Kratom

Kratom is a tree species (Mitragyna speciosa) originally from Southeast Asia. It can cause an analgesic, euphoric, sometimes sedating, and addictive[1][2] effect due to the µ-opioid active ingredients mitragynine and 7-hydroxy mitragynine contained in the leaves. People use it as an intoxicant, a cessation aid, and a medicine. The harvested leaves are fresh and dried, also known as biak, katawn, krton, mabog, or mambog.

Physical appearance

The tree is often called the “red sentol tree,” which grows between 3 and 12 meters high (other sources speak of growth heights of up to 10 to 25 meters) and has green, oval leaves, and yellow flowers.

The main psychoactive ingredient is mitragynine, chemically related to psilocybin and a semi-alkaloid.

Sorts

The coloring of the leaf veins is often used as a distinguishing feature for the different varieties. The three Kratom leave types have green, red, or white veins, hence the appropriate names: Green Vein, Red Vein, and White Vein.

  • Red Vein: One perceives this Kratom strain as being more sedating.
  • Green Vein: This is the middle ground regarding both stimulating and sedating effects.
  • White Vein (white veins): They have a stimulating, motivating effect and increase attention.

However, the variance in effectiveness is vast and may overlap with other strains. So far, there are no systematic studies that have examined the different effects of the active ingredient content of Kratom, nor are there any lack of standards or controls of varying quality for traders. The perception of the different varieties is very subjective. Therefore everyone should use all information on the types with caution.

Quality levels

In most cases, the higher the price of the Kratom, the more potent the respective Kratom is and the higher the effectiveness. The quality level varies between retailers. When speaking of high-quality Kratom, it is often finely ground or contains fewer plant branches or other impurities. Specific quality designations are as follows: Ultra, Super, Superior, Premium, Standard.

Consumption

Kratom exists in various processing forms, such as powder or crushed. People either chew or drink it. Sometimes they smoke it in the form of joints or use a vaporizer or a bong. The leaves of the red sentol tree are also often made into tea.

Oral application

Generally, one chews Kratom and thus ingests orally. Due to the bitter taste, many mix the dried plant parts into yogurt. The bitter taste is also avoided by filling capsules with it or mixing the grated Kratom powder with milk and cocoa and drinking it.

Application by inhalation

Another Kratom variant is smoking or vaporizing (at a temperature of 175°C-200°C).

Detectability

So far, drug tests can not find active ingredients contained in Kratom.

Effect

Short-term effects

You can sense Kratom’s effects after consuming just 5 to 10 minutes. The expression has a broad spectrum and is often paradoxical. The spectrum is essentially similar to that of weak opioids. If one consumes Kratom in small doses, the effect is euphoric or stimulating, and in larger doses as a depressant. Many consumers report enormous fatigue in the first 6 hours after ingestion. Because the main ingredient, mitragynine, stimulates the delta-opioid receptors in low doses and progressively stimulates the mu-opioid receptors in higher doses. Opiates stimulate the same receptors.

Because Kratom acts on opioid receptors, painkilling effects are often the result of ingestion. At high doses, the body is anesthetized.

The bitter taste often causes retching, nausea, and vomiting when chewing. In high doses, consumption often leads to nausea, dry mouth, loss of appetite, constipation, and an increased urge to urinate. Occasionally, there are reports of cardiovascular problems and increased body temperature. The ingredient mitragynine found in Kratom has a relatively long biological half-life of about a day.[3]

Long-term effects

Frequent Kratom use can quickly lead to addiction. It has a potential for addiction that is typical of weak opioids – both physically and psychologically. A study in Malaysia showed that half of those who used Kratom for at least six months developed addiction problems.[4]

Users often suffer from weight loss and dark facial pigmentation; psychological changes also occur in isolated cases.

If one stops the consumption abruptly, mental and physical withdrawal symptoms (e.g., irritability, crying, diarrhea, muscle pain) occur. Withdrawal symptoms seem very similar to opiate or opioid withdrawal, particularly with long-term and excessive use of Kratom. Cold symptoms, inner restlessness, exhaustion, loss of appetite, diarrhea, hot flashes, and tiredness are common symptoms[5] that disappear after about 4 to 7 days, depending on the dependency. However, there is only limited research on health risks and long-term consequences.

The potential for psychological dependence is because the effects help many users cope with everyday life as it reduces feelings and frustration or exhaustion. Since the drug also shows mood-enhancing results, people use it often as self-medication. It can rise to the surface of being unable to cope with everyday life without the drug.

