Dr. Randall Dwenger
Chief Medical Officer, Mountainside Addiction Treatment Center
Dr. Randall Dwenger is board-certified in both psychiatry and addiction medicine.
Kratom seems to be everywhere these days — at vitamin shops, cafes, gas stations, online stores — it is ubiquitous. Proponents claim it is a panacea for mental health. People are using kratom to self-medicate for depression, anxiety and even to self-detox from heroin and opioids.
However, kratom is currently not regulated by the FDA. What may be advertised as kratom may contain a variety of additives, and therefore the benefits and risks are unpredictable.
Kratom’s connection to mental health
Many Americans suffer from depression and/or anxiety. In 2020, an estimated 14.8 million U.S. adults aged 18 or older had at least one major depressive episode with severe impairment in the previous year. An estimated 31% of U.S. adults experience an anxiety disorder at some time in their lives. Advocates claim that kratom has the potential to alleviate the effects of depression and anxiety by regulating mood and boosting energy levels.
What is kratom, anyway?
Kratom is a tropical tree native to Southeast Asia. For centuries, indigenous communities have consumed the leaves for a range of therapeutic purposes. They would chew kratom leaves, brew them into teas, and use the leaves in herbal remedies to alleviate fatigue, improve stamina, and ease pain.
In the US, kratom started appearing more frequently in the early 2000s. With the rise of internet and e-commerce, not only did kratom awareness grow but the drug became more accessible to people all over the country. Simultaneously, as the opioid epidemic exploded, many individuals began seeking natural pain relief remedies which helped to fuel the interest in and demand for kratom.
Nowadays kratom is commonly found on the shelves of vitamin shops and natural health food stores in powder and capsule form as an “herbal supplement.” Kratom, however, is also increasingly found in smoke shops, vape shops, convenience stores, and gas stations sold in small bottles colloquially known as “shot bottles” similar to some energy drinks.
How does kratom work and what are its effects?
Kratom’s two main active compounds are mitragynine and 7-hydroxymitragynine, which bind to the body’s opioid receptors and produce a morphine-like effect. What someone feels after taking kratom is dose-dependent, with lower doses producing stimulant effects and higher doses producing sedative effects. However, the specific reaction an individual has depends not only on the quantity consumed, but also how it is consumed, and whether any other medications or substances are taken with the kratom.
Many people who use kratom report experiencing a rush of energy, similar to the effects of cocaine or amphetamines. Other common effects are pain relief and brief periods of euphoria. Over time, kratom can lead to changes in behavior and mood. Users may become more irritable, withdrawn, and less interested in activities they once enjoyed.
Additionally, kratom may cause psychiatric confusion whereas it mimics some psychiatric disorders such as bipolar disorders. Taking stronger doses of kratom makes users more likely to experience tremors, seizures, and psychosis. The likelihood of these adverse reactions increases when other medications or substances are involved. Like many other addictive substances, regular kratom use may result in tolerance, psychological and physiological dependence, and withdrawal symptoms.
Risks of using kratom as an opioid substitute
Many people have tried to swap kratom for opioids as they believe kratom is a natural alternative. While kratom may provide some initial pain relief, users have the potential to need increasingly larger amounts to experience the same effects. This can be incredibly disruptive, both mentally by creating a fixation on next use, as well as financially as the continued high-frequency use can be very expensive.
Kratom tolerance, and eventually dependence, raises the likelihood of withdrawal symptoms for some users. When kratom use is stopped abruptly after prolonged or large quantities of use, withdrawal symptoms like anxiety, irritability, muscle aches, insomnia, and depression are common.
What happens if I become addicted to kratom?
Some people may require a medical detox from kratom if they experience a physical dependence on the substance. In addition, clinical therapy is valuable in guiding people to overcome their psychological dependence — helping them to discover the root cause of their kratom abuse and learn healthy ways to cope with stress or hardships.
Anyone struggling with kratom use should reach out for professional support. Accredited addiction treatment centers offer programming to address critical mental health concerns that may have initially caused a person to first use kratom.
Rehabs with a holistic wellness approach are especially effective in providing treatment to address a person’s totality of mental and physical needs. They also often do so by providing alternative healing practices like acupuncture, yoga, and experiential therapies that appeal to many kratom users’ desire for natural solutions.
If you are concerned about your or a loved one’s struggles with kratom use, call SAMHSA’s National Helpline at 800-662-4357. For kratom addiction treatment and care, call Mountainside Treatment Center at 855-947-6862.