What is kratom?
Kratom is a tree native to Southeast Asia (Thailand, Malaysia, Myanmar [Burma],
and elsewhere). Its botanical name is Mitragyna speciosa. Kratom is in
the same family as the coffee tree (Rubiaceae). The leaves of kratom have been
used as an herbal drug from time immemorial by peoples of Southeast Asia. It is
used in folk medicine as a stimulant (at low doses), sedative (at high doses),
recreational drug, pain killer, medicine for diarrhea, and treatment for opiate
How is it taken?
In Thailand, kratom leaves are often chewed fresh (usually after removing the
stringy central vein). Dried leaves can also be chewed, but since they are a bit
tough, most people prefer to crush them up or powder them so that they can be
swallowed. Powdered kratom is sometimes mixed with fruit juice or apple sauce.
This partially masks the taste and allows it to be quickly swallowed. Dried
kratom leaves are often made into a tea that is strained and then drunk (this is
the most frequently used method in the West). Kratom can be smoked, but doing so
has no advantage over chewing or making a tea from it. The amount of leaf that
constitutes a typical dose is too much to be smoked easily. A paste-like extract
can be prepared by lengthy boiling of fresh or dried leaves. This can be stored
for later use. Small pellets of this extract can be swallowed, or it can be
dissolved in hot water and consumed as a tea. Some people like to mix kratom tea
with ordinary black tea, or other herbal teas, before it is consumed. This is
done to make it more palatable.
What are the effects?
Kratom is a rather unique drug in that a low to moderate dose will usually (but
not always) be stimulating, while a high dose is almost always quite sedating.
This is apparently because the active alkaloids have both stimulant and sedative
effects. Which predominates probably depends both on blood level and individual
differences between users.
The stimulant level: At the stimulant level the mind is more
alert, physical energy and sometimes sexual energy is increased, ability to do
hard monotonous physical work may be improved, one is more talkative, friendly,
and sociable. Some people find this level edgy rather than pleasant.
The sedative-euphoric-analgesic level: At this dosage you will
be less sensitive to physical or emotional pain, feel and look calm, have a
general feeling of comfortable pleasure, and may enter a pleasant dreamy
reverie. You may experience some itching or sweating. Your pupils may be
constricted (small). It is possible you may feel nauseated, but if you lie down
and relax the nausea should quickly cease. You may find your appreciation of
music is increased. It will be very pleasant to lie down on your back in a
semi-darkened room, with eyes closed, and just listen to your favorite music. If
you do this you may be fortunate enough to enter the delightful mixed-state of
‘waking-dreaming’ where you have one foot in dreamland and the other foot in the
real world. This state was much prized by the 19th century Romantic writers,
who, lacking knowledge of kratom, resorted to the much more habit-forming
narcotic, opium, to achieve it. The effects of kratom usually last about six
hours. The higher the dose, the stronger the effects, and the longer they last.
Many people report a positive ‘afterglow’ the next day.
What are the risks? How safe is it?
When kratom is taken by itself (without mixing it with other drugs), the
greatest risk is falling asleep while engaged in hazardous activities. NEVER
drive while under the influence of kratom, even if you feel stimulated, rather
than sleepy, for sleepiness may come on you without warning. Use common sense.
Do not use power tools or climb ladders while under the influence of kratom. Be
careful not to leave a pot on a lit stove and then fall asleep.
Pregnant women should not take any drug or medication except on medical
advice. Since there have been no studies of the risks of kratom use by pregnant
women, it is not known whether it could cause birth defects or fetal death. We
strongly recommend that any woman who could possibly be pregnant NOT use kratom.
Is kratom habit forming?
Although a small number of people have become dependent on kratom (primarily in
Thailand), kratom is not habit forming when it is used responsibly. If used
occasionally as a recreational drug, rather than daily, there is virtually no
risk of becoming dependent on it. But it is very important not to get into the
habit of using it every day. For kratom, like many drugs [e.g. alcohol, coffee,
tobacco, etc.] if used on a daily basis for a prolonged period of time, could
become a habit hard to break. IT IS IMPORTANT NOT TO USE KRATOM EVERY DAY.
Before starting to experiment with it set yourself usage guidelines. If you EVER
find it is hard to stay within your usage guidelines immediately quit using
Are there any reported health problems?
Health problems are unlikely unless one is consuming large quantities of kratom
every day. In Thailand, where there are some people who use kratom every day,
those dependent on it can develop weight loss, dark pigmentation of the face,
and have physical withdrawal symptoms if they quit abruptly. The withdrawal
symptoms may include muscle aches, irritability, crying, runny nose, diarrhea,
and muscle jerking. Health problems are unlikely to occur in occasional kratom
users. Like any drug or medicine, people's reactions vary and some people could
possibly have an allergic or other unusual reaction to kratom, even if they used
What is kratom's legal status?
Kratom is illegal in Australia, Malaysia, Myanmar (Burma), and Thailand (these
countries impose sever penalties for possession of the herb). It is legal in
most other countries, including the United States and all of Europe. Laws can
and do change, so be sure that kratom is legal where you live before using it.