Other dangers

In addition to possible short-term effects such as retching, nausea, and vomiting, several dangers can occur when consuming Kratom. Some of these dangers are as follows:

Liver damage

Liver damage and acute liver failure have been reported after short substance consumption. However, this damage was reversible and did not result in fatalities. However, studies of numerous long-term Kratom users showed that this substance does not damage the liver. Assuming that the affected consumers either had a genetic disposition, i.e., a genetically determined susceptibility to disease, which ensured that the liver could not properly break down the alkaloids contained in Kratom.[6] or the Kratom contained impurities.

Depressions

After the effects of Kratom wear off, sufferers may experience mild depression. So those affected may take more Kratom to weaken the depressive mood, which favors a dependency process.

Mixed-use

If people take Kratom with cocaine, amphetamines, or even high doses of caffeine, this mixed consumption can lead to high blood pressure. The combination with alcohol, benzodiazepines, and opiates can even lead to “over-sedation” and, worst case, shortness of breath.

Lethality

Although there has been no documented death from the sole use of Kratom, deaths have already occurred in connection with the mixed-use of Kratom with other substances or with active cutting agents (e.g., O-DEST). One assumes the opioid effect promotes choking on vomit or respiratory depression in mixed-use.

Other uses

Cessation aids

Since Kratom is considered a relatively low-potency opioid, the substance allows for an intermediate step in weaning off potent opioids. For opioid addicts, Kratom usually does not have a noticeable euphoric effect, but it can partially reverse the abstinence syndrome. However, there is no data on the success rate of Kratom as an opioid cessation aid.

Pharmaceutical

In some parts of the world, Kratom, like opioids, is used as a medicine for diarrhea, fever, and general pain. Vendors often advertise Kratom with incorrect uses, e.g., as bath salts, incense mixtures, or dyes, so they escape legal treatment as medicinal products.

History

In the literature, you can find the first entries about Kratom by the Dutchman Pieter Willem Korthals. Initially, they used the drug as a medicinal plant in Thailand and Malaysia because of its psychoactive effects. Today, however, these countries classify Kratom as a prohibited drug.[7]

Legal status

Updated July 2022
Until the 20th century, Myanmar, Malaysia, and Thailand consumed Kratom as an opium substitute. In traditional medicine, it was also often used as a diarrhea drug; today, it is illegal in those areas and Australia and Vietnam. In 1943 Thailand banned the Kratom tree; they felled the trees.

On the other hand, Indonesia is considered the largest Kratom exporter. Its use is still unregulated in many Western countries. It is used to some extent as a natural opioid substance but is often fraudulently sold as a placebo or adulteration.

Below is a listing of some countries with their legal status regarding Kratom use.

Asia and Oceania
ASEAN: Trading Kratom as a medicine or dietary supplement is prohibited between ASEAN member states.
Thailand: Possessing and consuming Kratom has been banned entirely since 1943.
New Zealand: Because Kratom is a prescription substance there, it is illegal for dealers to sell Kratom without a license.
America
Canada: It has been illegal to market Kratom products since 2016. However, the products not intended for consumption may be traded (it is semi-legal, so to speak).
United States: The DEA was due to ban kratom throughout the US in 2016; however, it was dropped due to public pressure. Nevertheless, Kratom was arbitrarily banned in several states.
Europe
Germany: Because Kratom is not listed in the Narcotics Act, it is considered legal.
Switzerland: Kratom has been illegal since 2017.
Denmark: Kratom is illegal.
Greece: Kratom is legal.
UK: Kratom has been illegal since 2016.
Latvia: Kratom is illegal.
Lithuania: Kratom is illegal.
Netherlands: Kratom is legal.
Austria: Kratom is legal.
Poland: Kratom is illegal.
Romania: Kratom has been illegal since 2010.
Sweden: Kratom is illegal.

Weblinks

References

[1] Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. https://www.ncbi.nlm.nih.gov/pubmed/24698080]

[2] The New York Times: Kratom, an Addict’s Alternative, Is Found to Be Addictive Itself

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425236/

[4] https://www.ncbi.nlm.nih.gov/pubmed/24698080

[5] https://www.ncbi.nlm.nih.gov/pubmed/24698080

[6] http://livertox.nih.gov/Kratom.htm

[7] Chittrakarn S, Keawpradub N, Sawangjaroen K, Kansenalak S, Janchawee B: The neuromuscular blockade produced by pure alkaloid, mitragynine and methanol extract of kratom leaves (Mitragyna speciosa Korth.) in Ethnopharmacol (2010)