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According to the Drug Enforcement Administration (DEA) and scholarly sources, such as an article in Current Topics in Medicinal Chemistry, kratom is a tree that is found in areas of Southeast Asia (Mitragyna speciosa Korth). The tree goes by other names that include biak-biak , kakuam, or ketum. The leaves and shoots of the tree are commonly used by the local people in the areas who chew the leaves or brew them in beverages like tea. The leaves are considered to have medicinal purposes and may produce stimulant-type effects when taken in small doses. In moderate to higher doses, it may have similar effects to opiate drugs.
The DEA lists kratom is a drug of concern; however, it is not a controlled substance, and there are no reliable figures regarding its abuse in the US. Several states, such as Alabama, have identified kratom as a potentially dangerous substance and enacted regulations to control its distribution.
Because kratom is reputed to have medicinal qualities and is used as an herbal remedy in many areas where the tree is indigenous, the drug has also received the reputation in the US as having significant medicinal uses. One of the uses that the drug is reported to have is it possesses antidepressant-like qualities when taken. Others report that the drug can be used as an opiate replacement medication for individuals attempting to undergo withdrawal associated with recovery from opiate use disorders. Numerous sites, such as The American Kratom Association, continue to list reported “research studies” that attest to its effectiveness; however, actual controlled research regarding the properties of the drug is scarce.
The major users of the drug even in the US continue to be of Asian background, although it has received some popularity as a sort of cure-all as a result of these sites. As a result, it may be infrequently used by other individuals.
The primary psychoactive substance occurring in kratom is mitragynine. The substance produces effects that are dependent on the dosage. The scholarly book The Medical Toxicity of Drug Abuse: Synthesized Chemicals and Psychoactive Plants lists these effects as follows:
People who use the drug for longer periods of time have been observed to have issues with weight and appetite loss, insomnia, and darkened skin tone. In some cases, they display issues with hallucinations or delusions. The book Kratom and Other Mitragynines: The Chemistry and Pharmacology of Opioids reports on a variety of other effects of kratom use.
These effects can include:
There are two main sources that have documented the development of physical dependence in individuals who use kratom. The majority of the individuals who display withdrawal symptoms were noted to be chronic users of the drug and used it regularly. The major form of use was to drink the drug as a tea. Articles in the journals Substance Abuse and Drug and Alcohol Dependence have documented a relatively consistent withdrawal syndrome associated with kratom.
In cases where the withdrawal syndrome was treated, individuals were successfully treated with anti-anxiety drugs, such as benzodiazepines and nonsteroidal anti-inflammatory drugs (e.g., Tylenol). In some cases, for individuals who had some persisting symptoms, antidepressant medications were prescribed. The majority of individuals expressed mild symptoms that are often considered to be consistent with the notion of psychological dependence. Even though these symptoms are not considered to be potentially fatal on their own, there are reasons for concern in any individual undergoing withdrawal from kratom.
There are several other reasons to consider kratom to be a potentially dangerous drug.
The empirical evidence indicates that kratom is a potentially dangerous drug of abuse. At the current time, it has no empirically documented medicinal uses. If research indicates that the drug can be used medicinally, it should be listed as a controlled substance by the DEA.