What are kratom's active constituents?
There are many closely-related tryptamine alkaloids in kratom. The most
important ones are mitragynine and 7-hydroxymitragynine. These are primarily
responsible for kratom’s pain relieving, sedative, euphoric, and stimulating
effects. These alkaloids resemble yohimbine in structure, but do not have the
Mitragyna speciosa (ketum,
kratom or kratum, Thai:
กระท่อม) is a
tropical deciduous and evergreen tree in the coffee family (Rubiaceae) native to
Southeast Asia in the Indochina and Malesia floristic regions. Its leaves are
used for medicinal properties. It is psychoactive, and leaves are chewed to
uplift mood and to treat health problems. M. speciosa is indigenous to
Thailand and, despite growing naturally in the country, has been outlawed for 70
years and was originally banned because it was reducing the Thai government's
tax revenue from opium distribution.
Kratom behaves as a μ-opioid receptor agonist like
morphine and is used in the management of chronic pain, as well as
recreationally. Kratom use is not detected by typical drug screening tests,
but its metabolites can be detected by more specialized testing. The
pharmacological effects of kratom on humans, including its efficacy and safety,
are not well-studied.
Young M. speciosa tree
It was first formally described by the Dutch colonial
botanist Pieter Korthals. The genus was named Mitragyna by Korthals
because the stigmas in the first species he examined resembled the shape of a
bishop's mitre. It is botanically related to the genera Corynanthe and
Uncaria and shares some similar biochemistry.
Mitragyna speciosa trees
usually grow to a height of 12–30 ft (3.7–9.1 m) tall and 15 ft (4.6 m) wide,
although some species can reach 40–100 ft (12–30 m) in height. Mitragyna
speciosa can be either evergreen or deciduous depending on the climate and
environment in which it is grown. The stem is erect and branching. The leaves of
the kratom tree are a dark green color and can grow to over 7 inches (180 mm)
long and 4 inches (100 mm) wide, are ovate-acuminate in shape, and opposite in
growth pattern. The flowers are yellow and round and tend to grow in clusters at
the end of the branches. The leaves of M. speciosa are elliptic and are
smaller at the end of the branchlets and are pointed at the tip. The leaves have
a round and heart-shape at the base with the petioles between 2 to 4 centimeters
long. The flowers are crowded in a round terminal inflorescences which are three
to five centimeters long. The calyx-tube is short and cup-shaped, with round
lobes. The corolla-tube is five millimeters long with three millimeter long
lobes and smooth and revolute in between.
There are 40 compounds in M. speciosa leaves,
including many alkaloids such as mitragynine (once thought to be the primary
active constituent), mitraphylline, and 7-hydroxymitragynine (which is currently
the most likely candidate for the primary active chemical in the plant). Other
active chemicals in M. speciosa include raubasine (best known from
Rauwolfia serpentina) and some yohimbe alkaloids such as corynantheidine.
Mitragyna speciosa also
contains at least one alkaloid (rhynchophylline) that is a calcium channel
blocker, and reduces NMDA-induced current. The amount of mitragynine within the
leaves depends highly on many factors, one major factor is the location of the
tree. When trees are grown in Southeast Asia, the levels tend to be higher but
when grown elsewhere (even in greenhouses) the levels tend to be low or
non-existent. One analysis of products marketed as kratom leaf found, using
liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS),
mitragynine at levels of 1–6% and 7-hydroxymirtrogynine at levels of 0.01–0.04%.
The chemical structure of mitragynines incorporate the nucleus of the tryptamine,
and these may be responsible for the molecules which are observed in the
serotonin and adrenergic systems. In mitragynine, the phenolic methyl ether is
considered to be stronger in analgesic paradigms according to some studies.
Moreover, studies concerning the pharmacokinetics of M. speciosa in
humans has not been well studied and various aspects such as the half-life,
protein binding properties and other properties such as the elimination or
metabolism is not known.
Kratom has been traditionally chewed, in raw leaf form, by
people in Thailand and especially in the southern peninsula. Kratom is also used
in neighboring countries in Southeast Asia where it grows naturally. As
traditionally used, kratom is not seen as a drug and there is no stigma
associated with kratom use or discrimination against kratom eaters. In southern
Thailand, kratom has been a part of traditional culture for thousands of years
and is common in traditional cultural performances and in agriculture. In
southern Thailand, kratom chewers generally start at around the age of 25 and
many continue to chew the leaves for the rest of their lives. The average number
of leaves consumed is between 10 and 60 leaves consumed daily, but even more
than this is common. In southern Thailand, upwards of 70% of the male population
uses kratom on a daily basis in some areas. Some users consume M. speciosa
along with dextromethorphan-containing cough syrup,
benzodiazepines. Kratom has seen therapeutic use in Thai ethnomedicine as an
antidiarrhoeal, as a treatment for opioid dependence, and rarely to increase the
duration of coitus.
Kratom and its derivatives have been used as a substitute for
opium as well as an aid for the management of opium withdrawal.
