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Kratom: Harmful or Helpful?

By Dr. Ronnit Nazarian

There is little information on Kratom, and there is much misinformation out there. Some people believe Kratom is a safe drug to use because it is legal, easy to obtain, natural, advertised heavily, and has “claimed” to treat many illnesses from anxiety to diabetes to opioid withdrawal symptoms. However, the consequences of Kratom use have shown that the drug can create dependence and addiction similar to the effects of opioids (e.g., pain relief and euphoria) and stimulant properties. In some cases, Kratom can actually create Opioid withdrawal symptoms and lead to opiate use disorders or even mimic them.2

Our New York City addiction psychiatrists are here to help provide the following information:

  • What is Kratom?
  • Why it is addictive?
  • The dangers of using Kratom
  • The recommended treatment approach

What is Kratom?

Kratom leaves come from a tree in Southeast Asia. Traditionally, Kratom has been cooked in food and brewed in teas as medicine for treating coughs, diarrhea, opiate withdrawal, chronic pain, and to boost energy and sexual desire. As of lately, it has become a recreational drug as well as drug that people have used to self-treat various emotional and behavioral problems (e.g., anxiety, ADHD, opiate withdrawal). Now, Kratom can be consumed by being ground up in pills, crushed, smoked, mixed into liquids, and produced into various products (e.g., soap bars).2

Is Kratom Addictive?

Kratom has the potential to cause dependence and addiction. This potential risk may be due to people using the drug for:

  • Reward-seeking behavior
  • Prevention of exhaustion
  • Improvement in energy
  • Improvement in productivity

Relatively recently, the phenomenon “drug instrumentation” was posed to discuss non-addictive drug consumption, such as Kratom, that are meant to be used in a purposeful and goal-directed manner. Though substances that fall under this category (e.g., Kratom, Nicotine, Marijuana, pain killers, alcohol) are meant to be used purposefully, they increase potential prolonged use and, consequently, addiction because of the positive effects they experience (e.g., completing tasks, focusing for extended time).2,5 In addition to the positive effects, people have relied on Kratom to assist as a harm reduction tool in place of using other substances (e.g., opiates). Using this as a harm reduction tool causes reliance and overstimulation. There is concern that because Kratom affects the same opioid brain receptors (like morphine), it can lead to risk of addiction, abuse, and dependence.4

What are the Side Effects of Using Kratom?

  • Nausea
  • Constipation
  • Sleep problems
  • Temporary erectile dysfunction
  • Itching
  • Sweating
  • Hyperpigmentation
  • Tremor
  • Anorexia
  • Weight loss
  • Hair loss
  • Addiction potential
  • Cognitive impairment
  • Enhanced punishment tolerance
  • Reward-seeking behavior
  • Organ system injuries (kidney injury, arrhythmia, lung injury, acute respiratory distress syndrome, hepatic injury)1,2

Dangers of Kratom Use

The misinformation regarding the content and potency of Kratom is a large reason for the dangers of Kratom use. Similar to other substances (e.g., Cocaine, Marijuana), Kratom is an unregulated substance that does not have regulatory oversight. The lack of oversight to ensure the authenticity, purity, quality, potency, and safety of Kratom has a negative impact on preparations and consumptions.2 For example, while Kratom products are being advertised as natural and safe, some products have been found to carry contaminations such as heavy metals (e.g., lead) and salmonella. In fact, in 2018 Kratom supplements were linked to an outbreak of salmonella.Users can potentially be at risk for Kratom toxicity, illnesses, and other potential risks because of the lack of regulation on this substance.

What are the Signs of Kratom Toxicity?

*(Kratom toxicity particularly occurs when Kratom powder has exceeded 8 grams)

  • Agitation
  • Tachycardia
  • Drowsiness
  • Confusion
  • Seizures
  • Hallucinations
  • Coma
  • Death2

What are the Withdrawal Effects from Kratom?

  • Muscle aches
  • Irritability
  • Mood disturbances
  • Runny nose
  • Diarrhea
  • Muscle jerking1

Treatment for Kratom Use

While there currently is no published guidelines on the treatment of Kratom, it has been beneficial to approach treatment similar to treatment for patients with opioid use disorders. Treatment includes: stabilization, alleviation of symptoms during acute withdrawal, and long-term maintenance of sobriety.2

Our New York City Addiction Psychiatrists Provide Evidence-Based Treatment

At Fifth Avenue Psychiatry, addiction psychiatrists in New York City can provide more psychoeducation on Kratom and meet you where you are in your treatment. Whether you would like to reduce your use or become completely sober. We can provide you the tools to assist you in understanding the role Kratom plays in your life and ways to replace it with healthier options. We provide tools for treatment that include everything from helping with motivation, Cognitive Behavioral Therapy for opines and opined like substance (Kratom) and Pharmacological treatment of Kratom Dependence and underlying disorders.

  1. Cinosi, E., et al. (2015). Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BioMed research international, 2015, 968786. https://doi.org/10.1155/2015/968786
  2. Eastlack, S. C., Cornett, E. M., & Kaye, A. D. (2020). Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review. Pain and therapy, 9(1), 55–69. https://doi.org/10.1007/s40122-020-00151-x
  3. https://www.fda.gov/food/outbreaks-foodborne-illness/fda-investigated-multistate-outbreak-salmonella-infections-linked-products-reported-contain-kratom#time
  4. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
  5. Müller, C. P., & Schumann, G. (2011). Drugs as instruments: a new framework for non-addictive psychoactive drug use. The Behavioral and brain sciences, 34(6), 293–310. https://doi.org/10.1017/S0140525X11000057

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