Kratom Benefits and Risks

Kratom Benefits and Risks | 2021 Guide

Some people claim kratom is an effective alternative to opioid medications, while others consider it an unsafe, unproven substance. Here’s what science says about this controversial herb.

Gleb Oleinik August 30, 2021

Kratom (Mitragyna speciosa) is an evergreen tree in the coffee plant family and is native to Indonesia, Malaysia, Thailand, and other parts of Southeast Asia. Kratom leaves and the preparations made from them have been used as stimulants, painkillers, and sedatives.

Kratom is also sometimes taken to help with opioid withdrawal and for recreational effects. Unfortunately, despite its long list of proposed benefits, kratom has seen little research. As a result, we don’t know enough about its effects.

Nonetheless, kratom use is growing in the United States and Europe, both as a recreational drug and an alternative to prescription medications. Read on to learn more about kratom’s potential benefits and risks.

Kratom Effects

Kratom can produce effects typical of both stimulant and opioid drugs.

This makes it somewhat unique because opioids are considered depressants that slow down brain activity and make you feel sedated, whereas stimulants (such as caffeine) have the opposite effect. ¹

Kratom can produce both of these effects because it contains compounds that interact with both stimulatory and inhibitory receptors in the human nervous system. ²

The precise effects of kratom depend on the dosage. Small doses are stimulating, with users reporting feelings of increased energy, sociability, and alertness. ²

Meanwhile, medium-to-high doses (5-15 g of dried leaves) of kratom work more like opioids, producing sedation and pain relief.

Kratom Benefits

According to anecdotal reports and historical records, kratom’s potential health benefits include: ³

  • Anti-diabetic
  • Anti-inflammatory
  • Antipyretic (fever-reducing)
  • Diarrhea relief
  • Muscle relaxing
  • Muscle spasm control
  • Pain relief
  • Relaxation
  • Stimulation

 

Some kratom users have also reported improved libido, mood, focus, motivation, sociability, and empathy, euphoria, reduced anxiety and PTSD symptoms, and being able to reduce or stop the use of prescription or illicit opioids.

One anonymous survey of 3024 American kratom users found that most use it for pain relief (48% of respondents). This was followed by treating mental health conditions (22%), increasing energy or focus (10%), and reducing opioid use or withdrawal symptoms (10%). ⁴

Kratom for Pain

Pain relief is the most sought-after benefit of kratom. In particular, many people use kratom products as alternative medicines for prescription opioid painkillers to treat chronic pain.

Although evidence is scarce, research into kratom’s pain-relieving benefits is growing.

One 2020 clinical trial out of Malaysia looked at the herb’s pain-relieving properties in 26 men with a long history of kratom use. They were randomly assigned to drink placebo or kratom beverages three times during one day and had their pain tolerance tested.

Whereas pain tolerance significantly increased an hour after taking kratom, there was no effect in the placebo group. ⁵ Additionally, kratom didn’t produce any side effects or withdrawal symptoms during the study.

In addition, animal studies have shown that the two main active compounds in kratom — mitragynine and 7-hydroxymitragynine — have analgesic (pain-relieving) effects. ⁶

Kratom for Mental Health Conditions

Some people also use kratom for anxiety, depression, post-traumatic stress disorder (PTSD), and other mental health disorders.

There isn’t much high-quality evidence for these effects. However, a comprehensive 2018 review of 13 surveys that captured a total of 28,745 survey responses from kratom consumers found that “kratom also enhances mood and relieves anxiety among many users.” ⁷

Additionally, a 2011 study found that mitragynine, the main active component of kratom, had antidepressant effects in mice. ⁸ Similarly, a 2016 study found that mitragynine relieved anxiety in mice but also produced withdrawal symptoms after 14 days of use. ⁹

Overall, more research is needed to say whether there’s any merit in using kratom for depression and other mental disorders.

Kratom for Energy

Anecdotal reports and studies of kratom users note that it can increase energy and focus. In fact, day laborers in Malaysia and Thailand frequently use kratom to boost endurance and tolerance to the hot and humid climate and physically demanding work. ³

However, this effect is dependent on the dose. Whereas low doses of kratom (1-5 g of raw leaves) are stimulating, higher amounts (5-15 g of raw leaves) have the opposite, sedating effect. ¹⁰ As such, it’s possible to use higher doses of kratom for sleep.