Data on the incidence and prevalence of its use are lacking, as physicians are
generally unfamiliar with it, and its use is not detected by typical
screening tests. Kratom metabolites can be detected by
spectrometry tests. Incidence of kratom use appears to be increasing among
those who have been self-managing chronic pain with opioids purchased without a
prescription and are cycling (but not quitting) their use. As of 2011, there
have been no formal clinical trials performed to study the efficacy or safety of
kratom to treat
The pharmacological effects of kratom on humans are not well
studied. Its metabolic half-life, protein binding, and elimination
characteristics are all unknown. Kratom behaves as a μ-opioid receptor agonist,
similar to opiates like morphine, although its effects differ
significantly from those of opiates. Kratom does not appear to have significant
adverse effects, and in particular appears not to cause the hypoventilation
typical of other opioids. Compulsive use has been reported among drug users who
inject opioids, and those who use opioids to manage pain without direction from
Side effects associated with chronic kratom use include loss
of appetite and weight loss, constipation, and darkening of the skin color of
the face. Chronic use has been associated with bowel obstruction. Chronic users
have also reported withdrawal symptoms including irritability, runny nose and
diarrhea. Withdrawal is generally short-lived and mild, and it may be
effectively treated with dihydrocodeine and lofexidine. Three case reports
document deaths involving kratom. Other drugs were used in all cases, and in
one, kratom was speculated to possibly be the primary cause of death. In 1975,
there was an isolated report of serious adverse effects such as psychosis,
convulsions, hallucinations, and confusion, among five individuals who had used
kratom daily for 10–35 years.
Possession of kratom leaves is illegal in Thailand, despite
the tree being native to the country. The Thai government passed the Kratom
Act 2486 which went into effect on August 3, 1943. This law made planting
the tree illegal and requires existing trees to be cut down. This law was not
found effective, since the tree is indigenous to the country. A large aspect of
Thai culture supports kratom, however despite this fact the Thai government had
initiated a program of destroying kratom trees by burning forests or chopping
large sections of kratom forests down. Eradication campaigns often destroy not
only the trees but also other trees and wildlife in these areas, which are often
untouched rainforests with sensitive ecosystems. A general consensus exists in
southern Thailand, where the use of kratom is endemic, among leaders, public
health officials, academics and policymakers that kratom use and dependence
causes little, if any, health risks.
In 2010, the Thai Office of the Narcotics Control Board
proposed decriminalizing kratom and affirmed its use as an integral part of Thai
culture. The ONCB concluded that decades of unproblematic use, and an absence of
health and social harm, make prohibiting the leaf unnecessary and
counterproductive. According to the ONCB's report, kratom was in fact banned for
economic reasons, not for health or social concerns. In a snippet from a book
written by Cassandra Hoffman:
"In Thailand, kratom was first scheduled for control in
1943 under the Kratom Act. At the time, the government was levying taxes from
users and shops involved in the opium trade. Because of the increasing opium
costs, many users were switching to kratom to manage their withdrawal symptoms.
However, the launch of the Greater East Asia War in 1942 and declining revenues
from the opium trade pushed the Thai government into action to curb and suppress
competition in the opium market by making kratom illegal."
As of October 2, 2013 the justice ministry of Thailand
suggested removal of Kratom from the narcotic drug list relating to Category 5
of the Narcotic Drug Law of 1979, though still recommended regulating kratom in
other ways due to its effects on the nervous system. This recommendation will be
made to the Ministry of Public Health, which can move forward with the removal
from the list or not.
The use of kratom leaves (locally known as 'ketum') is
prohibited in Malaysia under Section 30 (3) Poisons Act 1952 and the user may be
penalized with a maximum compound of MYR 10,000 (USD 3,150) or up to 4 years
imprisonment. Certain parties have urged the government to penalize the use of
kratom under the Dangerous Drugs Act instead of the Poisons Act which will carry
Kratom itself is not regulated by the United States federal
government. However, the Drug Enforcement Administration once included it in a
list titled "Drugs and Chemicals of Concern".
Indiana House of Representatives HB1196, sponsored by Edward
DeLaney, Steve Davisson, Terri Austin, Vernon G. Smith, and David Yarde during
the 2012 regular session as a response to increasing synthetic drug use, made
Indiana the first and only state to ban chemicals in kratom, although
indirectly. The text of the bill added kratom's two active alkaloids—mitragynine
and 7-hydroxymitragynine—to the state's list of controlled substances, though
kratom itself is not synthetic and was not specifically addressed by the authors
of the bill. Due to kratom not being on the banned plants list nor being a
synthetic, kratom is still legal in Indiana.
Iowa legislators grouped Mitragyna speciosa as a
synthetic cannabinoid when a bill was proposed that would reclassify nearly
all controlled substances in their state. The Louisiana legislature proposed an
age limit of 18 to be able to legally purchase, possess and consume kratom.
Violators would have been assessed a penalty of no more than $500, or sentenced
to six months in jail, or both. Massachusetts Representative Daniel K. Webster
sponsored legislation in 2011 that would have included compounds of Mitragyna
speciosa in the state's controlled substance classification list.
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