Kratom is a plant native to South East Asia – specifically Indonesia and Thailand.
Figure 1: Map of Kratom Growing Countries.
Kratom leaves contain certain molecules called alkaloids that have an interesting effect on humans.
These effects include:
• Reduced pain
• Reduced anxiety
• General sense of well being
Some side effects may include:
• Nausea at high doses
There are 2 primary active molecules in kratom leaves. Think of these like ethanol in alcoholic drinks or nicotine in tobacco or THC in cannabis. The active ingredients in kratom are:
• 7-OH mitragynine (7-OH)
These molecules appear to be partial or weak binders to the opioid receptor. The binding and actual effect of the kratom molecules in the brain is a debated topic requiring further research. Kratom’s pharmacodynamics (mechanism of a drug’s action) are not fully understood at this time.
What does appear clear is that the method of Mitragynines binding to the opioid receptor results in unique properties and effects compared to other mu-opioid receptor binders (ex. Heroin, methadone, oxycodone).
Kratom has been traditionally consumed by farmers and manual labourers in South East Asia to ease strenuous labour and stay focused and energized. These workers typically chewed the kratom leaves similarly to how South American workers chew coca leaves
Modern North American users typically ingest kratom like a tea using a fine powdered form of the leaf. Other methods will be discussed below including:
Most users feel the effects of kratom in 20 and 60 minutes. The effects last 60 to 90 minutes in low doses and 3 to 6 hours at higher doses.
There are currently no FDA approved reasons for kratom use. People who are actively using kratom claim it helps many different medical conditions and ailments including:
Pain – chronic and often neuropathic. Many people with severe back pain use kratom
• This includes people suffering pain disorders such as fibromyalgia
Depression and other mood disorders
• Trying to quit and/or reduce use of heroin, prescription pain killers (oxys, percocets, Vicodin, etc.)
Many people claim kratom can help avoid the withdrawal symptoms associated with quitting opioids or tapering. Kratom is used similarly to methadone and suboxone in this respect.
Many people report kratom leaves them more mentally acute and focused when using kratom compared to traditional opiates. They are better able to function and work.
Kratom is anecdotally reported to help with the following opiate withdrawal symptoms:
• drug craving
• flu like symptoms
• aches and pain
• depressive symptoms
Mitragyine and 7-OH mitragyine partially activate the mu-opioid receptor in the brain which causes kratom’s effects.
The partial activation of the opioid receptor is what is believed to result in the unique “opioid like” effects of kratom.
All kratom originates as the raw kratom leaf. The kratom leaf is processed to create the different forms of finished product such as raw powder, liquids, etc. The processing of kratom leaves typically involves drying and grinding the dried leaves. This process produces a fine kratom powder that is light green. This powder is the most commonly consumed form of kratom.
The powder may be further processed to create pre-bottled drinks or extracts which are high potency forms of kratom.
High potency forms of kratom are processed in to increase the mitragynine and/or 7-OH mitragynine contents of a product.
Traditional Indonesian and Thai farm workers would drink kratom tea in the mornings and chew the leaf throughout the day to provide them with energy, pain relief and motivation to complete the strenuous and monotonous tasks associated with farming in the hot sun.
Kratom is used and viewed similarly to coffee in many countries.
North American users most typically purchase kratom in powdered form. Average American users consume 2-8 grams per day.
The most common ways to use kratom are:
The taste of kratom has been compared to over steeped green tea. Kratom is extremely bitter and generally not considered a pleasant taste. The tea is quite “earthy” tasting.
Many users “toss and wash” to avoid tasting the kratom as much as possible.
Kratom is unique in that different sized dosages have different effects. Low doses produce stimulating effects similar to coffee including increased focus, motivation and attentiveness. Ancient kratom use likely fell into this category of dosing with the low doses obtained from chewing kratom leaves.
Higher doses produce more sedentary and euphoric, opioid like effects such as:
Typical low and starting doses of powdered kratom are 1-2 grams. Average doses vary between 4-6 grams per day. High doses are beyond 10 grams per day. Some users report consuming up to 60 grams of kratom per day.
Most regular kratom users take kratom a few times a day. Most often kratom is used in the morning before work and at night before bed.
Heavy users of kratom use kratom multiple times through the day, often 6+ times.
Kratom leaves and their molecular content can change if exposed to oxygen, sun, moisture or heat.
The drying and processing of kratom leaves likely has a large effect on the end quality of the kratom consumed and its effects.
The active ingredient in kratom, mitragynine, is susceptible to oxidation/degradation. Mitragynine can be oxidized to 7-OH mitragynine if exposed to sunlight. This isn’t necessarily “bad” as in the human body mitragynine is oxidized to 7-OH mitragynine which some researchers believe is the primary medically active component of kratom.
Mitragynine exposed to oxygen can become Mitragynine pseudoindoxyl. Mitragynine pseudoundoxyl also possesses analgesic effects.
The grinders used to turn dried kratom leaves into powder can heat up during the powdering process. This heat can destroy the mitragynine
Many users claim kratom strain color does seem to have a legitimate effect on a user’s experience.
This is despite the fact that many claim that 90%+ of the kratom sold on the market is red vein kratom regardless of what color the vendor claims. Some claim the color of the kratom is determined by the drying and light conditions.
The purported and traditionally claimed effects of different vein colors are:
Red kratom is most commonly purchased vein in the United States.
Green strains are reported to be more energizing than red strains and their effects last longer.
White veins are known for their effects on the mood with an energy boost.
These claims are purely anecdotal and not approved by the FDA.
Since kratom is susceptible to change when exposed to sun or moisture it is highly advisable to store kratom in a cool, dark and dry area. Many kratom users store their kratom in the freezer.
The largest problem with moisture and kratom is that moisture can cause mold which ruins kratom and makes it unsafe to use.
The most common side effects when using kratom are nausea, constipation, itchiness, and headaches. Another common result of kratom use is dehydration. Kratom users are therefore highly recommended to drink lots of water.
The “wobbles” is another potential side effect when using kratom. A kratoms user’s eyes may start twitching uncontrollably making it difficult to focus. The eye wobbles are often accompanied by nausea, dizziness and the feeling of motion sickness. The wobbles generally occur only when a large dose of kratom is used and/or a highly concentrated form is taken.
Another side effect of consistent kratom use is tolerance. Tolerance occurs when you need to use larger doses of a substance to feel the desired effects. Tolerance occurs with nearly all drugs including alcohol, cannabis and opiates. Many kratom users feel the need to use higher and higher amounts of kratom to feel the desired effects.
As discussed above, dependence and addiction appear to be a potential side effect of consistent kratom use.