Kratom: Panacea or Poison?

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Kratom comes from a tree from Southeast Asia, related to the coffee plant, that contains mind altering substances in its leaves and has become a drug of abuse. The drug is legal to purchase and can be found online or in specialty shops, but the FDA may choose to ban kratom at some point due to safety concerns.

Two active compounds in the plant, mitragynine and 7-α-hydroxymitragynine are responsible for the pharmacological effects. Kratom users take the drug by eating, smoking, brewing a tea, or chewing the leaves. It interacts with opioid receptors in the brain and can produce sedation and decrease pain, especially when large amounts are consumed. When taken in smaller amounts, users may experience stimulant effects, and become more alert and sociable.

Some of the negative effects include nausea, sweating, constipation, hallucinations, and seizures. The FDA has identified kratom use as a factor in 44 deaths, mostly when mixed with other substances. Users may become addicted to kratom due to its opioid-like effects. Withdrawal symptoms are possible in regular users who stop taking the drug. Several kratom products were found to be contaminated with salmonella in 2018, causing illness in over 130 people, and 35 deaths.

Proponents of the drug believe it may be useful to curb opioid abuse and manage chronic pain associated with conditions like arthritis or fibromyalgia. It may help with depression also, due to serotonin-like effects.

Since the drug is sold as an unregulated supplement and not FDA approved as a medicine, there is not sufficient information about safety or effectiveness. Products sold as supplements may or may not contain the labeled ingredients, and may contain different amounts than claimed on the label.

For more information on kratom see https://www.drugabuse.gov/publications/drugfacts/kratom or https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171

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