Potential Risks and Side Effects of Kratom
Answering if any drug or substance is safe is never a simple yes or no answer. Many currently illegal substances started with actual medical purposes until the points of abuse caused change in legislation on the legality of the substance, such as that with heroin. Often the changes in legality are due to advancements in the medical fields with newer compounds or substances that have less chance of dependence, decreased side effects, or any associated positive advancements with the newer replacement medication. There are also times in which substances are made illegal solely on the harm that the substance causes the population due to the vast number of negative aspects associated with that substance. Lastly, which is controversial, some legalities of drugs may be fueled by other agendas and/or compensation by said parties involved. One such controversial drug regarding legality is around cannabis.
Then to answer the question, is Kratom safe? The best answer is NO, it is not a safe substance. As the author of this blog is not an expert on Kratom nor a leading medical researcher, this is an opinion only, based from research on the addictive nature of a substance which has led to fatal overdoses. Currently Kratom is legal in some of the United States, but it continues to grow in being outlawed for usage in many areas across the world. Kratom in small doses and infrequent use could be deemed as safe, but the potential for abuse and even worse addiction is why it is this author’s opinion that Kratom is not a safe substance.
Mentioned in the Kratom Part 1 blog on this website, Kratom is not currently regulated by the Food and Drug Administration (FDA) and the research on the substance is still less robust than with many other substances. From information reported to poison control centers there are multiple side effects associated with Kratom usage. Kratom is also known to be both physically and psychologically addictive, which is a very concerning side effect. Even more concerning are the associated deaths reported with Kratom, which is the most severe negative consequence of any substance usage. In many of the reported deaths there were other medications or substances in the individual’s system, but there have been overdoses reported in which Kratom is the only substance in the person’s system. This shows the potential danger of Kratom as a substance alone for fatal overdoses.
Side Effects Include:
- Loss of appetite
- Muscle soreness
- Runny nose
There are multiple noted adverse effects associated with Kratom usage. Previously mentioned the physiological and psychological addiction to Kratom could also be viewed as an adverse effect, which some of the side effects from the withdrawal could fall into this category. Other adverse reactions can be all of those commonly associated with withdrawal seen with many opioids and opiates, despite Kratom not being an opioid or opiate.
Adverse Effects Include:
- Unintended weight loss
- Liver disease
Withdrawal Effects Include:
- Muscle aches
- Emotional Changes/Instability
- Loss of appetite
Interactions with Medications
As there are lists of negative side effects and adverse effects associated with Kratom there are also some reported drug interactions that need to be noted. Most of the reported drug interactions are related to Kratom’s Central Nervous System (CNS) depressant effects. Kratom when used with barbiturates, opioids, opiates, alcohol, benzodiazepines, anxiolytics, antidepressants, and other CNS active drugs can have both synergistic and additive effects. It is important to understand the difference between additive and synergistic effects. Additive effects are rather simple, it is when combining the effects of two drugs equal the sum of the effects of each of the two drugs acting independently. This is more straight forward in figuring out how combining drug interactions will affect a person, as simple as one plus one equals two. Synergistic effects are when the combined effects of two or more drugs is greater than what would be predicted by adding their individual potencies, such as that with additive effects. The example here would be that one plus one equals three, four, five, or more. A major concern here is that when substances have synergistic effects it can lead to overdoses when abused, making this a concern with Kratom.
Currently there is little known direct drug interactions with the active substances in Kratom. This mainly means that more research into this substance and potential other drug interactions is required. It is known that Kratom can be attributed to CYP enzyme interactions. And caution is advised if Kratom is used in combination with any other medication or drugs that are a substrate of CYP isoforms 3AF, 2C19, and 1A2. This is the extent to which current medical research has defined concerns of interactions, and these interactions are still not fully understood due to the unknown routes of metabolism of the active substances in Kratom.
Regulatory Status of Kratom
The regulatory status of Kratom is constantly changing. Therefore, the provided information is only accurate at the time this blog is being written as laws in the United States and other countries could and some will change. If you are curious as to the current legality of Kratom in your area, it is important that you conduct research to see the current laws regarding this drug in your local areas. In the United States there is a great deal of varying laws around Kratom. Overall, at the Federal level the substance is still not illegal, but the Drug Enforcement Administration (DEA) has listed Kratom as a drug and chemical of concern.
To start the current state of the legality of Kratom let’s look internationally. This is not a fully comprehensive list as some countries in areas such as Africa are harder to find definitive laws regarding Kratom and the legality could vary from city to city in those countries. There are at least 28 known countries that have made Kratom completely illegal including use and possession of the drug. Many countries make it illegal due to the psychoactive properties of the drug, the potential for abuse, and the high likelihood of addiction to the substance. Countries such as China also have varying laws, such as Kratom is banned and completely illegal in Hong Kong. Most of Europe and Southeast Asia have made Kratom illegal. What is most interesting here is the areas where the Kratom tree grow have made it illegal, besides production to be shipped to other countries like the United States. Kratom is legal in Thailand, a main producer of the drug, but was only brought back to being legal in 2021. This change to the legality of this drug was largely due to the long-standing cultural tradition in Thai culture for the use of Kratom tea. Do remember as mentioned in Part 1 of this Kratom blog, that the doses typically used historically in Thailand and other countries is greatly less than that seen in concentration produced for Western countries such as the United States.
When it comes to North America there are many variations on the legality of Kratom. Currently the substance is legal in Mexico and essentially legal in Canada. However, in Canada as it is “legal” it is not considered safe for human or animal consumption. The law in Canada is that Kratom is not criminally prohibited for personal use and possession. But the sale, distribution, and other activities involving Kratom are illegal in Canda, placing this legality in a unique position in this country. When it comes to legality in the United States there are vast differences depending on the state and region.
Overall Kratom is not illegal at the Federal level in the United States, however states and regions can have differing laws and ordinances around Kratom. At the current time Kratom is outlawed completely in the states of Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. Rhode Island is reviewing the proposed Kratom Consumer Protection Act (KCPA) and may reverse the outlaw of the substance in the near future. Other states have regions which have banned the use of Kratom such as in California where the region of San Diego has a complete ban of Kratom. Other states with region specific ordinances are Colorado, Florida, Illinois, and Mississippi. New Hampshire has made it illegal for use for anyone under the age of 18 and the states of Oregon and Tennessee have the age limit set at 21.
The Kratom Consumer Protection Act (KCPA) has been passed in the states of Georgia, Nevada, Oklahoma, and Utah. The KCPA states the purpose of the bill is to ensure that individuals can legally and safely enjoy the use of Kratom. The following is all the opinion of the author of this blog and will pose questions which you should investigate and answer yourself when looking at things such as legality and the KCPA. How can a substance with unknown pharmacological effects be safely consumed? If a substance is known to cause fatal overdoses, cause physiological and psychological addiction, and have a list of negative effects, should it continue to be unregulated by the FDA and sold to consumers at stores such as gas stations and vape stores? Should laws be set forth to protect public safety while more research on the substance is performed, then monitored the amounts and concentrations if allowed to be legal to assist in decreasing overdoses and addiction? On the next parts to this blog, we will go over the known potential benefits of Kratom, precautions to usage, suppliers of Kratom, educational sources for information on Kratom, and how the industry may affect law decisions in the United States.