Kratom (Mitragyna speciosa) is a tropical evergreen tree native to Southeast Asia, particularly Thailand, Malaysia, Indonesia, and Papua New Guinea. The leaves of this plant have been used for centuries in traditional medicine due to its psychoactive and stimulant effects (Cinosi et al., 2015). However, in recent years, kratom has garnered attention in Western countries as both a potential therapeutic agent and a substance of abuse. This article aims to provide a comprehensive analysis the pros and cons of kratom, with a focus on scientific studies and research.
Pros of Kratom
1. Pain Relief
Kratom has been traditionally used for its analgesic properties, and recent research supports these claims. The active compounds in kratom, mitragynine and 7-hydroxymitragynine, interact with the body’s opioid receptors, providing pain relief (Kruegel et al., 2016). This has led to the use of kratom as an alternative or adjunct to prescription opioids for managing chronic pain (Grundmann, 2017). For example, a survey of kratom users in the United States found that 51% used the plant to relieve pain (Grundmann, 2017).
2. Opioid Withdrawal Relief
Kratom has shown promise as a potential tool for managing opioid withdrawal symptoms. In a study conducted by Swogger et al. (2015), participants reported using kratom to alleviate withdrawal symptoms, with 41% considering it “very effective.” Additionally, a case report by Galbis-Reig (2016) demonstrated successful use of kratom in helping a patient taper off high-dose prescription opioids. However, further research is needed to establish the efficacy and safety of kratom in managing opioid withdrawal.
3. Mood Enhancement and Antidepressant Effects
Kratom users often report mood enhancement and relief from symptoms of depression and anxiety. A study by Singh et al. (2014) found that kratom users reported increased energy, sociability, and alertness. Additionally, a study by Swogger et al. (2018) found that kratom users experienced reduced symptoms of depression and anxiety. Although these findings are promising, more research is needed to determine the mechanisms behind these effects and the potential long-term consequences of kratom use for mental health.
Cons of Kratom
1. Addiction and Withdrawal
While kratom may offer relief from opioid withdrawal, it is not without its risks for and addiction. Regular kratom use can lead to the development of physical dependence and withdrawal symptoms upon cessation (Singh et al., 2014). Withdrawal symptoms can include anxiety, irritability, insomnia, and physical discomfort (Boyer et al., 2008). Furthermore, a study by Lanier et al. (2019) found that rats self-administered 7-hydroxymitragynine, indicating that the compound has abuse potential.
2. Adverse Effects
Kratom use can also be associated with various adverse effects. These can range from mild symptoms such as nausea, vomiting, and constipation to more severe effects such as seizures, respiratory depression, and liver injury (Anwar et al., 2016; Prozialeck et al., 2012). Additionally, kratom has been implicated in several cases of toxicity and death, often in combination with other substances (Warner et al., 2016).
3. Legal Status and Regulation
The legal status of kratom varies widely across countries and states, with some jurisdictions banning the plant entirely. In the United States, the Drug Enforcement Administration (DEA) has considered placing kratom under Schedule I of the Controlled Substances Act, which would make it illegal to possess or distribute (DEA, 2016). This has raised concerns about access kratom for those who use it for legitimate medical purposes, as well as the potential for an unregulated black market.
Conclusion
Kratom presents a complex and multifaceted issue, with potential benefits and risks that require careful consideration. While research has demonstrated promising therapeutic applications for pain relief, opioid withdrawal, and mental health, the potential for addiction, adverse effects, and legal complications must not be overlooked. More research is needed to determine the safety, efficacy, and appropriate uses of kratom in various populations.
References
- Anwar, M., Law, R., & Schier, J. (2016). Notes from the field: Kratom (Mitragyna speciosa) exposures reported to poison centers – United States, 2010-2015. MMWR. Morbidity and Mortality Weekly Report29), 748-749.
- Boyer, E. W., Babu, K. M., Adkins, J. E., McCurdy, C. R., & Halpern, J. H. (2008). Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction, 103(6), 1048-1050.
- Cinosi, E., Martinotti, G., Simonato, P., Singh, D., Demetrovics, Z., Roman-Urrestarazu, A., … & Corazza, O. (2015). Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BioMed Research International, 2015.
- Drug Enforcement Administration (DEA). (2016). Schedules of Controlled Substances: Temporary Placement of Mitragynine and 7-Hydroxymitragynine Into Schedule I. Federal Register, 81(169), 59929-59934.
- Galbis-Reig, D. (2016). A case report of kratom addiction and withdrawal. WMJ: Official Publication of the State Medical Society of Wisconsin, 115(1), 49-52.
- Grundmann, O. (2017). Patterns of Kratom use and health impact in the US-Results from an online survey. Drug and Alcohol Dependence, 176, 63-70.
- Kruegel, A. C., Gassaway, M. M., Kapoor, A., Váradi, A., Majumdar, S., Filizola, M., … & Sames, D. (2016). Synthetic and receptor signaling explorations of the Mitragyna alkaloids: Mitragynine as an atypical molecular framework for opioid receptor modulators. Journal of the American Chemical Society, 138(21), 6754-6764.
- Lanier, R. K., Fant, R. M., Cone, E. J., & Huestis, M. A. (2019). 7-Hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects. ACS Central Science, 5(6), 992-1001.
- Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. The Journal of the American Osteopathic Association, 112(12), 792-799.
- Singh, D., Müller, C. P., & Vicknasingam, B. K. (2014). Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug and Alcohol Dependence, 139, 132-137.
- Swogger, M. T., Hart, E., Erowid, F., Erowid, E., Trabold, N., Yee, K., … & Walsh, Z. (2015). Experiences of kratom users: a qualitative analysis. Journal of Psychoactive Drugs, 47(5), 360-367.
- Swogger, M. T., Walsh, Z., Gueorguieva, I., & Kruegel, A. C. (2018). Kratom use and mental health: a systematic review. Drug and Alcohol Dependence, 183, 134-140.
- Warner, M. L., Kaufman, N. C., & Grundmann, O. (2016). The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. International Journal of Legal Medicine, 130(1), 127-138.
