The Ultimate Guide to Kratom Health & Safety
- Marc C. Close
- Jun 30, 2023
- 7 min read
If you Google anything to do with kratom, or I guess these days, ask ChatGPT, you'll find a lot of concern and disclaimers about its safety. This is understandable given the lack of scientific inquiry into the obscure Southeast Asian leaf. After all, it is only in recent years that there's been an explosion of interest in kratom and its use, and it takes time for the scientific community to catch up and reach consensus. Nevertheless there is a lot we do know about kratom's safety, and this guide aims to share everything you need to know to enjoy kratom worry-free.
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1. What is kratom?
Kratom (Mitragyna speciosa) is the leaf off an evergreen tree endemic to Southeast Asia. It has been used in traditional medicine in Southeast Asia for centuries, perhaps even thousands of years, though exact timelines are difficult to establish. Its use in traditional medicine has primarily been documented in countries like Thailand, Malaysia, and Indonesia.
In these traditional contexts, kratom leaves have been used as a stimulant in low doses, typically chewed by workers to combat fatigue and increase productivity. In larger doses, it has been used as a sedative, for pain relief, or for its psychoactive properties during religious ceremonies. Kratom has also been used traditionally to treat various health problems.
In modern times kratom is consumed in several forms, including capsules, tablets, tea, and powder. The method of consumption and the dose can significantly affect the user's experience. Higher doses tend to produce more physiological effects, while lower doses are more likely to produce stimulant-like effects.
2. What are the effects and benefits of kratom?
The health effects of kratom are derived from two primary active ingredients, mitragynine and 7-hydroxymitragynine, which interact with certain receptors in the brain to elicit the following effects:
Mood elevation: Many users report feeling euphoria or a boost in mood after taking kratom. It may also have anxiolytic (anxiety-reducing) effects for some people.
Stimulant effects: Kratom can have stimulant-like effects, providing users with increased energy, alertness, and sociability, but without the jitters of other stimulants like coffee.
Improved focus: Some people use kratom to increase their mental focus and productivity.
Pain relief: Kratom leaves are often used to treat a variety of pain types, from headaches and muscle pain to chronic conditions like arthritis or fibromyalgia.
Opioid withdrawal relief: Some individuals use kratom to help alleviate the symptoms of opioid withdrawal, such as muscle aches, insomnia, irritability, and mood disturbances.
Other conditions: In traditional medicine, kratom has been used to treat cough, diarrhoea, and other conditions, though these applications haven't been well studied in modern medicine.
3. What are the side-effects of kratom? Is it safe?
Kratom side-effects in general are mild when consumed in moderation. Just like alcohol however, it can be dangerous if consumed excessively, or in combination with specific drugs:
Physical Effects: These can include nausea, vomiting, dry mouth, constipation, loss of appetite, increased urination, and sweating. Long-term excessive use can lead to weigh loss.
Psychological Effects: These can include agitation, irritability, restlessness, and mood swings. Long-term excessive use can lead to insomnia.
Cardiovascular Effects: Kratom can affect heart rate and blood pressure, potentially leading to increased heart rate (tachycardia), palpitations, and in rare cases, irregular heart rhythms.
Liver Health: There have been reports of kratom causing liver damage with long-term, excessive use.
Respiratory Depression: In high doses, kratom can slow breathing.
Dependency and Withdrawal: Regular use of kratom can lead to physical dependence and addiction. Withdrawal symptoms can include muscle aches, insomnia, irritability, hostility, aggression, emotional changes, runny nose, and jerky movements.
Interactions with Other Substances: Kratom can interact negatively with other substances, including alcohol, opioids, benzodiazepines, and certain prescription medications.
4. How do you dose kratom?
Each bottle has approximately 6.75g of fresh leaves, which equates to around 70-90 mg of mitragynine alkaloids. The range is due to the leaves being naturally occurring and having inherent variation in alkaloid concentration from leaf to leaf.
If you've never tried kratom before and are not sure about your sensitivity, we recommend starting with half a bottle first (or 35-45 mg of mitragynine) and seeing if you notice any effects within 30 minutes. If you don't, then you can next attempt a full bottle. Most people will feel mildly-perceivable effects after one bottle, and more pronounced effects after two bottles. The time it takes for you to consume each bottle will impact the intensity of your experience (i.e. drink fast and you'll feel the effects more quickly and wholly).
5. How long does it take for kratom effects to kick in?
The onset of kratom's effects can vary depending on several factors, including the dose, the specific strain of kratom, the method of consumption, and individual factors like metabolism, body mass, and tolerance. Generally, when kratom is taken orally — as a capsule, tablet, or as a tea — its effects can usually be felt within 30 minutes to an hour.
