In the U.S., kratom is a relatively new drug. It contains compounds that might promote psychotropic effects that work to alter the mind. In most states, this is not an illegal substance to buy or sell.
People use kratom in the form of a capsule, pill, extract, or leaves. Someone might consider using kratom to help with the withdrawal effects from opioid drugs. Other people use kratom to experience euphoric and stimulant effects. It is possible to build a tolerance to kratom, so those using this substance should know how this happens and how best to respond.
Kratom produces both sedative and stimulant effects. There is limited research on the potential dangers and ability to develop a tolerance to kratom. The effects that kratom causes are a mixture of those seen with stimulants and opioids.
There are two primary compounds in the leaves of the kratom plant that interact with the brain’s opioid receptors, including 7-a-hydroxymitragynine and mitragynine. This works to cause sedation, reduced pain, and increased pleasure, according to the National Institute on Drug Abuse (NIDA). When mitragynine acts on other receptors in the brain, stimulant effects are produced. These can cause increase sociability, energy, and alertness.
Possible side effects of kratom use include:
Once someone takes kratom, the effects start to occur within about five to 10 minutes, according to the U.S. Drug Enforcement Administration. The high that occurs with kratom lasts for an average of two to five hours. How quickly the effects occur and how long they last appear to be the same for all of the administration methods. Using other substances with kratom, such as alcohol or stimulants, might increase the effects.
It is possible to develop a tolerance to kratom; however, the tolerance that develops is not like what people experience with benzodiazepines, alcohol, and opioids, according to Scientific American. Those using kratom to attempt to stop using opioids may develop rapid tolerance to kratom. This could also result in cross-tolerance with opioids since both substances have similar effects. This could make quitting or tapering opioids more difficult.
Tolerance might also develop for specific strains of kratom. This is possible if a person only uses one strain and does not vary the types they use. For some people, using the same strain frequently means tolerance happens faster than for people who use multiple different strains.
Kratom is not regulated in the U.S. Because of this, there is no way for people to know if it has been cut with dangerous substances. It is also unknown what the exact dosage is in each capsule or package. This means there is the potential for overdose, side effects, and tolerance related to other substances that might be present in the kratom.
There have been a few reports about kratom causing liver damage. In these cases, the people were long-term users of the drug, according to the National Institutes of Health. It is said that other organ damage might also be possible with two to eight weeks of regular use.
Since kratom works on brain receptors similarly to opioids, most people who want to recover from kratom use require help. In some cases, the withdrawal effects are so severe that people can’t achieve abstinence unless they get help from a rehabilitation facility, according to Psychology Today.
There are no established medical treatments that are used to treat kratom addiction, but behavioral therapy appears to be beneficial, according to NIDA. Several behavioral therapy options might be considered for kratom addiction treatment.
Cognitive behavioral therapy operates on the theory that people can learn to identify negative thoughts that result in negative behaviors, according to NIDA. People can determine the thoughts that contribute to their substance abuse so that they can correct the associated behaviors. This therapy emphasizes developing coping skills that will help clients to maintain their recovery on a long-term basis.
Contingency management involves reinforcing good behavior, such as abstaining from kratom use, by providing tangible rewards to people in recovery. Studies show that this method has a high level of efficacy with promoting abstinence from drugs and increasing treatment retention, according to NIDA.
This method usually involves up to two sessions a week with a counselor. The person gets vocational training, learns how to better communicate with family, and works on building social networks and new recreational activities.
Motivational enhancement therapy helps people resolve the issues they have that are preventing them from stopping drug use, NIDA says. This therapy tends to work quickly to help people get into a treatment program.
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People looking to overcome kratom dependence or addiction might also benefit from a 12-step program. These programs might be part of a comprehensive treatment plan that includes a variety of different therapy types, including those discussed above.
Those who developed a tolerance to kratom might be able to reduce their tolerance and possible dependence on this drug by taking a break. Since this drug has no established medical use, it is recommended that people not just take a break from kratom but stop taking it altogether.
It is possible to experience dependence on kratom. When someone is dependent on the drug, withdrawal symptoms are possible when they stop taking it. These symptoms might include:
The research on kratom is limited, so it is largely unknown what the long-term effects might be. People who are using this substance will ultimately benefit from stopping use, whether or not tolerance has formed.
(September 2018) Kratom. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/publications/drugfacts/kratom
September 2017. Kratom Drug Ban May Cripple Promising Painkiller Research. Scientific American. Retrieved December 2018 from https://www.scientificamerican.com/article/kratom-drug-ban-may-cripple-promising-painkiller-research/
Kratom. National Institutes of Health. Retrieved December 2018 from https://livertox.nih.gov/Kratom.htm
(January 2016) Drink to Your Misfortune: Reasons to Avoid Kratom. Psychology Today. Retrieved December 2018 from https://www.psychologytoday.com/us/blog/ending-addiction-good/201601/drink-your-misfortune-4-reasons-avoid-kratom-0
(January 2013) Kratom. Drug Enforcement Administration. Retrieved December 2018 from https://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf
Cognitive-Behavioral Therapy. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral
Contingency Management Interventions/Motivational Incentives. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0
Community Reinforcement Approach Plus Vouchers. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-1
Motivational Enhancement Therapy. National Institute on Drug Abuse. Retrieved December 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-2