Also known by many other names (Biak-Biak, Gratom, Ithang, Kakuam, Katawn, Kedemba, Ketum, Krathom, Kraton, Kratum, Madat, Maeng Da Leaf, Mambog, Nauclea, Thang, and Thom, to name a few), Kratom is the herbal extract of Mitragyna speciosa, an evergreen tree from the coffee family (Rubiaceae), which grows in several South-East Asian countries, namely Papua New Guinea, Myanmar, Malaysia, Thailand, and Indonesia.
This plant has been taking the alternative healing scene by storm as users worldwide seek to alleviate symptoms of their psychophysical disorders or break their addiction to opioids. More users still just enjoy its recreational psychoactive effects, which can vary from stimulating to sedating depending on the dose and the strain.
The scientific research conducted so far is overwhelmingly supportive of Kratom’s therapeutic effects, but with two major caveats: there have been no large-scale human clinical trials conducted yet (all studies are either on animals, in vitro, or surveys), and there are also studies indicating risks of adverse effects and forming tolerance and dependence to Kratom. Because of the lack of scientific validation and industrial regulation of this plant, we urge caution when using it.
That said, the numerous reported Kratom benefits so far appear to outweigh the risks. In this article, we will look into everything we know about the therapeutic properties of this plant, which is still relatively new to science, and try to give you an objective idea of what it can or may be used for, as well as the risks involved. But first, let’s take a brief dive into how people have been using Kratom before the West picked up on it.
Kratom has been used traditionally for at least 200 years in treating various medical and psychological symptoms, as a stimulant, and an opioid addiction breaker. It is an integral part of the culture in southern Thailand, where its leaves are chewed in ceremonies and traditional cultural performances, and, more casually, brewed in teashops for purposes of socializing. Kratom is also used by Thais to counter fatigue during agricultural and manual labor, and in seafaring. Many compare the use of Kratom in indigenous Southeast Asian cultures to the use of coca leaves in South American Andean cultures.
During the opium use epidemic in Thailand and Malaysia, which lasted from the 1830s until the 1920s, Kratom was often employed as a substitute substance to help opium users wean off from the dependence. Then, in the mid-20th century, during World War II, as the opium prices skyrocketed in the Golden Triangle (the region in SE Asia where most of the world’s supply was being produced), a new wave of recreational use began in the region. Both Thai and Malay governments were quick to regulate Kratom (Thailand banned it in 1943, Malaysia in 1952); however, as a locally abundant plant, its use was difficult to curtail.
While Kratom never reached huge popularity throughout Southeast Asia (barring southern Thailand), its recreational use has been reasonably due to its low cost and high availability. However, being an alternative to opioids has deserved it notoriety and condemnation throughout ASEAN countries and beyond.
Around 2010, there was a big spike in use among the youth in this region, especially among young Thais, who came up with a Kratom cocktail mixed with Coca Cola, cough syrup, and ice, and named “4x100.” The cheap mix became particularly widespread in the southernmost Muslim provinces of Thailand, where many of its users were also dependent on methamphetamines. They explain that they do these drugs to decompress from their difficult lives as rubber planters and laborers, compensating with these vices for the absence of alcohol, which is illegal and unavailable (or prohibitively expensive) in these parts. With a 94% rate of use among teenagers, the “4x100” epidemic grew serious enough to draw international attention.
This outbreak of Kratom abuse in Thailand added to the peculiarity of the 2018 move taken by the otherwise strict Kingdom to legalize the medicinal use of Kratom, along with cannabis. Both plants were legally sold and used until their respective bans, after which possession of either could warrant the perpetrator a hefty prison sentence. This amendment to the law, although controversial, was hailed by the global community as both progressive and respectful of local traditions of plant medicine use.
Recently, Kratom has been ‘discovered’ by the Western public. According to the FDA, it appears to have entered the American market as a dietary supplement as early as 1994. Over the last decade, however, its use as both a healing agent and a recreational psychedelic has exploded. Although there are pending localized regulatory movements happening both in some US states and in certain European countries, the plant is largely unregulated and available to buy and ship. Even in Australia, where Kratom was banned in 2005, its import and use remain prevalent under the guise of “green tea.”
The most common Kratom benefits driving its use in the West are its effectiveness in pain management, rehabilitation from alcohol and opioid dependence, for treating various emotional and mental conditions, and, recreationally, for either its stimulant, mood-enhancing (low doses), or opioid-like effects (higher doses).
Testimonials of Kratom benefits are abundantly available online, and they have even reached the mainstream media, with Forbes publishing touching accounts of individuals overcoming numerous personal issues by using this plant. According to the American Kratom Association (AKA) and independent research, an estimated ten to sixteen million people are regular users of Kratom at this point in time in the US. Europe is not far behind, although underground use is more prevalent as some countries have already taken to prohibiting the plant.
Despite anecdotal reports of its benefits, Kratom has divided both the scientific and policy-making communities due to the lack of conclusive scientific evidence pertaining to its safety and a growing body of reports focusing, conversely, on cases of adverse effects, overdoses, and deaths.