6. How long does kratom effects last?
Kratom's effects may last several hours. The half-life of the primary active compound in kratom, mitragynine, is estimated to be about 3.5 hours, but the effects of kratom can often be felt for up to 6 hours.
7. Can you overdose on kratom?
Recorded cases of overdoses involving kratom are extremely rare, and post-mortem toxicology reports by the CDC discovered that opiates such as fentanyl, heroin, benzodiazepines, prescription opioids, as well as cocaine, to be the primary culprit. What's clear is that you should never mix kratom with hard drugs. In fact, if wasn't obvious enough, just avoid hard drugs all together!
Regarding the risks attributable specifically to kratom, those who attempt to consume immoderate amounts of it will typically be met with fierce nausea and vomiting well before it can have potentially dangerous implications. If you do manage to consume excessive amounts, you may experience exacerbated respiratory depression, tachycardia (or fast heart rate), and hypertension. For those with pre-existing health conditions, this could prove to be potentially fatal.
There is rightly a lot of caution directed toward kratom usage given the lack of rigorous medical research mapping out the full risks at this point in time. However there are tens of millions of people worldwide consuming kratom responsibly every day with virtually no reports of dangerous implications. If only the same could be said for alcohol.
8. Is kratom addictive?
Kratom can be addictive, just like alcohol and opioids. Long term and excessive use can increase the risk of addiction, dependence, and misuse. It is recommended to always consume kratom products in moderation, and with caution. Kratom's inherent traits, like increasing pleasure and decreasing pain, can increase the tendency for misuse, and misuse can lead to dependency. To mitigate the risk of addiction, we recommend consuming kratom at most every other day, limiting your total intake (ideally to less than 200 mg/day), and keeping consumption to a single time of the day (e.g. in the morning before sitting down to work, or in the evening while drinking with friends).
9. Is kratom an opioid?
Kratom is not an opioid. When people refer to opioids, they're usually referring to a class of drugs that includes substances derived from the opium poppy (like morphine), synthetic opioids (like fentanyl), and certain prescription medications (like oxycodone).
The active compounds in kratom, mitragynine and 7-hydroxymitragynine, do interact with the same opioid receptors in the brain that drugs like morphine do. Because of this, kratom can produce effects that are similar to opioids, including pain relief and a feeling of euphoria. Furthermore, just like opioids, regular excessive use of kratom can lead to physical dependence and withdrawal symptoms when use is discontinued.
10. What is kratom withdrawal like?
Kratom withdrawal can be uncomfortable, and symptoms can vary in intensity depending on factors such as the duration of use, the amount used, individual physiology, and whether or not the person is also withdrawing from other substances.
Symptoms of kratom withdrawal may include:
Physical symptoms: Muscle aches and pains, fever, sweating, headache, decreased appetite, abdominal cramps, diarrhoea, and tremors.
Psychological symptoms: Restlessness, irritability, mood swings, anxiety, and depression.
Sleep disturbances: Insomnia, nightmares, and other sleep disturbances.
Cravings: Individuals withdrawing from kratom may experience strong cravings for the substance.
Other symptoms: Runny nose, watering eyes, and yawning.
The onset of withdrawal symptoms typically begins 12 to 48 hours after the last dose, peaking around the second or third day and lasting for about a week or so in total. However, psychological symptoms like anxiety, depression, and cravings can persist for several weeks or more.
Withdrawal from kratom can be a challenging process and it's recommended that individuals who are dependent on kratom seek professional medical help to manage withdrawal symptoms and prevent relapse. It's possible to prevent developing a kratom addiction by consuming it strictly in moderation. We recommend limiting your intake of kratom to at most every other day, and avoiding it if you have a propensity for substance abuse.
11. Does kratom show up on drug tests?
Standard drug tests, such as the SAMHSA-5 and 10-panel drug tests used by many employers, typically test for substances like marijuana, cocaine, amphetamines, and opioids. Kratom is not usually tested for in these standard drug tests because its active compounds, mitragynine and 7-hydroxymitragynine, are structurally different from the substances these tests are designed to detect.
There are however specific tests that can detect the presence of kratom in the body. These specialised tests include certain urine, blood, and hair follicle tests. These tests are not commonly used, but they could be employed in situations where kratom use is suspected.
It's worth noting that the length of time kratom can be detected in the body depends on several factors, including the individual's metabolism, body mass, frequency of use, and the dose taken.
Final thoughts
It's not always sunshine and rainbows with kratom. Like alcohol, it carries risks including potential for addiction, withdrawal symptoms, and interactions with other substances. Knowledge is your best defence against the risks, and this guide should give you the skills to confidently and safely incorporate kratom into your daily life.
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