Additional research is needed to test the safety and effectiveness of using kratom for an energy boost.

Kratom for Opiate Withdrawal

Another reason people turn to kratom is to reduce their use of prescription and illegal opioids, as well as the associated withdrawal symptoms.

For example, one 2010 Malaysian study of 135 kratom users found that 90% used it to help with their addiction to more expensive opiates such as heroin, and 84% used it to reduce opioid withdrawal symptoms. ¹¹ Kratom was also described by the users as having no serious side effects.

Similarly, the authors of a 2015 study on how kratom is absorbed and metabolized by the body noted that “kratom would be a good candidate for opioid substitute in patients who are addicted to these substances.” ¹²

These findings aren’t surprising because both mitragynine and 7-hydroxymitragynine interact with opioid receptors in the brain, similar to other opioids. ³

Given that the opioid epidemic is a major healthcare emergency in the United States, it may explain kratom’s growing popularity.

Kratom for Euphoria

Kratom users also report feeling euphoric and mood-boosting effects at both low and high doses. However, this euphoria is less intense than the one caused by opium and other opioid drugs.

This lines up with reports of kratom having a lower risk of addiction and milder withdrawal effects than other opioids.

Kratom Side Effects & Safety

Although users consistently report that the side effects of kratom are milder than opioids, there isn’t enough research evidence to conclude that it’s a safe substance. Furthermore, kratom is not approved by the Food and Drug Administration (FDA) as a dietary supplement.

The most commonly reported side effects of kratom are: ¹³

  • Nausea
  • Constipation
  • Dizziness or drowsiness

 

These side effects are more likely if you’re taking large (over 5 grams) or frequent doses (22 times or more per week). Kratom can also cause short-lasting tongue numbness, whereas long-term consumption may lead to weight loss and dehydration.

Additionally, there have been reports of kratom on its own or in combination with other substances resulting in agitation, vomiting, fast heartbeat, and confusion.

It can also cause serious side effects such as seizures, hallucinations, and hypoventilation, but these are rare and associated with high dosages (over 15 grams). ¹⁴

Similarly, despite ongoing concerns, reports of liver damage are rare and appear to be related to taking continuous or high doses and interactions with other drugs.

One 2020 review paper found a total of 85 cases of liver injury, where it took an average of 21 days of kratom use before symptoms appeared. ¹⁵

Finally, research and user reports suggest that kratom can interact with some drugs, producing potentially dangerous effects. ¹⁶

Kratom Overdose

It’s not easy to overdose on kratom. While there have been reports of kratom-related overdose deaths, they are rare and typically involve other drugs, suggesting possible interactions.

For example, one 2019 review found that there were a total of 1807 cases of kratom overdose reported to poison control centers in the United States from 2011 to 2017. This included 11 deaths, 9 of which included other drugs, such as alcohol and benzodiazepines. ¹⁷

Kratom Addiction & Withdrawal

Similar to other drugs with opioid-like effects, kratom has the potential to be addictive and may lead to dependence. This means that people who stop taking kratom after using it for a long time can experience unpleasant withdrawal symptoms. ³

These include physical and psychological issues, such as pain, muscle spasms, difficulty sleeping, hot flashes, fever, runny nose, decreased appetite, diarrhea, restlessness, tension, anger, and sadness.

These symptoms are similar to those experienced during opioid withdrawal. Having said that, kratom addiction typically requires heavy, long-term use.

For example, one 2014 Malaysian study examined kratom addiction in 293 people who took it regularly for over 6 months. The researchers found that 55% of the users had severe kratom dependence, while the remaining 45% had moderate dependence. ¹⁸

More than 70% of the kratom users also experienced psychological withdrawal symptoms alongside physical symptoms. These include nervousness, sadness, restlessness, anger, tension, and depressed mood.

Additionally, reports of users and their healthcare providers consider kratom withdrawal and cravings to be milder than those experienced during opioid withdrawal. These reports also note that the symptoms of kratom withdrawal last shorter than opioids.

