But many doctors say kratom (pronounced KRAY-tum or KRAH-tum) is dangerous because it works like an opioid, can make users high and can also be habit-forming. Plus, experts say, there’s no real scientific proof it can cure anything.
The federal government agrees. In May, a federal judge sentenced a Royal Oak man to two years in prison for illegally importing kratom — he claimed it was incense — and selling it as a medical treatment.
And last week the U.S. Food and Drug Administration issued warnings to two kratom distributors who made such claims. “As we work to combat the opioid crisis, we cannot allow unscrupulous vendors to take advantage of consumers by selling products with unsubstantiated claims that they can treat opioid addiction or alleviate other medical conditions,” Dr. Ned Sharpless, acting Food and Drug Administration commissioner said in a statement.
In Troy, the police department is about to begin a kratom awareness campaign. “That’s really the main concern for us — kids or some person not knowing what they’re getting into could buy this stuff,” said Sgt. Meghan Lehman.
And yet, across the nation about 15 million people use kratom, according to the American Kratom Association.
Here’s what you need to know about kratom:
What is kratom, exactly?
Kratom (Mitragyna speciosa) is an evergreen tree native to southeast Asia. A member of the coffee family, its leaves contain mitragynine and 7-hydroxymitragynine which act on opioid receptors in the brain. They’re sold as an herbal supplement, most often in capsule or powder that can be mixed with liquid. Sometimes the leaves are used for tea. In small doses, kratom acts as a stimulant. In large doses, experts say, it makes users high.
So is it an opioid?
No. It acts on the same brain receptors as opioids, but it’s not an opioid.
Is kratom legal?
It’s legal in Michigan and throughout much of the United States. It’s illegal in Washington, D.C, Indiana, Alabama, Tennessee, Arkansas, Wisconsin and Vermont. In 2016, the Drug Enforcement Administration announced it would ban kratom but later changed its mind, saying it needed more time to study the plan and consider public comments. The FDA has not approved kratom for any use and warns people to stay away from it.
When did kratom become popular?
Researchers date its use to 1836 in southeast Asia. But in the United States, its popularity began about 1½ years ago and shows no signs of leveling off. “I am seeing more kratom positive drug screens in the last six months than I have in the last four years,” said Dr. William Morrone, an addiction medicine specialist and deputy medical examiner in Bay County.
Why is it becoming popular?
So many reasons. Kratom is easy to get; it’s readily available in stores and online. It doesn’t always show up on drug screens. “With the drug screenings that are utilized in most clinics, you’re not going to detect it,” says Dr. Edward Jouney, a clinical psychiatrist at the University of Michigan medical school who specializes in addiction. It makes users feel good.
Some use it as a substitute for opioids “People … some of them, were trying to get off opiates with it,” said Brad Lander, a clinical psychologist who works in addiction medicine at the Ohio State University Wexler Medical Center. “The supply of prescription opiates is going down. I think we’re seeing some people try to shift to something else as a substitute. They figure since it’s natural, it’s totally safe,” he said. Others have suggested that it reduces opioid cravings. But Morrone said: “The people who are coming to me are taking it to … get high.”
What does the high look like?
“Usually, we’re seeing sedation and a state of euphoria, but not to the extent you’d see with heroin or fentanyl,” said Jouney.
Mac Haddow, spokesman for the American Kratom Assocation, said whatever doctors are seeing isn’t being caused by kratom. “In low doses, it’s a stimulant. If you take a lot of kratom in one sitting .. it does not create any euphoric effect. None,” he said. “If you’re getting a euphoric effect from kratom, you’re getting an adulterated product.” You’re getting kratom that’s been cut with something else.
You mean kratom could be contaminated?
“It’s not regulated,” said Lander. “When you’re getting kratom, you don’t know what you’re getting. You never know what’s in it.” The FDA has said it has found high levels of heavy metals in kratom products. Last year, a multistate salmonella outbreak — which included Michigan — was linked to kratom.
The American Kratom Association is in favor of regulating kratom.
Can you really become addicted to kratom?
Yes, but the severity of that addiction — or dependency — is the subject of debate.
“There’s no question there’s a dependency that can develop much like caffeine,” Haddow said. “If you go off that dependency, your withdrawal symptoms typically last four to five days. You have a headache, you might have a minor upset stomach. … You might have some associated pain with the headache (but) not the particular withdrawal symptoms you see (with opioids.)”
Morrone: “When you’re addicted to kratom and you don’t get it, you go through withdrawals like fentanyl and heroin. You crap on yourself, you vomit, your body aches, you have panic attacks.”
Can you overdose on kratom?
Many doctors say you can. In addition, the Mayo Clinic lists these potential side effects for kratom: weight loss, dry mouth, chills, nausea, vomiting, constipation, changes in urine, liver damage, muscle pain, dizziness, drowsiness, hallucinations, depression, delusion, seizure and coma.
Can you die from kratom?
According to a new report from the U.S. Centers for Disease Control and Prevention, kratom was determined to be a cause of death in 91 overdoses from July 2016 to December 2017. In seven of those deaths, kratom was the only substance detected in toxicology test, though the CDC said it couldn’t rule out other substances might be present.
“Pure kratom does not act as an opioid, it does not kill people,” said Haddow. “It’s when it’s adulterated when it’s a problem.”
What’s next for kratom?
Research. “I would highly caution anybody to use it at this point and it’s because there’s just not enough research, clinical trials or research to establish it has clinical effects,” Lique Coolen, a Kent State University biology professor who studies addiction.
“It’s really poorly understood,” said Dr. Ryan Marino, an emergency medicine physician and toxicologist at the University of Pittsburgh Medical Center. “It’s kind of concerning when people just want to outlaw a substance without understanding it. I understand the desire to protect people but it would be (good) to understand what we’re protecting people from.”