychoactive plant compound that’s been receiving much attention recently. It’s legal in many U.S. states, but there’s a push to make it federally illegal.
In this article we’ll review the published medical research on kratom to determine whether it’s proven to be effective in treating any health conditions. We’ll also highlight its side effects and share some natural alternatives that consumers may want to consider.
What is Kratom?
Kratom is atropical plant native to Thailand, which is now grown throughout the world due to increasing demand. Its botanical name is Mitragyna speciosa.
Because it has similar physiological effects as opioids, many consumers take it recreationally or as a way to wean off harsher drugs like heroin.
Kratom is proven in medical research to be addictive and to cause withdrawal symptoms when usage is stopped.
How Does Kratom Work?
Kratom contains chemical compounds called alkaloids that are thought to be responsible for its psychoactive effects.
Two specific alkaloids (mitragynine and 7-OH-mitragynine) are opioid receptor agonists, which means they cause a similar biological response to opioids such as oxycodone.
Mitragynine also favorably blocks pain signaling due to its anti-inflammatory effect and inhibition of certain enzymes.
Kratom can be considered a natural and weaker opioid than pharmaceutical opioids like oxycodone.
How is Kratom Used?
Traditionally, raw kratom leaves were used to make tea, but now there are a variety of intake methods. A medical review of kratom published in the Substance Abuse and Rehabilitation journal documents how the effects are reported to be different based on method of use.
Kratom appears to have a stimulatory effect when the raw leaves are chewed, but a pain-relieving and relaxing effect when the leaves are brewed into a tea.
The linked research study also documents how in the U.S., kratom is typically sold in liquid or capsule form online.
Because there haven't been many clinical trials on medicinal use of kratom, there isn’t a clear standard for the most effective and safest form and dose of kratom.
Kratom Side Effects
One of the most concerning, rare side effects of kratom use is its ability to interact with pharmaceutical medications and increase their potency in some cases. The medical review linked in the previous section documented a 27 year old man who was taking an antipsychotic medication called quetiapine while taking kratom.
The man was found dead in what was ruled an accidental overdose, because there was an interaction between kratom and quetiapine which significantly increased its potency and overwhelmed his system.
Because many kratom-drug interactions are yet unknown, it’s incredibly important for patients considering kratom use to speak with their doctor first about any medications they’re on, and the potential for negative interactions.
The most common side effects of kratom, as detailed by a medical study from 2019, were agitation (18.6%), increased heart rate (16.9%), and drowsiness (13.6%).
Kratom is clearly a drug with substantial side effects on average.
What Are Kratom Withdrawal Symptoms?
A systematic review of medical case studies on kratom withdrawal found that the withdrawal symptoms are often similar to opioid withdrawal symptoms. The onset of symptoms typically begins between 12 and 24 hours after the last use, and continues for up to 7 days.
Nausea, sweating and chills, muscle and body aches, diarrhea, insomnia and mood disturbances are just some of the withdrawal symptoms noted.
Withdrawal symptoms of kratom can be severe, even though this is a drug that’s legal in some states. We recommend that patients considering stopping use of kratom speak with their doctor first and see if they can visit a treatment facility to help manage the process.
The linked medical review notes that high doses of alpha-2 agonist medications can help manage the kratom withdrawal process, and it’s unlikely that patients would be able to access these medications if experiencing withdrawal at home.
There’s lacking medical reference ranges for safe kratom dosage, which is unfortunate for users.
One medical review of kratom which we linked to previously in this article found that the risk of kratom toxicity increased significantly over an 8 gram (g) daily dose. The same review found that kratom overdose symptoms were similar to opioid overdose symptoms at a dose of 15 g.
A separate medical study categorized low doses as 1-5 g, and higher doses as 5-15 g.
It’s clear from the available medical research that there is no proven safe and effective dose of kratom.
In the U.S., kratom is not federally illegal, as indicated by the Drug and Enforcement Agency (DEA).
According to the American Kratom Association, kratom is also legislated at the state level, and is illegal in the following U.S. states: Arkansas, Wisconsin, Alabama, Vermont and Rhode Island.
This organization, which advocates for kratom legislative reform, maintains a useful updated map with the current state of kratom legality in the U.S. According to the map, kratom is legal with restrictions in some states like California and North Carolina.
Kratom is illegal in Australia as well as many European Union (E.U.) countries including France and Sweden.
Clearly the legality of kratom is highly contested across the world, and it’s important for users to remain up-to-date on their local laws to ensure compliance and avoid risk of unknowingly committing an illegal act.
How Hard is Kratom on the Liver?
Kratom, like most drugs, gets filtered by the liver. Users are often curious about what the potential damage of kratom use is.
A review published in the Drugs journal in 2020 analyzed human case reports, Food and Drug Administration (FDA) data and animal studies on kratom. The study authors concluded that “Kratom likely causes liver injury.”
The researchers noted that the human data is of poor quality, so future research may emerge proving kratom to be safe, but for now we have to assume it’s harmful to the liver.
Kratom is used primarily for pain relief, stimulatory effect (at low doses) and sedative effect (at high doses). There are natural compounds with much more favorable safety profiles which we would recommend over kratom.
Turmeric is one of the most well-studied plant compounds for analgesic (pain-reduction) effect. A medical review of herbal medicine for pain management found turmeric to be effective in most studies reviewed, and as effective as Non-steroidal anti-inflammatory drugs (NSAIDs) in some cases.
Most medical research on turmeric involves an extract standardized for curcuminoids, as this is more potent than raw turmeric powder. We recommend that patients seeking natural solutions for pain speak with their doctor about a high-potency turmeric extract.
Panax ginseng extract is arguably the herbal stimulant with the most research backing. It’s proven in medical research to improve mood and energy, and users typically describe a milder and more full-body improvement in energy compared with caffeine.
Illuminate Labs sells a third-party tested panax ginseng extract that’s standardized for ginsenosides, just like that used in most medical research on the compound.
L-theanine has anxiolytic (anxiety-reducing) effects, and none of the side effects of kratom. This compound is an amino acid that is proven to reduce stress and depression and improve cognitive function in healthy adults. The linked research study used a dose of 200 milligrams (mg) per day.
L-theanine favorably affects neurotransmitter function according to the study above, and also may influence brain wave activity to induce relaxation.