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Kratom Addiction and Abuse

Kratom Addiction and Abuse

Is Kratom Addictive?

Kratom is a substance made from a tree native to Southeast Asia called the Mitragyna speciose.1 The leaves contain a compound that has mind-altering (psychotropic) effects on the brain. Its use in the United States was first reported in the early 2000s.2 Today, federal agencies are reporting more incidences of abusing the drug.

No Official Determination

The United States Drug Enforcement Agency and the Food and Drug Administration haven’t made an official determination on this drug. This unregulated status means it is still widely available for purchase by the public. It is typically available in powder packets, as an extract, or in a gum format. The packets will usually read “not for human consumption.” Some people disregard this warning and brew the leaves into a tea or incorporate it into food. 

Researchers Believe it’s Addictive

While it’s a fairly new drug on the market in the United States, researchers believe that it is addictive. People who use Kratom experience withdrawals and cravings for the substance. As a result, dependence can occur.

Some people have reported experiencing addiction when used three times a day or more. Addiction has also been known to occur when it’s taken in dosages higher than 5 grams per dose each time used.  Addiction could require treatment in a drug rehab facility.

Warning Signs of Addiction

Some of the warning signs of addiction to Kratom include:3

Having problems controlling substance use, such as wanting to quit, but not being able to stop.

Taking more than intended or using it for longer than intended.

Feeling the need to use larger and larger doses to achieve the same effects.

Spending a lot of time and money on the drug, even if it hurts other parts of life.

Engaging in risky behaviors to obtain the drug, such as stealing. Other risky behaviors include driving under the influence, or having unprotected sex while using the drug.

Experiencing withdrawal symptoms when substance use has stopped.

Ultimately, addiction can cause changes in personality, mood, and physical appearance. Loved ones may also start to notice these changes.

Street Names for Kratom

Other names for Kratom include the following:

Biak

Herbal speedball

Ithang

Kakuam

Ketum

Thom

Kratom's Class

In 2014, the FDA ruled that it would not approve Kratom as a dietary supplement. However, they did approve it for other purposes, such as aromatherapy and for making soaps. People still use Kratom for consumption even though the labels say not to.

According to a survey published in the journal Drug and Alcohol Dependence, the most common group of people who use Kratom are those aged 31 to 50 years old who have a household income of $35,000 or more a year.4 Researchers surveyed 10,000 people who reported using Kratom in their social media posts. The most common uses reported in this population include:

%

Self-Treating Pain

%

Self-Treating Emotional/Mental Conditions

The most common side effects reported were nausea and constipation, which people didn’t usually experience unless they took high doses of the drug.

Where is Kratom on the Drug Schedule?

Currently, Kratom is available without a prescription and can be sold without regulation. As a result, the United States Drug Enforcement Agency hasn’t placed it on any part of the drug schedule. However, the DEA did place it on its list of Drugs and Chemicals of Concern. Other drugs that are on this label include DXM and salvia divinorum.

Being on the Drugs and Chemicals of Concern list means the DEA is closely monitoring the health and safety effects of Kratom. The substance has the potential to become a controlled substance if more information becomes available regarding its use and addictive properties.

According to Harvard University, the DEA has issued statements that Kratom may become a Schedule I substance. This means that kratom doesn’t have any medical use and has high addictive potential. If it were to become a Schedule I drug, it would become illegal in the United States and less accessible to the public. For this reason, the Harvard cautions people against using it because if it were to become illegal,  people may turn to risky practices to obtain it.

Is Kratom Safe?

One of the major problems with Kratom is that very few regulations exist regarding its manufacture and use. For example, in 2018, the FDA released a recall on packaged Kratom products because they found they contained Salmonella bacteria that had the potential to make users very ill.

The potency of the drug isn’t always the same. It may depend upon where it’s harvested and also what time of year it’s harvested.5 As a result, it’s hard to make blanket statements that Kratom is safe at a certain level because the amount of psychotropic substances can vary.

Some people try to use it as an alternative to addictive opioids and alcohol.  According to the National Institute on Drug Abuse, there is no evidence to suggest that Kratom is an effective treatment for these or other addictions.

Researchers can’t really say that Kratom is safe for a number of reasons. Doctors haven’t established safe or unsafe dosages of the substance because there isn’t a lot of research or information on it one way or the other. Also, there aren’t any regulations on how it’s currently made. One person could purchase a packet that is pure, while another may purchase a packet that contains a number of other, potentially harmful substances.

How is Kratom Used?

People in Asia have used the drug for hundreds of years for many purposes. Examples of these include to treat cough, chronic pain, diarrhea, and to reduce opiate abuse.

It has a strong bitter taste when consumed orally or swallowed as a pill. As a result, sugary or sweet substances are frequently used with the compound. Examples include adding sugar into tea. Some people also mix it in combination with cough syrups that contain codeine.

Scientists have identified two compounds in Kratom that have mind-altering effects: mitragynine and 7-a-hydroxy mitragynine. These compounds act somewhat like opioids because they relieve pain. But they also act as stimulants by increasing feelings of alertness. 

