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What are the signs and symptoms of Kratom abuse?

Mitragyna speciose or Kratom is from a tree of the coffee family which grows in Thailand, Malaysia, Indonesia, and Papua, New Guinea. Kratom has effects similar to both caffeine and an opiate. People use it for its euphoric effects, as well as an analgesic to manage pain, and to manage withdrawal from opiates. It has no recognized medical uses, and an official statement from the FDA (Food and Drug Administration) advises against its’s use, but is readily available for purchases on line or on head shops, aka smoke shops. The FDA has been seizing inbound shipments of Kratom and the DEA (Drug Enforcement Administration) have stated its intention to place Kratom on the schedule of controlled substances. As of 2016, six US states, Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin have made laws controlling Kratom, and the US Army has banned its use among soldiers.

What is Kratom?

Refined Kratom is a green/brown powder, which contains at least two psychoactive substances, mitragynine and 7-hydroxymitragynine, which bind to mu-opiate receptors. These are receptors in the brain and spinal cord that opiates such as heroin and morphine attach to, which produce the high and other characteristic effects of opiates. 

How Kratom is used?

The leaves of the tree are dried and pulverized, and the powder can be put in capsules for oral use, added to a smoothie, or infused in water to make a tea. In Southeast Asia, a beverage is made called 4x100, which consists of Kratom leaves, cough syrup, and Coca-Cola over ice. The quantity or potency of the psychoactive substances in Kratom are relatively weak, and are taken in doses of two to three grams. By comparison, oral Morphine is taken in doses up to 120mg over a full day. 120 mg is about 1/12th of a gram, so Kratom must be taken in about 24x that amount to produce an effect. 

What are the effects of Kratom on the user? 

Kratom has the following effects:

  • Analgesia (pain relief)
  • Euphoria (a high)
  • Energy, alertness, and wakefulness similar to caffeine 

Short term and long term Risks of using Kratom  

There have been cases of deaths in the US from using Kratom, but this is inconclusive as the Kratom had been combined with other drugs. The primary risk of any opiates is respiratory depression, which can result in death. Opiates are also highly addictive, both psychologically, and physically. The method of administration, or how the drug is used, it a critical part of whether or not dependency develops. A rule of thumb is the faster the drug works, and the faster it wears off, the more addictive it is. 

Conclusion 

It is important for the public media, government and law enforcement to react appropriately to “new “drugs, instead of overreacting in a fit of moral hysteria, or underreacting and disregarding a serious threat to public health. There is limited and contradictory information on Kratom. It appears that it is dangerous when mixed with other drugs. As Kratom works on the same parts of the nervous system as heroin and other opiates, it can be presumed that combing Kratom with opiates can increase the risk of respiratory depression. Alcohol and benzodiazepines also produce respiratory depression, making this a dangerous drug to combine with either. The other risk with using any type of non-standardized minimally researched chemical compounds from a plant source is the disparity of potency between lots. One batch of Kratom may contain more of the active ingredients than other, which increases the risk of overdose of an adverse interaction effect with other drugs or alcohol. The other risk is that diagnosis and treatment of a physical disorder is for qualified professionals, and cannot be obtained from a blog or on line video. This is a chemical substance that will have to be monitored as research is done and information emerges.