What Is Kratom?
Kratom is a tree-like plant that grows in Southeast Asia and is distantly related to coffee and gardenia plants.
Kratom isn't the only name for this substance. In various parts of the world, kratom may be referred to under a variety of monikers:
Kratom has been used as an herbal medicine in countries like Thailand and Malaysia for hundreds of years. It has become increasingly popular in the US and Europe as an unregulated recreational drug--a "legal high." It has also found some popularity as an unsanctioned method of managing opiate withdrawal symptoms; however, this practice is largely against accepted medical advice and potentially dangerous."
Even though there are no recognized medical uses for kratom in the US, it is not a controlled substance and is sold both online and in head shops (also known as smoke shops and smart shops). It is available in the form of chopped leaves used for making tea or capsules or tablets that are swallowed.
Kratom Abuse question 1
Signs and Symptoms
Kratom contains more than 20 biologically active compounds, although the most well-studied of these are mitragynine and 7-hydroxymitragynine. Many of the chemicals found in kratom are known to activate various neurotransmitter pathways in the brain and spinal cord including opiate, serotonin, and acetylcholine signaling. Because of these various activities in the brain, kratom intoxication has several distinct effects that depend on the amount of drug ingested.
Low doses of kratom (<5 g of raw leaves) generally have stimulant effects similar to amphetamine, though not as intense. These effects include:
- Reduced fatigue and increased energy.
- Greater alertness.
- Decreased appetite.
- Heightened sex drive.
- Increased sociability.
- Impaired coordination.
Higher doses of kratom elicit more opiate-like effects in users similar to those of narcotic drugs such as morphine or oxycodone, but less intense. These effects include:
- Reduced pain.
- Cough suppression.
- Dysphoria (sense of unease or impending calamity).
Kratom Abuse question 2
Effects of Kratom Abuse
In addition to some of the associated negative effects such as tremors, nausea, anxiety, and sedation, users may experience even more harmful physical effects when kratom is combined with other drugs, including prescription medications.
Some of the chemicals found in kratom can interfere with the metabolism of other drugs by the liver. This can create dangerous drug interaction effects in kratom users who are also using other drugs (including legal medications). Such drug interactions can result in either an under- or over-activity of the concurrently taken medication, with consequences ranging from seizures to liver damage.
One particular kratom product - sold as "Krypton" - has been marketed as an especially potent form of the drug.
Laboratory analysis has shown that Krypton is actually a combination of 2 drugs:
- O-desmethyltramadol, a chemical that activates opiate receptors and is found in patients taking the painkilling drug tramadol (Ultram).
These drugs combine to reduce activity in the nervous system even more than kratom alone. Use of Krypton has reportedly resulted in several deaths due to respiratory failure.
Kratom Abuse question 3
Researchers have shown that the 2 main opiate-activating chemicals in kratom, mitragynine and 7-hydroxymitragynine, can induce physical dependence in rodents after only 5 days. Likewise, human users in both Southeast Asia and the West have been reported to develop physiologic kratom dependencies after long-term use. Individuals who become dependent on kratom also may have developed tolerance to the drug--requiring progressively bigger doses of kratom to achieve the desired effects.
Individuals who develop a kratom addiction may also experience withdrawal symptoms when the drug is stopped suddenly. The kratom withdrawal syndrome has been described as longer-lasting than withdrawal due to prescription opiates, such as hydrocodone or oxycodone, but less intense.
Withdrawal symptoms are similar to those for opiate withdrawal and include:
- High blood pressure.
- Abdominal and muscle pain.
- Cravings for kratom.
Kratom Abuse question 4
Kratom Abuse Treatment
Treatment for people who have become dependent on kratom often begins with a medically supervised withdrawal from the drug at a professional detoxification (detox) facility.
At a detox center, the patient can be supervised and necessary medical treatment administered to ensure their safety and make them more comfortable through the process. There is some support for the use of low potency prescription opiate drug taper to help kratom users withdraw more gradually. Additionally, some problematic withdrawal symptoms can be managed supportively or with use of medications such as antihypertensives.
Following detox, patients may enter a drug rehabilitation program on either an inpatient or outpatient basis. Inpatient facilities provide round-the-clock support, while out-patient programs allow individuals to continue working and living at home while still receiving treatment.
If you need help determining the right treatment option for yourself or someone you love, call 1-888-744-0069Who Answers?. A supportive treatment advisor can help you understand your options for care.
Kratom Abuse question 5
The popularity of kratom is clearly increasing as demonstrated by the growing availability of kratom online and the increase in the number of people using Internet forums to discuss kratom use. However, this drug is not a controlled substance in the US, and large drug-use surveys do not incorporate questions about kratom. As such, it is difficult to estimate the true extent of this drug's use.
One study from 2013 that examined the number of kratom-related cases reported to the Texas Poison Control Database found that reports increased from a total of 3 in the years from 2009 to 2010 to 4 in 2012 to 7 from January to September 2013. This rapid increase is similar to an increase in cases reported in the System to Retrieve Information from Drug Evidence and the National Forensic Laboratory Information System. Clearly, kratom use is on the rise.
Kratom Abuse question 6
Teen Kratom Abuse
As discussed above, no solid figures are available regarding teen use of kratom, but this drug is on the radar of healthcare professionals who deal with substance abuse issues.
Emergency room doctors have reported treating teens who have taken kratom to get high, and there is concern that this drug is especially appealing to adolescents because it is easier for them to buy than alcohol. (source)
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