Some of the effects people report when they take Kratom include:

Decreased pain

Increased energy

Increased alertness 

Increased sensations of pleasure 

While these are some of the potentially pleasant effects of Kratom, there are negative effects, including:

Appetite loss

Constipation 

Dry mouth

Hallucinations 

Nausea

Seizures

Some people who use Kratom report experiencing psychosis. This is when a person loses touch with reality. They can’t tell what is real and fake – they may see, smell, and hear things that aren’t there.

Effects

Short-term Effects

Kratom can have different effects based on how much is used. For example, when low amounts are used, the effects are that of a stimulant. A person may report feeling more alert and having a greater overall sense of well-being. They may find they are more talkative and sociable.

Researchers have found that Kratom can stimulate mu-opioid receptors.6 These are the same receptors that opiates like morphine and fentanyl stimulate to achieve pain-relieving effects. In addition to these pathways, it may stimulate adrenergic, serotonergic, and dopaminergic pathways. These are the same pathways that stimulants like cocaine and amphetamines use to increase feelings of alertness.

If a large amount of Kratom is taken, more opioid-like effects are likely to occur. Examples include pain-relieving effects and sleepiness.

Long-term Effects

Although people in Asia have used Kratom for quite some time, there isn’t a lot of published and scientific research available on the substance.

According to a letter to the editor published in the journal Innovations in Clinical Neuroscience, some of the known long-term effects of Kratom include:

Appetite loss

Changes in the pigmentation of skin and eyes

Increased urinary frequency 

Problems sleeping

Weight loss

Therefore, not enough information is available on the long-term effects of Kratom on the mind and body.

Can You Overdose on Kratom?

It is possible to experience severe and potentially deadly effects from using Kratom. Examples include rapid heart rate, drowsiness that can lead to accidents, and even cardiac arrest. Some people have reported experiencing seizures due to using the compound. Seizures can have brain-damaging effects on the body, which can also lead to death.

According to the National Institute on Drug Abuse, there have been reported deaths regarding Kratom use and exposure. An estimated 11 people have died from 2011 to 2017 while using it. However, nine out of the 11 deaths were in people who had also used other substances such as alcohol, benzodiazepines, and cocaine. In 2017, 44 reported deaths also had Kratom involved in them.

It appears most of the reported deaths involved a person using tainted Kratom or using multiple substances.

How Do I Stop Using Kratom?

If you or someone you love is ready to stop using Kratom, it is time to consult an addiction treatment center. Arrow Passage Recovery can help you begin your recovery journey.  If you aren’t sure where to start, the Substance Abuse and Mental Health Services Administration (SAMHSA) may also be able to help at 1-800-662-HELP (4357). This 24/7 hotline can connect you to help for addiction and dependence on Kratom as well as other substances.

Family Support Network

It important to tell trusted friends, family, or your doctor that there is problem and you are ready to quit. This support network can help identify the resources needed to quit successfully.

Education 

Educating yourself on the potential withdrawal effects can help you understand what to expect when substance use ends. Typically, these symptoms will start to subside after several days. Afterward, it is normal to experience strong cravings for the substance. Engaging in other activities like getting enough sleep, going on walks, and visiting with friends and family can help you feel stronger and resist the urge to return to Kratom abuse.

12-Step Programs

Joining a support group or seeking the help of a therapist can help you navigate a world free from Kratom abuse. Examples may include 12-step programs like Narcotics Anonymous. Even if the drug isn’t technically a narcotic substance, these programs deal with the same concerns and temptations for returning to substance abuse.

Treatment for Kratom Addiction

The FDA hasn’t approved any medications specifically to treat Kratom addiction. However, there are therapies that can be used to help with recovery from addiction. An example is behavioral therapy, an approach that involves helping to recognize the thoughts and behaviors that continue the drug abuse. A behavioral therapist can also teach how to deal with strong cravings for the drug.

What is Kratom Withdrawal Like?

Some of the known withdrawal symptoms from Kratom include:

Aggression

Hostility 

Jerking movements

Muscle aches

Problems sleeping

Runny nose

Sometimes, a rehabilitation facility may recommend slowly tapering off the dosages of the drug as a means to stop using the drug entirely. Others may take a “cold turkey” approach and immediately end the drug use.

When withdrawals from Kratom occurs, the most significant symptoms typically occur for three to 10 days. Some drug rehabilitation facilities may prescribe the medication buprenorphine-naloxone for a few weeks to reduce the withdrawal effects.

Finding Help

Kratom is a substance that has the potential to lead to addiction and dependence. The U.S. Drug Enforcement Agency is evaluating the drug for potentially adding it to its drug schedules list. As this substance has addictive side effects and has been connected with causing deaths and overdose, there are very serious medical concerns over its safety. Because the manufacture and sale of the substance aren’t highly regulated, it’s difficult to say the substance is safe to use.