There haven’t been any noteworthy conversations about a kratom ban in the U.S. However, like kratom, they also cause a high effect when misused. No, kratom and tianeptine are not the same thing. Yes, kratom can cause liver problems such as acute liver injury and, in rare cases, acute liver failure. Kratom products work as a sedative and stimulant depending on the dose and cannot be marketed as a supplement.

Kratom for Addiction & Withdrawal

Kratom, like many other mind-altering plants, has a checkered history with the legal system. Yes, kratom is legal in most (but not all) parts of the world. Green-vein kratom is usually quite balanced, offering a good array of sleep-supportive, anti-anxiety, and stimulating benefits. White vein kratom is generally thought to be the most stimulating option (with some exceptions).

Is Kratom Bad for Your Heart?

For example, instances of kidney injury , cardiotoxicity and arrhythmia 98, 99, thyroid injury and hypothyroidism lung injury/acute respiratory distress syndrome (ARDS) 101, 102, neonatal abstinence syndrome, 103–107 and hepatic injury 23, 108–116 have all been linked to kratom. For example, laboratory and epidemiological evidence identified kratom as the source of a multi-state salmonella outbreak in 2018 94, 95. Without regulatory oversight, there is little to ensure the authenticity, purity, quality, potency, and safety of commercially available kratom preparations . The authors attribute this outcome to a drastic reduction in clearance of quetiapine (a CYP3A4 substrate) secondary to the acute suppression of hepatic metabolism by kratom. As current work is limited to animal models, future studies will need to confirm the relevance of this discovery in human physiology. The metabolism of kratom alkaloids is primarily hepatic, with several cytochrome P450 (CYP) isoforms involved, including CYP3A4, with lesser contributions from CYP2D6 and CYP2C9 .

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However, as previously stated, there is currently no reliable clinical evidence that kratom is an effective alternative for achieving this purpose 30, 88. Additionally, a significant number of patients report psychiatric symptoms, most commonly nervousness, anxiety, and depression 33, 127. However, screening is dependent upon patient disclosure, as kratom is not detectable with any commercially available toxicology screens. If seizures or neurological symptoms are present, appropriate management with anti-epileptics is warranted .

The same report identified at least five cases of opioid-like neonatal abstinence syndrome in infants born to women who regularly used kratom but not opioids. A 2021 report suggests that many cases of kratom use during pregnancy likely also involve the use of other substances, and the effects of kratom alone on pregnancy are difficult to determine without further research. Learn more about pain treatment from the NIH Pain Consortium and about mental health treatment from the National Institute of Mental Health. The most well-studied kratom-related compounds are mitragynine and 7-hydroxymitragynine. Researchers are still learning how kratom and kratom compounds affect the body, as well as how short- and long-term kratom use may impact health. NIDA supports and conducts research on kratom and related chemical compounds to help inform kratom policy and health decision-making around kratom use.

How Long Does Kratom Last?

The APA recently conducted a survey that found only 19% of U.S. adults were familiar with this substance. Kratom has been a top news topic due to growing concerns about its potential for harm. NIDA is a biomedical research organization and does not provide personalized medical advice, treatment, counseling, or legal consultation. Learn more about kratom and its legal status in the United States from the Drug Enforcement Administration (DEA). To be diagnosed with a substance use disorder, a person must meet specific diagnostic criteria for continued, compulsive substance use despite negative consequences. Very little research is available on kratom use before, during and after pregnancy.

The FDA has restricted it from being marketed as a drug, supplement, or food additive. But it’s legal and available online and in many places in the U.S. For example, kratom is illegal in countries such as Singapore, Denmark, France, and Croatia.

Associated Data

Users report having higher energy levels, Kratom overview better focus, and a stronger sense of health and well-being after using microdoses of kratom. Some people have posted results of their experiences microdosing kratom. Citrus juice, like lemon or grapefruit, works best to cover the flavor and can act as a potentiator, increasing kratom’s effects.

Kratom does not denote a single, specific compound, but rather a cocktail of the psychoactive alkaloids occurring naturally in the plant. The efficacy of kratom for such purposes remains highly questionable, and more research is needed to establish a conclusive answer. To be sure, its unscheduled status and widespread availability have contributed to the expansion of kratom within Western markets . However, as of 2019, six states legislatures (Alabama, Arkansas, Indiana, Wisconsin, Rhode Island, and Vermont) have successfully passed statutes criminalizing kratom possession . This trend is also reflected in the expanding scientific literature, where the number of case reports describing kratom intoxication continue to accumulate 20–23. If accurate, this would correspond to approximately 0.9–1.5% of the US population reportedly using kratom.

