What is Kratom?
Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia. In recent years, kratom has gained popularity in the natural health community for its natural pain-relieving properties and to elevate mood.
In cultures where the plant grows, kratom has been used in traditional medicine. The leaves are chewed to relieve musculoskeletal pain and increase energy, appetite, and sexual desire in ways similar to khat and coca. The leaves or extracts from them are used to heal wounds and as a local anesthetic. Extracts and leaves have been used to treat coughs, diarrhea, and intestinal infections. They are also used as intestinal deworming agents in Thailand.
Kratom is often used by workers in laborious or monotonous professions to stave off exhaustion as well as a mood enhancer and painkiller. In Thailand, kratom was “used as a snack to receive guests and was part of the ritual worship of ancestors and gods”. The herb is bitter and is generally combined with a sweetener.
As of 2018, there have been no formal trials to study the efficacy or safety of kratom to treat opioid addiction. Kratom is not approved for this or any other medical use.
Data on how often it is used worldwide are lacking, as it is not detected by typical drug-screening tests. Rates of kratom use appear to be increasing among those who have been self-managing chronic pain with opioids purchased without a prescription and are cycling (but not quitting) their use.
In 1836, kratom was reported to have been used as an opium substitute in Malaysia. Kratom was also used as an opium substitute in Thailand in the nineteenth century.
At low doses, kratom produces euphoric effects comparable to coca. At higher doses, kratom produces opioid-like effects. The onset of effects typically begins within five to ten minutes and lasts for two to five hours.
According to the US DEA and a 2020 survey, kratom is used in the public to alleviate pain, anxiety, depression, or opioid withdrawal.
In Thailand, a 2007 survey found that the lifetime, past year, and past 30 days kratom usage rates were 2.32%, 0.81% and 0.57%, respectively, among respondents aged 12–65 years, and was the most widely used drug in Thailand.
Commercially available kratom may be mixed with other psychoactive drugs, such as caffeine and codeine. Starting in the 2010s, a tea-based cocktail known as “4×100” became popular among some young people across Southeast Asia and especially in Thailand. It is a mix of kratom leaves, cough syrup, Coca-Cola, and ice. Around 2011, people who consumed the cocktail were often viewed more negatively than users of traditional kratom, but not as negatively as users of heroin. As of 2012, use of the cocktail was a severe problem among youth in three provinces along the border of Malaysia and southern Thailand.
In the US, as of 2015, kratom was available in head shops and over the Internet; the prevalence of its use was unknown at the time. In the United States, kratom use increased rapidly between 2011 and 2017.