Kratom for Opioid Withdrawal

Opioid withdrawal is a set of symptoms caused by the abrupt cessation or reduction of opioid use after a period of heavy and prolonged use. Opioid withdrawal can last anywhere between a few days to a few weeks and cause many opioid relapses. Although many clinically proven treatment options are available to overcome opioid withdrawals, surveys indicate that many individuals don’t have access to the appropriate care they need. As a result, more and more individuals are opting for natural approaches.

One of the most controversial approaches for treating opioid withdrawal is kratom, a herb from the other side of the world. Kratom is classified as an opioid as it works on the same brain mechanisms and circuits as other opioids. While the FDA does not approve kratom for any medical use, the first indication of its use to treat OUD date back to 1836. 

In August 2016, the U.S. Drug Enforcement Administration (DEA) attempted to designate kratom as a Schedule I substance due to its high potential for misuse and dependence. However, this attempt was unsuccessful due to public backlash. Kratom remains legal in America except for six U.S. states. And for the time being, the DEA has designated kratom as a “medication of concern.”

What Is Kratom?

Kratom (Mitragyna speciosa) is a tropical tree indigenous to Southeast Asia and certain parts of Africa, with a long history of medical and ceremonial use. Kratom is known by many other names, including Ketum, Biak, Thang, Kakuam, and Thom. In the United States, kratom is typically sold as a dietary or nutritional supplement. And is readily available via the internet as dried or crushed leaves, capsules, tablets, liquids, and resin.

The two main compounds in kratom leaves (mitragynine and 7-α-hydroxy mitragynine) interact with opioid receptors in the brain to induce stimulating effects at low doses and sedative effects at high doses. Hence, kratom is becoming an increasingly popular alternative therapy in the United States for pain relief, digestive ailments, and opioid withdrawals. 

There are currently 25 compounds identified in kratom, but since the two main compounds of kratom interact with opioid receptors in the brain, the FDA classified kratom as an opioid. While kratom produces opioid-like effects, it also has the same potential for producing tolerance, dependence, and addiction.

Kratom Effects & Uses

Kratom has a wide range of effects depending on the dosage consumed. Kratom effects activate within 5-15 minutes and last for two to five hours after being consumed. The stimulant effects of kratom at low doses can be experienced in 10 minutes and can last anywhere from 60 to 90 minutes. According to the National Center for Biotechnology Information (NCBI), kratom effects include:

• Antidepressant effects
• Antinociceptive effects (pain relief) 
• Anorectic effects (reduces appetite)
• Anxiolytic-like effects (relieves anxiety)

Other anecdotal uses of kratom also include:

• Anti-inflammatory (reduces inflammation or swelling)
• Antipyretic (to lower fever)
• Antitussive (cough suppressant)
• Antihypertensive (to lower blood pressure)
• Anesthetic (to lower blood sugar)

None of these uses, however, have been clinically tested or confirmed to be safe or beneficial. They are not endorsed treatments by the U.S. Food and Drug Administration(FDA) or any other medical board. 

Kratom Withdrawal – Is It the Same as Opioid Withdrawal?

Since kratom and opioids are known to generate similar effects, kratom withdrawal symptoms have also been compared to opioid withdrawal, although there are some differences. According to the National Center for Biotechnology Information (NCBI), kratom is considered to work on opioid receptors in the brain similarly to morphine. However, kratom is regarded to be 13 times stronger than morphine.

Prolonged and regular use of kratom can cause tolerance, dependence, and addiction. Kratom dependence can occur in as little as six months, and the DEA reports that the following symptoms may be observed during kratom withdrawal (similar to opioid withdrawal).

• Runny nose
• Muscle aches
• Joint or bone pain
• Jerky movements of arms and legs
• Hostility
• Aggression
• Mood swings

In addition, psychotic symptoms such as hallucinations, delusions, disorientation, and seizures may also occur with severe kratom dependence. When experiencing kratom withdrawal, individuals are highly advised to seek assistance from a professional detox facility, as withdrawals can be incredibly uncomfortable and possibly life-threatening.

How Effective Is Kratom for Opioid Withdrawal?

It’s unclear how effective kratom is at relieving opioid withdrawal symptoms. But since kratom works on some of the same opioid receptors as traditional opioids, it does seem plausible that kratom could help reduce withdrawal symptoms. However, the lack of clinical studies and research on kratom’s long-term health effects and its potential as a medication for opioid use disorder and withdrawals opens up the possibility that kratom can lead towards trading one chemical dependence for another. In addition, the lack of regulatory oversight, production standard, and the sale of tainted kratom products contaminated with potentially poisonous and infectious chemicals pose a threat to all who consume kratom.

Despite the lack of medical and scientific evidence, many individuals utilize kratom to treat opioid withdrawal. It’s worth noting that kratom is a considerably weaker opioid receptor stimulator than traditional opioids. Hence someone dependent on opioids will need to use a substantial dose of kratom to alleviate withdrawal symptoms, which could be risky, as long-term consequences are not fully understood.

The safety and effectiveness of kratom have yet to be determined in a clinical setting. The U.S. Food and Drug Administration (FDA) has expressed major concerns about the toxicity and death associated with its usage. According to the FDA, there is no scientific evidence to support the use of kratom for medical purposes. Furthermore, the FDA advises against using kratom as a substitute for prescription opioids, even if it’s to treat opioid withdrawal symptoms.

Health Risks Associated with Kratom 

It’s possible that kratom, like many herbal products, could be tainted with illegal and poisonous substances. Hence consumers should avoid purchasing unfamiliar medical items over the internet. When combined with other substances, the effects of kratom are unknown and potentially harmful. Mixing prescription opioids, over-the-counter medicines, or even alcohol with kratom has been found to cause substantial negative effects.

As of April 2018, more than 130 people had contracted Salmonella after consuming kratom in 38 states. Salmonella poisoning can be lethal, and the FDA and the Centers for Disease Control and Prevention (CDC) have linked kratom strains tainted with Salmonella to more than 199 cases in 41 states. Salmonella contamination has no visible signs, so avoiding products that may contain it is the best way to avoid becoming ill.

Kratom is most often sold as a dietary supplement in the United States. Therefore, it’s important to be aware of the following information about such products before using them:

• Federal laws in the U.S. don’t require supplement manufacturers to prove that their products are safe before selling them to consumers.
• Dietary supplements may include more or fewer ingredients than the label states, meaning you could end up taking far more than you intended.
• Dietary supplements aren’t meant to treat or prevent illnesses. Taking a supplement instead of a prescribed treatment could be harmful to your health.
• The phrase “natural” doesn’t imply that a product is safe.

Before taking kratom or any other herbal supplement, consult your doctor to ensure that the product is safe and appropriate for you.

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