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Other Names: (Thai) krathom, thom, kakuam, ithong; (Bahasa Malaysia) ketum, biak-biak; (Filipino) mambog

15 Minutes Read | Published Oct 04 2023 | Updated Feb 22 2024 Expert Verified
Emma Collins
Written by
Dameisha Gibson
Reviewed by
Emma Collins
Written by
Dameisha Gibson
Reviewed by

Kratom is a drug derived from the Southeast Asian tropical evergreen species Mitragyna speciosa. Its popularity in the West has surged in recent years, and though the full extent of kratom’s impact on the human body is still being studied, updated science on it indicates the need to be careful when using it. Poison control centers nationwide tallied more than 1,800 reports related to kratom use from between 2011 and 2017 alone. Half of these reports documented extremely adverse outcomes, such as seizures and death. Most reported deaths involving kratom use also involved the ingestion of other substances, like alcohol, cough syrup, the antihistamine diphenhydramine, fentanylbenzodiazepines, and cocaine.

The buying, selling, and usage of kratom is currently banned in the US states of Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. But the demand for it continues, especially via online channels and shops on the Internet. In 2012, there were more than 2 million search results for the keyword “kratom” on Google. This  number is likely to trend upwards, since it’s being touted as a dietary supplement with a number of health benefits.

You may see the name “kratom” pop up more often in conversations about illicit drug use. Moreover, addiction to this opioid and stimulant-like drug may one day become a problem in your community. Here are the facts that you need to know about kratom, how it’s used and sold, and how it works on the human body. This information will be important if ever you know someone who develops a dependence on the drug.

A Brief History of Kratom

Mitragyna speciosa, the tree where kratom comes from, is native to Southeast Asian countries like Thailand, Myanmar, Malaysia, Indonesia, and the Philippines. It is a relative of the coffee and gardenia plant varieties. Its genus name, Mitragyna, was given by Pieter Willem Korthals on the account of the plant’s leaves and flower stigmas resembling a bishop’s miter. Its first appearance in modern scientific literature was in 1836. It was observed that Malays chewed the tree leaves to achieve a similar effect as opium. Kratom is illegal in Thailand and is reported to be the country’s most commonly used illicit drug. It is also banned in Malaysia, in Australia, and in certain countries in the European Union.

In recent years, the drug has become more fashionable in Western countries. This is largely due to its marketing as a “plant-based” medicine and an appealing alternative to “big pharma” drugs. It is advertised as a cure for various ailments, such as cough, fibromyalgia, chronic pain, diarrhea, anxiety, and depression. It is even a purported cure for addiction to other harmful substances, like hydrocodone and oxycodone. But no scientific evidence exists thus far on the therapeutic effects of kratom. If anything, anecdotal evidence indicates that the substance is itself habit-forming.

It is important to note that the production of any kratom-based product is not regulated by the US Food and Drug Administration (FDA). That also means that there are no established safety standards for its production, which makes its consumption a contentious issue.

How is Kratom Used?

Kratom is commonly sold either as a dark green or light brown powder, and it may come in either packets or in plastic capsules. It’s also possible to consume kratom in paste or extract form, or to brew its dried leaves to make tea. Moreover, it’s not unheard of for kratom to be smoked or incorporated into food just like cannabis, although this type of delivery is less common.

The drug can also be mixed into an intoxicating drink with ingredients like cola, coffee, and codeine- or diphenhydramine-based cough syrup. This potent cocktail goes by the name “4×100,” and its multidrug composition has been known to cause death.

It is currently not very difficult for Americans to find and purchase kratom products on the Internet. College students and up-and-coming professionals may also encounter it in recreational settings, like music festivals or parties. One thing’s for certain: illicit use of kratom has the potential to occur more often, especially since it is sold under the guise of being a miracle drug.

How Does Kratom Work in the Human Body?

Kratom leaves contain two compounds that have psychotropic, or mind-altering, properties, which are mitragynine and 7-hydroxymitragynine. Some users have compared their experience of kratom to hallucinogenic mushrooms, which contain the psychoactive substance psilocybin. But the drug also mimics the relaxing and pain-relieving effects of opioids like codeine and morphine. Which of these effects is most pronounced depends on  whether the drug is consumed in small quantities or in large quantities.

When taken in miniscule amounts, kratom can induce higher energy levels, mental alertness, giddiness, and increased sociability. The drug’s effects can be felt in as little as 10 minutes and last for as long as an hour and a half. But at high doses, this drug interacts with the human brain’s opioid receptors and causes sensations like heightened pleasure or euphoria, pain tolerance, and relaxation. This potent high can last up to six hours.

The amount of time kratom stays in someone’s system depends on how frequently it’s used and how much was consumed. Other factors include the age of the user, their genetics, their body fat percentage, metabolic rate, and their water or food intake while using kratom.

