Kratom, a psychoactive substance that is technically legal in the United States, comes from the plant Mitragyna speciosa, which is in the same family as the coffee tree.
Kratom is abused by chewing the leaves of the plant, brewing them in tea, mixing it in other drinks such as caffeinated beverages or codeine-containing cough syrups (called “4×100”), or by taking it in powder or tablet form.
In low doses, kratom has a stimulant effect, resulting in increased energy, talkativeness, and less need for sleep. Higher doses of kratom are said to have an effect similar to morphine, the New York State Office of Alcoholism and Substance Abuse Services (NY OASIS) reports, by working on opioid receptors and some of the brain’s chemical messengers related to emotional regulation and pleasure.
Kratom abuse appears to be on the rise in the United States, as the Journal of Addictive Diseases reports on increased poison control center calls. In America, kratom is often marketed as a nutritional or dietary supplement. Negative reactions to the toxicity of the drug prompted the U.S. Food and Drug Administration (FDA) to ban its import in 2014. The Drug Enforcement Administration (DEA) lists kratom as a “drug of concern” in the United States. Although the drug is not currently under federal control, it is still considered a possibly dangerous drug of abuse with the potential for dependence and addiction with prolonged and regular use.
Dependence and AddictionWhen a person takes a mind-altering drug such as kratom, the brain’s natural chemistry is changed. Some of the chemical messengers produced in the brain and sent throughout the body may be stimulated, depressed, or not absorbed properly. Opioids, and likely kratom as well, fill opioid receptors in the brain and along the central nervous system, which can create a kind of backlog of some of the neurotransmitters involved in how a person feels pleasure. This can cause a rush of euphoria, or “high.”
With regular interference, the brain’s chemistry is altered to expect kratom’s presence. These chemical messengers may not be produced or moved throughout the central nervous system in their normal fashion. A drug dependence is then formed.
When kratom use is stopped, or the drug wears off, withdrawal symptoms may occur.
According to the Nursing Show, these may be similar to withdrawal symptoms from opioids and include a runny nose, fatigue, muscle or bone pain, nausea, constipation, hostility, aggression, tremors, or even psychotic symptoms like confusion, delirium, or hallucinations. Anxiety, insomnia, and depression may be common psychological side effects of kratom withdrawal, as the brain’s pleasure and reward processing centers struggle to regain a natural balance without the drug.
Drug dependence may be increased with higher doses, a longer time abusing the drug, polydrug abuse, an underlying mental health or medical condition, history of substance abuse and/or addiction, genetic contributors, and chronic stress or other environmental factors. Drug dependence is not the same as addiction, although when a person battles drug addiction, dependence is likely a symptom of the disease as are withdrawal symptoms and drug cravings when the drug is removed.
- Increased risk-taking behaviors
- Continued use of the drug in full awareness of problems its use may create
- Decreased production at work or school
- Social withdrawal and increased secrecy
- Lack of interest in social, recreational, or other activities that used to be important
- Inability to stop using the drug despite multiple attempts to do so
- Lack of control over amount taken or duration of abuse
- Drug tolerance (needing to take more of the drug to feel its effects), drug dependence, and withdrawal symptoms
- Mood swings and a potential personality shift
- Changes in sleeping and eating habits, and a possible significant loss of weight
Opioid drugs are considered highly addictive.
The National Institute on Drug Abuse (NIDA) estimates that about 2.5 million Americans suffer from opioid addiction related to prescription painkillers and heroin (based on 2012 national survey data). It may be that kratom’s narcotic effects lead it to be an addictive substance as well. Places like Thailand, where it is the most commonly abused illegal drug, according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), and several states in the United States have outlawed its use.