Kratom

Haylie Dickson

Fall 2022

History/background

Kratom is an herbal extract native to Southeast Asia and has a scientific name of mitragynine and 7-hydroxymitragynine. Users commonly brew it into tea, swallow it as a pill, crush the pills and smoke it, or chew on the leaves 1 Kratom can also be made into a liquid form that is used for muscle pain, cramps, diarrhea, or to suppress hunger.2

Slang terms

• Thang

• Kakuam

• Thom

• Ketum

• Biak

Patient.practicalpainmanagement.com

Pharmacology/drug effects

At low doses, kratom acts as a stimulant and binds to the opioid receptors in the brain.2,3 The mu-opioid agonist effects of kratom is thought to be ten times as potent as morphine. Users may feel energetic and have increased alertness while taking it. With higher doses, euphoria and relief of pain can happen for the user. With the use of very high doses, it is thought to act as a sedative.

Drug interactions/toxicology

Kratom can interact with CNS depressants, sympathomimetics, and drugs that are metabolized by the CYP-450 enzymes.4 Addiction is a risk with this drug and the patient can go through withdrawal symptoms that are similar to other stimulant withdrawals. Symptoms like dry mouth, drowsiness, and constipation are also common with kratom.

Verywell mind. What is Kratom? Accessed October 13, 2022. Verywellmind.com/kratom-for-painmanagement

Laws

In 2016, the DEA wanted to classify kratom as a schedule I drug, but was met with protests and petitions by people who are for the drug. Before this decision, kratom was considered an herbal product and was legal in most parts of the US. The abuse potential was a huge concern to the DEA, but the backlash from the public caused them to delay making a decision on the matter. Currently, kratom is legal at the federal level, but states may vary on their policies regarding the drug.5

Monitoring/drug screens

Users should watch out for respiratory depression, hallucinations, and overdose with high doses of drug. Kratom cannot be detected with a standard drug test, but can be found with a urine or blood test for an average of 5 days after use.6

Professional opinion

Kratom has cultural significance that should be respected, but clinical use of the drug has not been thoroughly studied. Using this drug for opioid withdrawal symptoms is not recommended, as kratom has some abuse potential itself. ~

H. Dickson

References

1. Kratom. Natural Medicines. Therapeutics Research Center. Stockton, CA. Accessed October 13, 2022. https://naturalmedicines-therapeuticresearch.com

2.Mayo Clinic. Kratom: Unsafe and ineffective. Accessed October 13, 2022. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171

3.DEA. Kratom. Accessed October 13, 2022. https://www.dea.gov/factsheets/kratom

4. Kratom. Natural Products Database. Facts & Comparisons eAnswers. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed October 13, 2022 http://online.factsandcomparisons.com

5.US Pharmacist. The DEA Changes Its Mind on Kratom. Accessed October 13, 2022. https://www.uspharmacist.com/article/the-dea-changes-its-mind-on-kratom

6.The Recovery Village. How Long Does Kratom Stay in the System? Accessed October 13, 2022. https://www.columbusrecoverycenter.com/blog/how-long-does-kratom-stay-in-system/