The Short-Term and Long-Term Effects of Kratom Abuse

The short-term and long-term effects of kratom abuse are still being documented by modern science. But so far, the following adverse side effects have been attributed to kratom soon after its consumption:

  • Excessive sweating
  • Itchiness
  • Discolored cheeks
  • Excessive urination
  • Dry mouth
  • Chills
  • Nausea
  • Vomiting
  • Muscle pain
  • Appetite loss
  • Constipation
  • Insomnia
  • Hallucinations

On the production side, it’s also possible for kratom products to be contaminated with salmonella, which can cause serious complications to people with weak immune systems.

Continuing research has also uncovered the possibility of psychotic symptoms appearing in kratom users, thus precipitating psychotic episodes. However, these are rare, and the nature of their  relationship to kratom use is still unclear.

The long-term effects that are linked to kratom use currently include the following:

  • Serious liver damage
  • Difficulty breathing
  • Seizures
  • Withdrawal
  • Coma

Kratom also affects infants if their mothers consumed it while pregnant. There’s a chance that fetuses exposed to kratom  will develop withdrawal to the drug.

Most kratom-related deaths reported to the FDA have involved either the consumption of adulterated kratom, or the combination of kratom with other dangerous substances. Thus, the highest risk factor for kratom-related death is still  mixing kratom with alcohol or other drugs.

Signs of Kratom Use Disorder

Those in the medical profession have cited kratom’s potential to cause drug dependence due to its addictive opioid-like effects. There’s good reason for this substance to be on the US Drug Enforcement Administration’s watchlist of “Drugs and Chemicals of Concern.”

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) is the medical professional’s guidebook to determining whether someone has substance use disorder, with 11 criteria that, if fulfilled, may point to addictive behavior. They are the following:

  • If the person has begun consuming kratom in larger amounts than before.
  • If the person can’t stop consuming kratom, even if they’ve said they want to stop.
  • If the person has started spending more and more of their time using kratom.
  • If the person experiences cravings for the drug more often.
  • If kratom has gotten in the way of the person’s duties at home, at work, or at school.
  • If the person can’t stop taking kratom even when usage of the drug has caused a strain on their personal relationships.
  • If the person has shelved previous interests in sports, hobbies, or other interests in favor of using kratom.
  • If the person has begun using kratom in riskier situations.
  • If the person still chooses to take the drug even in the face of obvious physiological or psychological harm to themselves.
  • If the person has developed a tolerance to kratom, or needs more of it to achieve the same high as before.
  • If the person manifests withdrawal symptoms when they stop consuming kratom.

Aside from the criteria indicated by the DSM V, you should also watch out for the following behaviors in your loved one:

  • If they’ve started spending a lot of time and money on websites that openly sell or promote kratom and other unregulated substances.
  • If they’ve become unusually sociable or talkative, or are acting in a manner that’s unnatural to them.
  • If they’ve undergone any major changes in their appearance, such as sudden weight loss or weight gain.
  • If they’ve engaged in alarming behaviors just to procure kratom for themselves. This includes stealing money to buy it or lying about their purchasing history in order to cover up their purchases.

If these signs are present in your loved one, you should consider seeking help immediately.

Rehab and Treatment for Kratom Use Disorder

Kratom use disorder is not as widely documented as other more common substance dependencies such as alcohol or cocaine.  Nevertheless, kratom still has addictive potential, and kratom use disorder should be treated with the same core practices used for these other addictions. This involves appropriate medical care paired with behavioral therapy, counseling, and dietary and exercise routines that will return the person to optimal health. Depending on their health situation and financial resources, the person will be enrolled in either an inpatient or an outpatient rehabilitation program.

If the person has begun experiencing withdrawal, they will need medical assistance to undergo detoxification and manage their withdrawal symptoms in a safe and regulated manner. Appropriate medical intervention will also be administered in the case of polydrug use or in the case of kratom use disorder occurring with any comorbidities.

As part of their treatment for kratom use disorder, the patient will also enroll in a type of therapy called cognitive behavioral therapy (CBT). CBT will help them identify the triggers for their kratom use, avoid these triggers, and cope with their cravings in a healthier way. In addition to CBT, the patient may also participate in group or individual therapies and counseling sessions alone or with their loved ones.

Upon graduation from rehab, it is a good idea for the person to find a local 12-step support group. This will be a good environment for them to be open about their kratom use and to foster accountability for a  sober life among their peers. Hopefully, their participation in a support group, as well as any other continuing interventions, will help them curb their kratom use. It is never too late for anyone to be free of drugs and to live a life where they are more in control of themselves.

Get the Help You Need

More Americans may find themselves vulnerable to the appeal of this so-called miracle drug. Taking it may induce in them a sense of euphoria, heightened pleasure, or relief from pain. But this false happiness is only temporary, and it won’t be long before kratom abuse leads to more unhealthy behaviors and a loss of control over one’s life.

If someone you love has shown signs of addiction to this drug, get help for them today. You can check out Better Addiction Care’s updated network of local drug rehab centers so that you know where to get appropriate medical treatment. Don’t delay in addressing a potential kratom addiction or polydrug abuse that involves kratom. Your decision to help your loved one may save their lives and get them on track to the swiftest possible recovery.


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