Kratom may not save you from opioid addiction, and may even lead you to it

David Heitz

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Here’s why I tell people I care about to steer clear of Kratom:

Kratom binds to the same receptors in the brain as opioids. So, although it does not contain opiates, it works the same way on the brain.

I admit I never have tried Kratom.

And I never would, based on what I have read and heard about it from people I interview.

Here’s why.

Any herb can be incredibly dangerous. I say this admittedly being a proponent of medical cannabis.

But even medical cannabis, which is lacking research due to government restrictions, has plenty of research on the books demonstrating its relative safety.

Kratom does not.

Why? Most natural herbal supplements and the like have not undergone any sort of rigorous clinical trial on humans, so we don’t really know what’s good or what’s bad about them, or what’s the proper dose.

Herbal medicine second class in American healthcare

I once was assigned a series of “encyclopedia entries,” as I used to call them, by a client. My task was to research Chinese herbs then write largely positive reviews about how they can benefit your health.

For the first time I ever, I pulled out of an assignment.

I felt like I was being pushed to find the good in these herbs when all I really could find online was warnings about just how dangerous herbs can be because we know so little about them.

I did not feel comfortable with the assignment.

It probably is just a culture clash. No doubt research exists about Chinese herbs in China.

Kratom is a tree in Southeast Asia. There, its medicinal properties have been lauded and celebrated for centuries.

More research on kratom needed to support claims

Research published in Human Psychopharmacology concluded “More objective-controlled trials and experiments on humans need to be conducted to validate self-report claims by kratom users in the community.”

The researcher reported, “Kratom has long been used by rural populations in Southeast Asia as a remedy for common ailments, to fight fatigue from hard manual work, as a drink during social interaction among men, and in village religious functions. Studies based on self-reports suggest that prolonged kratom use does not result in serious health risks or impair social functioning.

“Two recent trends have also emerged: (a) Kratom is reportedly being used to ease withdrawal from opioid dependence in rural settings; whereas (b) in urban areas, adulterated kratom cocktails are being consumed by younger people to induce euphoria.”

In the context of the opioid epidemic, many people are experimenting with kratom in a well-intentioned effort to get off opioids.

But when it’s being used by someone already prone to addictive behavior, taking too much kratom could spell disaster.

Kratom may lead to opioid dependence

And in fact, kratom may even lead to opioid dependence. More on that in a second.

And can I speak addict to addict? Even when we are of the mindset of getting off drugs, let’s be honest. “Well, if one kratom doesn’t do anything for me, I’ll take two. If two doesn’t do anything, I’ll take three.”

And the next thing you know you’re dizzy and throwing up. Maybe your heart is beating fast.

Maybe somewhere in the mix you threw an opioid down the hatch on top of the kratom because you weren’t feeling relief from the kratom.

Don’t!

Kratom works the brain much like opioids

Kratom binds to the same receptors in the brain as opioids. So, although it does not contain opiates, it works the same way on the brain. You can read more about how kratom works on the brain in this Scientific American piece.

So, a person trying to get off opioids with kratom likely isn’t going to see much success. In fact, they may end up craving “the real thing” even more.

It’s sort of like giving a recovering alcoholic like myself benzodiazepines (valium, Xanax, Ativan) for anxiety…they work on the brain the same way as alcohol, so it’s just a bad idea.

Facts about kratom from the FDA commissioner

Here are some takeaways from FDA Commissioner Scott Gottlieb about Kratom:

· The FDA knows people are using kratom to treat conditions like pain, anxiety, and depression, which are serious medical conditions that require proper diagnosis and oversight from a licensed health care provider.

· Evidence shows that kratom has similar effects to narcotics like opioids, and carries similar risks of abuse, addiction and in some cases, death. It’s not surprising that often kratom is taken recreationally by users for its euphoric effects.

· It’s very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms. The FDA is devoted to expanding the development and use of medical therapy to assist in the treatment of opioid use disorder.

· There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder. Patients addicted to opioids are using kratom without dependable instructions for use and more importantly, without consultation with a licensed health care provider about the product’s dangers, potential side effects or interactions with other drugs.

· The use of kratom is associated with serious side effects like seizures, liver damage and withdrawal symptoms.

· At least 36 Americans have died from using kratom.

· The FDA has a well-developed process for evaluating botanical drug products. The agency has a team of medical reviewers in the FDA’s Center for Drug Evaluation and Research that’s dedicated to the proper development of drug applications for botanicals. To date, no marketer has sought to properly develop a drug that includes kratom.

'Science before speculation'

There is a fierce kratom lobby quick to point to their own studies. They say the plant is safe and effective even at managing opioid addiction.

Peer-reviewed research published in International Journal of Drug Policy last year noted that research in this field is rapidly evolving. That's good news for proponents of kratom who have tired of hearing not enough is known about kratom.

"User reports and results of preclinical studies in animals strongly suggest that kratom and its main constituent alkaloid, mitragynine may have useful activity in alleviating pain and managing symptoms of opioid withdrawal, even though well-controlled clinical trials have yet to be done," the authors concluded.

As for kratom contributing to opioid addiction, Dr. Nora Volkow of the National Institute of Drug Abuse seems to disagree with the FDA's position.

“Research published in June in ACS Central Science provided new insights while raising new questions about the drug kratom," Volkow writes. "These findings point toward the potential of this drug in pain research as well as the need for further research on the pharmacology of kratom’s constituents, their toxicity and potential value in the treatment of (Opioid Use Disorder).”

So, what makes medical cannabis any better?

In states where it’s legal, especially Illinois, it’s regulated.

It’s heavily regulated in Illinois, in fact. No state is stricter. You know what you’re getting, where it came from, and what’s in it.

Everything is labeled, right down to THC and CBD percentages per harvest. What you’re consuming has been tested, guaranteed to be all-natural, and even pesticide-free. It has been followed from seed to dispensary sack.

Kratom in its varying online forms is dangerous. There’s no regulation. It’s potentially addictive.

Stay away from it.

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I have been in the news business more than 30 years, spending much of my career at some of the best newspapers in the country. Today, I specialize in Denver local news, health reporting, social justice issues, addiction/recovery/mental health news, and topics surrounding homelessness and human trafficking.

Denver, CO
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