Frequent use of high doses of kratom may cause tremors, anorexia, weight loss, seizures, and psychosis. However, in case reports associating kratom use with psychosis, it remains unclear whether kratom use directly caused psychosis or simply unmasked the condition. Herb-drug interactions may result when kratom is combined with alcohol, sedatives, benzodiazepines, opioids, caffeine, cocaine, yohimbine, or monoamine oxidase inhibitors . Rhabdomyolysis is one of the rare and serious complications of this herb at high dosage. As of 2018, kratom is a controlled substance in 16 countries and, in 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use, while others have argued that it could be a tool to help the opioid crisis.
When this happens, the body falls into a state of relaxation and, at very high doses, bliss. Kratom contains two specific alkaloids responsible for causing positive effects on people are 7-hydroxy mitragynine and Mitragynine ; generally they create a painkilling and sedative effect. Young people feel the need to drink 4×100 in hidden settings due to fears of arrest by law enforcement. In one district, 21 of 39 villages reported the presence of 4×100 users in their community. Compared to traditional use, 4×100 users are subject to some measure of community discrimination, though community perceptions are far milder than for yaba or heroin users.
If you took that much kratom, even low quality, you would get sick as hell. That’s the way to tell if you’re dealing with M Speciosa or M Hirsuta. Kratom is scheduled to become an illegal substance in Indonesia in 2024 once new regulations from the Indonesian National Narcotics Agency go into effect. This pending ban has been in place since 2019; the date of the ban going into effect was pushed out to 2024 to give Kratom farmers time to switch to other crops. Notably, this ban would likely devastate the Kratom supply in the United States, since almost all of America’s Kratom is supplied via Indonesian exports.
Kratom is under preliminary research for its possible antipsychotic and antidepressant properties. Survey studies found that some people use kratom as a self-treatment strategy for conditions such as opioid use disorder, acute pain, chronic pain, and various mental health conditions, including anxiety and depression. Kratom is also being studied in order to design novel drugs for treating pain, opioid use disorder, and alcohol use disorder. There is no scientific evidence that kratom is safe or effective for any medical condition, as of 2021, and concerns remain about its safety.
As of January 2015, kratom was controlled as a narcotic in Australia and under Medicines Regulations in New Zealand. In the U.S., as of 2015, kratom was available in outlets such as head shops and over the Internet; the prevalence of its U.S. use was unknown at the time. In the United States, kratom use increased rapidly between 2011 and 2017. By 2020, it was estimated that 15 million people in the U.S. use kratom. 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.
In 2021, the World Health Organization’s Executive Committee on Drug Dependency investigated the risks of kratom and declined to recommend a ban following a scientific review. The committee, however, recommended kratom be kept “under surveillance.” In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts. If you thought kratom and kra thum khok were the only two plants in the mitragyna genus, think again. There are actually quite a few other plants that each share a number of similarities. In addition to providing many of the same benefits as kratom, Mitragyna hirsuta provides a reliable alternative for people who cannot legally obtain kratom.
In 2017, kratom was designated a Schedule 1 illegal drug in the Republic of Ireland, under the names 7-hydroxymitragynine and mitragynine. As of 2013, kratom was listed by ASEAN in its annex of products that cannot be included in traditional medicines and health supplements that are traded across ASEAN nations. Over 18 months in 2016 and 2017, 152 overdose deaths involving kratom were reported in the United States, with kratom as the primary overdose agent in 91 of the deaths, and 7 with kratom being the only agent detected.
Reported liver biopsies tend to show cholestasis; however, blood biomarkers can show a range of cholestatic, mixed, or hepatocellular injury pattern. The majority of users do not seem to develop liver injury, and it is unclear which users are at heightened risk. The mechanism by which kratom causes liver damage in some people is unknown and poorly studied, but a model has been proposed.