Although there have been many studies conducted on the subjective effects and psychopharmacology of Kratom, large-scale clinical trials with humans are amiss. The lack of studies influenced the FDA to eventually ban the import and manufacturing of Kratom as a dietary supplement in the US on the grounds of there being “inadequate information to provide reasonable assurance that such ingredient does not present a significant or unreasonable risk of illness or injury.”
A number of fatalities attributed to the use of Kratom have been reported in the United States, prompting the DEA to announce its intention to criminalize the plant in 2016. However, faced with a major backlash from the public and congress, as well as the scientific community, they reversed their decision.
The leading argument was that Kratom abuse is commonly concomitant with the dependence on alcohol and/or opioids. In other words, many people use Kratom to alleviate psychological conditions for which they are being medicated, break their substance addictions or, recreationally, to add the plant’s opioid-like qualities to the effects of the substance they are using. As such, the majority of overdoses that were reported to have happened cannot be attributed exclusively to Kratom; in fact, only seven deaths from the 2019 report on an eighteen-month period happened with Kratom being the only agent detected. The numbers vastly underscore the statistics and estimates on mainstream opioid overdoses (by a factor of >1,000).
Although certain studies have found that Kratom’s abuse potential is low, most research indicates that Kratom does indeed have addictive properties. A 2019 study reported that the second main active alkaloid in the plant, 7-hydroxymitragynine, creates a state of biochemical dependence, which leads to “Severe somatic withdrawal signs […] and increased level of anxiety” after administration cessation in mice.
The withdrawal symptoms in humans, which may include anxiety, depression, physical discomfort, some pain, and trouble sleeping, are often compared to opioid withdrawal, but are regularly described as significantly less intense. In fact, a recent study reported that “these effects appeared to be relatively mild, since the majority of the participants did not seek treatment for their pain and sleep problems and, in fact, the withdrawal effects only lasted between one and three days.” Getting addicted to Kratom in order to break the addiction to heroin or meth appears to be the lesser of the two evils as of now.
Finally, a danger that isn’t attributed to the plant per se but is rather a consequence of its unregulated state—some Kratom products on the market can be of dubious safety. As of May 24, 2018, 199 people in 41 US states were reported as ill with the Salmonella bacteria after consuming Kratom products. Although no deaths were recorded in this outbreak, Salmonella poisoning is potentially fatal. This is why Kratom products should be purchased only from trusted providers with a proven track record.
While it’s necessary to again point out that the research results you will read here should not be taken at face value, the animal model studies and surveys of human users that we will discuss are numerous and promising, although the results can, at times, be opposing. In any case, the field is new and lacking in large-scale human clinical trials, so we can only extrapolate based on what findings are available at the moment. Without further ado, here are some of the most prominent psychosomatic issues Kratom seems to be effective against.
In a 2018 study conducted on rats, mitragynine has been shown to help reduce self-administration of heroin. However, it had little effect on the self-administration of methamphetamine. A 2019 study found that mitragynine helped decrease morphine self-administration in rats, while the other active alkaloid in Kratom, 7-hydroxymitragynine, was found to increase morphine intake.
Both of these studies indicate that mitragynine can help with reducing opioid dependence and that the compound itself has low abuse potential; however, 7-hydroxymitragynine, which is present in Kratom in much smaller quantities than mitragynine (2% to 60%), actually appears to instigate addiction and be an addictive substance itself.
The chemical reasoning behind Kratom’s anti-addictive benefits is that it interacts with the same receptors as classic opioids (the μ-opioid receptors), but that, unlike them, it doesn’t recruit the β-arrestin protein. When this protein isn’t recruited, chemical signals that can cause side effects like respiratory failure aren’t sent out, leading to a significantly decreased chance for overdose (by a factor of 1,000). More simply put, this means that Kratom’s alkaloids mimic the effect of opioids, but, to a large degree, not their side effects.
Finally, the 2019 study also reported that 7-hydroxymitragynine, the addictive component of Kratom, was also more susceptible than morphine to treatment with classical anti-addiction pharmaceuticals. This seems to imply that the trade-off of getting addicted to Kratom in the process of breaking an opioid addiction is worth it, as the Kratom dependence seems significantly more manageable.
Results from an online survey of over 3,000 Kratom users further support its effectiveness in battling addiction—the study reports that “Over 90% of respondents who used it in place of opioids indicated that it was helpful to relieve pain, reduce opioid use, and relieve withdrawal.”
In practical terms, the positive anti-addiction effects of Kratom on humans are reported to be mood enhancement, appetite and sleep regulation, reduction in pain, anxiety, cramps, nausea, vomiting, and craving for the opioid in question.
Some of the best Kratom varieties used in managing opioid addiction include: Bali Red Vein, Sumatra Red Vein, Maeng Da, Green Thai, and Green Malay.
Effective pain management is among the most sought-out Kratom benefits and the main driving cause of the plant’s popularity. Several studies and a research review have already reported and discussed at length the analgesic effects of mitragynine.
