This opioid-like substance may be natural, but that doesn’t mean it’s safe. In this WebMD article, Mindpath Health’s Julian Lagoy talks about the dangerous side effects of a drug some people use to detox.
Kratom is an opioid-like substance obtained from the leaves of a tree (Mitragyna speciosa) that is found in Southeast Asia and Africa. The drug has a long history of medicinal use in areas where it naturally grows. In the United States, kratom often comes as capsules, in a powder, or as leaves that are chewed or ingested in another form, such as brewed into a tea. Since kratom is typically considered a “natural supplement,” and is often minimally regulated, many people think that kratom is harmless to consume.
Is kratom safe? Kratom’s side effects can be significantly harmful, and its use has even resulted in death in severe cases.
Myth 1: Kratom is not addictive.
According to Mayo Clinic, kratom is typically used for a wide range of purposes, including recreation, attempted detox from opioids or other drugs, and pain relief. Its legality varies by jurisdiction, but it is generally not particularly difficult to access.
Kratom has a high potential for addiction. When you take kratom, the drug produces effects similar to both opioids and stimulants, according to the National Institute on Drug Abuse (NIDA). Chemicals found in kratom—most potently, mitragynine and 7-hydroxymytragynine—interact with opioid receptors in your brain and produce feelings of pleasure, reduced pain, sedation, sociability, and excitement.
Because it has opioid-like effects, “Kratom can be addictive and can cause withdrawal symptoms,” Monty Ghosh, MD. Indeed, regular use of kratom can lead to dependence on, increased tolerance to, and persistent cravings for the drug.
Myth 2: You can safely use kratom in medication assisted treatment for opioid addiction.
People who want to stop taking opioids may consider using kratom powder or kratom capsules as an herbal alternative to pharmaceutically-based medication-assisted treatment. The rationale is that kratom’s similarity to opioids, and “natural” origins, will safely prevent unpleasant opioid withdrawal symptoms.
However, since kratom also has opioid-like properties, it carries many of the same risks as opioids, including dependence and uncomfortable side effects, reports NIDA.
Katom addiction may ultimately require the same sort of detox treatment that conventional opioid substance abuse disorder requires.
Myth 3: There is no risk of overdose with kratom.
According to NIDA, there have been multiple reports of death following kratom use. In 2017, the FDA reported nearly 44 deaths associated with kratom use, with one case involving the use of pure kratom. However, most of these kratom-related deaths involved the intake of kratom and other substances like alcohol, opioids, and benzodiazepines.
NIDA also notes that many of these fatalities appear to have resulted from the use of adulterated kratom products. According to a Mayo Clinic report in 2018, over 130 people had been sickened with salmonella bacteria that had contaminated kratom products. In some cases, salmonella poisoning can be fatal.
Myth 4: There are no kratom side effects, because it is a supplement.
Kratom may be obtained from plants, but that does not mean it is entirely safe, reports Cleveland Clinic. Kratom can cause serious side effects, including the following:
- Brain disease
- Heart attack and abnormal heartbeat
- Kidney damage
- Liver damage
- Respiratory depression
“Increased skin pigmentation is an odd side effect associated with kratom use,” says Kelly Johnson-Arbor, MD, and Medical Toxicologist and Co-Medical Director at the National Capital Poison Center. “Both addiction and withdrawal have been reported to occur in kratom users. Signs and symptoms of kratom withdrawal include nausea, vomiting, diarrhea, and body aches.”
People sometimes mistake the legality and accessibility of kratom as an endorsement for its safety. But as with other unregulated products, the fact that it is easy to access does not necessarily mean that it is safe.
“Supplements actually are not regulated by the FDA. Therefore, there is no guarantee that a supplement will actually contain the ingredients listed on the label. Also, there are no requirements for scientific studies to assess its efficacy. Lastly, side effects are still a possibility,” says Julian Lagoy, MD, and psychiatrist with Mindpath Health.
Indeed, due precisely to a lack of regulation, the strength and purity of kratom sold in any given product can be difficult to ascertain and may contain harmful byproducts.
Myth 5: Kratom is completely legal.
Kratom remains legal on the federal level. It is also widely accessible and can be ordered online with relative ease. However, its legal status is actually more complicated than it may appear and will likely continue to evolve in the future.
Finally, despite being formally unregulated federally at the present moment, it is quite possible this will change. In 2019, the Food and Drug Administration (FDA) put out a warning encouraging Americans not to use kratom, noting that the drug “appears to have properties that expose users to the risks of addiction, abuse, and dependence.”
Despite the 2016 decision not to classify kratom as a Schedule I drug, the DEA currently warns that kratom use can lead to addiction and has classified it as a “Drug and Chemical of Concern.”
Regardless of its legal status, the evidence is clear that the drug can be addictive in some cases, and oftentimes dangerous. Fortunately, like similar substances, including opioids, kratom dependence is treatable. Medically-assisted detox programs can be highly effective in treating addiction.
Read the full WebMD article with sources.
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