• Kratom has been a top news topic due to growing concerns about its potential for harm.
• In a survey of 129 regular kratom users in the U.S., most consumed kratom daily, and most consumed 1-3 grams of kratom per dose.
• Studies suggest people may experience mild to moderate withdrawal symptoms when they stop regular kratom use,41, 42 but more research is needed to understand to what extent people develop substance use disorder symptoms related to kratom.1, 3, 9
• To date, kratom has not been found to be safe or effective for any use.
• As with just about any substance, the more often you use it, the longer it takes for it to be removed from the body.

Kratom: Weighing the Benefits and Risks

• Mitragynine works like opioid drugs such as codeine and morphine to relieve pain.
• Like yohimbine, experimental evidence indicates that mitragynine activates α-2 adrenergic postsynaptic receptors .
• As current work is limited to animal models, future studies will need to confirm the relevance of this discovery in human physiology.
• Due to lack of regulation, there’s also the risk of not knowing where the kratom you purchase is sourced from or if it might be laced with other substances.

The isolated risk of each molecule versus their contribution to polysubstance overdose has not been systematically described. Serious medical complications, including overdose and death, have been linked to Kratom and derivatives – both by themselves and when used in combination with other substances. Recently, widely available Kratom-derived products, including capsules, tonics, and pressed tablets, have increased the availability of concentrated, high potency 7-OH. Different opioid molecules exhibit wide differences in affinity for the mu receptor, as well as in how strongly they agonize (or antagonize) receptor activity. Kratom is a leafy plant native to southeast Asia, that has found popularity in the United States due its psychoactive properties. This post provides a brief overview of kratom, current concerns surrounding it, current legal status, and sources of additional information.

Thus, the selective inactivation of β-arrestin represents a desirable feature for an opioid, and suggests that mitragynine might be a useful template for designing novel opioids with more tolerable side effect profiles. Like the opioids, binding of the indole alkaloids to opioid receptors initiates G-protein-coupled receptor (GPCR) signaling; however, unlike traditional opioids, the activation of GPCRs by indole alkaloids does not initiate the β-arrestin pathway . Accordingly, these compounds have been called atypical opioids to distinguish them from morphine, semisynthetic opioids, and endogenous ligands . Importantly, the indole alkaloids in kratom are structurally and pharmacodynamically distinct from their opioid counterparts, producing partially overlapping but nonidentical effects.

Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Kapp FG, Maurer HH, Auwarter V, Winkelmann M, Hermanns-Clausen M. Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa). A coincidence of addiction to “Kratom” and severe primary hypothyroidism. Ethnopharmacology of kratom and the Mitragyna alkaloids. A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines.

The importance of these pathways has only recently become apparent, and represent a major advancement in the complex neurobiological understanding of pain . For instance, mitragynine shares considerable structural homology with yohimbine, another indole alkaloid, which has well-known adrenergic properties . This phenomenon, known as biased agonism or ligand-directed signaling, enables a single receptor to mediate multiple different intracellular effects by selectively disengaging the various signaling cascades coupled to the receptor . Its highly active oxidized metabolite, 7-OH-mitragynine, is present in far lower quantities, generally under 0.02% .

There is some evidence to suggest kratom use during pregnancy can cause withdrawal symptoms in newborns. The effects are mild compared to those of opioids or heroin. Kratom is an herbal product made from the leaves of the kratom tree (Mitragyna speciosa), said to have opioid-like effects. Further, kratom use is not recognized as a substance use disorder, which limits insurance coverage for detox and rehabilitation treatment. The researchers concluded that kratom could be used as an opioid substitute for those addicted to opioids. “If you drink it Kratom, it slows down the heart and affects your central nervous system and can damage your kidneys and liver,” he says, adding that additional studies are needed to see the drug’s full effects on the body.

The most well-studied compounds related to kratom are mitragynine and 7-hydroxymitragynine.1 (See How do kratom compounds work in the brain?) Kratom may lead to dependence and withdrawal and can cause serious adverse effects in high doses. Anecdotally, kratom is used for pain, opioid use disorder, anxiety, and other conditions.