The most relevant research, however, is hot off the press; a 2020 study conducted on rats reported that that mitragynine successfully reduces chemotherapy-induced neuropathic pain. The rats were injected with oxaliplatin (a chemotherapy drug) and were treated with mitragynine for 5-7 days. At low doses of 5 or 10 mg/kg, the compound significantly reduced the experienced pain through interaction with α-adrenoceptors, revealing that it also has an effect on the adrenergic system. This study is important as it’s the first one to actually give us insight into the biochemical processes behind Kratom’s analgesic function.
The best Kratom strains reported to produce strong analgesia include: Maeng Da Red and White Vein, and Bali Red Vein.
A low dose of 2 grams is effective in countering pain. The effect lasts for four to six hours, and work for conditions such as osteoarthritis, osteomalacia, osteoporosis, chronic backache, rheumatoid arthritis, joint pain, and others.
Aside from treating pain as a symptom, Kratom has also been shown to be able to alleviate the cause of many localized pains—inflammation. Although this mechanism of action is not sufficiently understood, it is assumed that through its inhibitory action on the parasympathetic system, mitragynine may be able to cause the contraction of the blood vessels and exhibit its anti-inflammatory effect.
The strains and dosages for inflammation are similar to those used for pain management.
Kratom has been shown to have stimulant effects at low doses. This translates to increased energy and focus. The assumed mechanisms of action that contribute to this effect are:
The best Kratom strains recommended for energy and focus are: Maeng Da Red Vein, all Bali strains, Green Malay, Borneo Red Vein, Thai White Vein, and Sumatra White Vein.
Small doses of between 1 and 4 grams are sufficient for achieving mild stimulating effects.
A 2017 research review found that Kratom users consider mood improvement and anxiety relief to be among the plant’s benefits. The analgesic effect that comes from the binding of mitragynine to the opioid receptors in the brain is assumed to play a role in Kratom’s reported anti-stress, antidepressant, and anxiolytic effects.
Red Vein Kratom strains are advised for mood enhancement, specifically the Borneo, Indo, and Bali varieties.
Low doses of just a few grams should suffice for those wanting to take advantage of this Kratom benefit.
At higher doses, some strains of Kratom have been reported to have a sedative effect. This sedation can be employed in order to help those having trouble sleeping; however, due to the higher doses needed, it is more likely that the user will develop a dependency on Kratom, so it is not recommended to use it frequently in this manner.
Red Vein strains are said to be the most calming, especially the Red Thai and Red Maeng Da varieties.
Dosages needed to depend on experience with Kratom—3 grams should suffice for beginners, while upwards of 5 grams is suitable for more experienced users..
The main deteriorating processes behind aging and disease formation are the by-products of the oxidation of our cells. The brain is especially vulnerable to oxidation; most neurodegenerative diseases can be traced back to this process.
In a 2014 in vitro study, mitragynine has been shown to have moderate antioxidant, concentration-dependent cytotoxic, and profound antiproliferative effects. This means that, outside the context of the organism, Kratom’s main compound appears to help cell preservation by impeding proliferation and oxidation, and that it even attacks cancerous cells. Far more research is needed to verify these effects, of course, but the results of this study are promising.
A 2008 study conducted on rats showed that Kratom extract had an antidiarrheal effect and inhibited intestinal transit. These effects are similar to those of morphine and are assumed to be the result of direct drug action on gut opioid receptor sites. The results were dose-dependent and the researchers used substantial doses (50-400mg/kg).
In animal studies, the antinociceptive and cough-suppressant effects of mitragynine were comparable to those of codeine. Utilizing the antitussive (anti-cough) benefits of Kratom also aligns with one of the most traditional forms of the plant’s use. However, it appears that high dosages are needed for cough suppression, so, just as with cough syrup, the potential for abuse is present.
Multiple studies have concluded that the combination of reported Kratom benefits including its antiproliferative, antioxidant, and antibacterial effects, as well as its anti-inflammatory effects and its inhibition of vascular permeability all add up to an overall positive effect of this plant on the immune system.
The traditional way of utilizing these Kratom benefits is by chewing its leaves. They can also be dried and pulverized, then swallowed in capsules or brewed into a tea. Kratom extract can be used to make a liquid product or be infused into chewing gums as well. Some people choose to smoke dried Kratom leaves or the extract, although this appears to be the least effective way or ingestion.
Kratom has quite poor oral absorption rate, although, thanks to the many other alkaloids the plant contains, it still significantly surpasses that of mitragynine alone. Still, to maximize Kratom benefits, we advise the application of one of the potentiation techniques. These are all anecdotal, but their biochemical explanations make sense. Here is a quick breakdown of the main methods:
All this said, you are advised to go low and slow with Kratom. The use of this plant builds tolerance and dependence over time, and the long-term side effects are unknown. So far, purported Kratom benefits seem to outweigh its risks, but the science behind it is in its infancy and it is best to be cautious without sufficient data.