To illustrate, a 2018 study of 150 kratom tea users found that the most common side effects of withdrawal were mild anxiety (in 71% of participants) and mild depression (in 81%). ¹⁹

Meanwhile, a 2015 study of the experiences of kratom users found that only 10% had withdrawal symptoms after a period of heavy kratom use. They also reported that withdrawal was mild compared to opiates. ²⁰

Finally, evidence from Malaysia shows that kratom use and dependence don’t result in major social problems, and the majority of regular kratom users are employed, married, and relatively healthy. ²¹

Summing Up

The potential benefits of kratom include pain relief, improvement of mental disorders, increased energy, and the reduction of opioid use and withdrawal symptoms.

Unfortunately, there’s little research evidence for these effects, and most of what we know comes from reports of kratom users and their caretakers.

Similarly, there’s little clinical data on the safety of kratom.

Although most of its proposed side effects are considered minor and reports frequently describe kratom withdrawal and addiction as milder than opioids, there are some rare reports of more serious complications, including kratom-related deaths.

The bottom line is that kratom does hold some promise as an alternative to prescription opioids and could be helpful for opioid addiction and withdrawal.

However, until more research is done to fully understand kratom’s side effects, drug interactions, dosage, and overall safety, there are simply too many risks.

References

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3. Veltri, Charles, and Oliver Grundmann. “Current perspectives on the impact of Kratom use.” Substance abuse and rehabilitation 10 (2019): 23.

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5. Vicknasingam, Balasingam, et al. “Focus: Plant-based Medicine and Pharmacology: Kratom and Pain Tolerance: A Randomized, Placebo-Controlled, Double-Blind Study.” The Yale Journal of Biology and Medicine 93.2 (2020): 229.

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8. Idayu, N. Farah, et al. “Antidepressant-like effect of mitragynine isolated from Mitragyna speciosa Korth in mice model of depression.” Phytomedicine 18.5 (2011): 402-407.

9. Yusoff, Nurul HM, et al. “Abuse potential and adverse cognitive effects of mitragynine (kratom).” Addiction biology 21.1 (2016): 98-110.

10. Michael White, C. “Pharmacologic and clinical assessment of kratom.” The Bulletin of the American Society of Hospital Pharmacists 75.5 (2018): 261-267.

11. Vicknasingam, Balasingam, et al. “The informal use of ketum (Mitragyna speciosa) for opioid withdrawal in the northern states of peninsular Malaysia and implications for drug substitution therapy.” International Journal of Drug Policy 21.4 (2010): 283-288.

12. Trakulsrichai, Satariya, et al. “Pharmacokinetics of mitragynine in man.” Drug design, development and therapy 9 (2015): 2421.

13. Grundmann, Oliver. “Patterns of kratom use and health impact in the US—results from an online survey.” Drug and alcohol dependence 176 (2017): 63-70.

14. Eggleston, William, et al. “Kratom use and toxicities in the United States.” Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 39.7 (2019): 775-777.

15. Schimmel, Jonathan, and Richard C. Dart. “Kratom (Mitragyna Speciosa) liver injury: a comprehensive review.” Drugs 80.3 (2020): 263-283.

16. Tanna, Rakshit S., et al. “Refined prediction of pharmacokinetic kratom-drug interactions: time-dependent inhibition considerations.” Journal of Pharmacology and Experimental Therapeutics 376.1 (2021): 64-73.

17. Post, Sara, et al. “Kratom exposures reported to United States poison control centers: 2011–2017.” Clinical toxicology 57.10 (2019): 847-854.

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19. Singh, Darshan, et al. “Severity of kratom (Mitragyna speciosa Korth.) psychological withdrawal symptoms.” Journal of psychoactive drugs 50.5 (2018): 445-450.

20. Swogger, Marc T., et al. “Experiences of kratom users: a qualitative analysis.” Journal of psychoactive Drugs 47.5 (2015): 360-367.

21. Singh, Darshan, et al. “Social functioning of Kratom (Mitragyna speciosa) users in Malaysia.” Journal of psychoactive drugs 47.2 (2015): 125-131.


Gleb Oleinik

Gleb Oleinik is a freelance CBD & cannabis writer from Vancouver, Canada. He’s read thousands of studies about cannabinoids and other beneficial natural compounds, helping him translate complex science into plain language. He’s also written third-party lab test reports of CBD products and knows the industry inside and out. When he’s not writing, Gleb likes to spend his time in the gym and out in nature.

Frequently Asked Questions

Kratom can cause increased heart rate but there haven’t been any reports of serious heart-related issues.