For Andy, kratom produces a similar effect to the opioids he was once addicted to, giving him enough energy to get through the day and reducing some of the pain he feels from working in physically demanding jobs in fast food and factories. Kratom, a plant from Southeast Asia with stimulant and opioid-like effects that is commercially available across most of the U.S., also helped him stop drinking and quit opioids. Yet Andy is now completely dependent on kratom instead.
“It’s been kind of a blessing and a curse for me,” Andy, who requested using only his first name for privacy, told Salon in a phone interview. “I was able to quit alcohol and I don’t do opiates anymore, but I do take quite a bit of kratom now and I am addicted to kratom.”
The kratom tree (Mitragyna speciosa) is a member of the coffee family, but the similarities end there. Its leaves are dried up and ground to be sold in smoke shops, online or sometimes even cafes. Chemical compounds within the plant, especially mitragynine and 7-hydroxymitragynine, bind to the opioid receptors in the body, acting as a stimulant in lower doses and behaving more closely to an opioid at higher doses. Importantly, the alkaloids in kratom are considered “atypical opioids” so a one-to-one comparison to something like morphine isn’t entirely accurate.
At higher doses, kratom has been associated with side effects like liver injury and slowed breathing, with other drugs or medications potentially affecting a person’s susceptibility to some of these adverse outcomes. Unlike opioids though, the National Institute of Health reports that kratom fatal overdoses are “extremely rare,” and the drug has actually been used by many as a tool to cope with opioid withdrawal symptoms or quit drugs like fentanyl entirely.
“There are people who say it is very bad, and there are people who have said it has changed my life.”
As a commercially available product that is relatively affordable, many have turned to kratom when they do not have access to other treatments for conditions such as chronic pain, depression and anxiety, or substance use disorder. People with all of these conditions notoriously suffer from treatment disparities, with 94% of people with substance use disorder going untreated in 2021. Additionally, there are few available treatments for people with chronic pain, and far too few resources for the millions of Americans who experience anxiety and depression.
According to the Centers for Disease Control and Prevention (CDC), 80% of people who experienced a kratom overdose between July 2016 and 2017 had a history of substance use and 90% were untreated for pain.
Like cannabis and other medicinal plants, kratom doesn’t consist of just one drug but multiple. As mentioned, some of these alkaloids work on the central nervous system’s opioid receptors, binding to them as partial agonists. However, they don’t cause the same strong effect as something like heroin would,