Kratom

Kratom, scientifically known as Mitragyna speciosa, is a tropical evergreen tree indigenous to Southeast Asia. The leaves of this tree have traditionally been utilised for their medicinal properties. In nations such as Thailand and Indonesia, it has been employed for centuries for various purposes, including pain relief, boosting energy, and as a means to wean off opiate addiction.¹

Kratom’s history extends back to ancient times but came to Western attention in the early 19th century when Pieter Korthals, a Dutch botanist, formally categorised the plant. Subsequently, in the 20th century, the plant underwent scientific scrutiny to isolate its active compounds—primarily mitragynine and 7-hydroxy mitragynine—contributing to its psychoactive effects.

The effects of kratom are dose-dependent. It is a stimulant at low doses, heightening alertness and sociability. At higher doses, it displays opioid-like effects, including pain relief and sedation.² However, it’s crucial to note that kratom has been associated with a range of adverse effects, such as nausea, vomiting, and increased heart rate.

Appearance

Kratom leaves are generally green and come from the Mitragyna speciosa tree. These leaves are broad, with a dark, glossy appearance when fresh. The leaves are commonly dried and either crushed or powdered for various forms of consumption, often taking on a darker, brownish or greenish hue when processed. ^2,4

Tastе

Kratom is often described as having a very bitter and astringent taste. The bitterness is considered extremely potent, making it challenging for some users to consume. To combat this, kratom is often mixed with sweeteners, juices, or other flavourings to make it more palatable.¹

Smell

Fresh kratom leaves emit a mild and somewhat grassy or herbal aroma. The smell becomes stronger and more distinctive when the leaves are dried and crushed. The scent has been described as earthy and somewhat similar to green tea when the leaves are powdered.

• Minimum to Feel Something (mg)
  The minimum amount required to feel the effects of kratom can be as low as a few grams. This is highly individual and can vary based on factors like body weight and tolerance.⁵
• Low Dose:
  Consuming 1-5 grams of raw leaves is considered a low dose. At this dosage, users may experience increased energy and focus. It’s often used to improve social interactions or during manual labour.⁷
• Common Dose:
  A moderate dose typically ranges between 5-15 grams of raw leaves. At this level, users often report feeling effects similar to opioids, such as pain relief and a feeling of euphoria.⁶
• High Dose:
  Taking more than 15 grams of raw leaves is considered a high dose and is not recommended due to the risk of severe side effects. These can include sedation and respiratory depression. Users may also experience a greater likelihood of adverse reactions like nausea and vomiting at high doses.³

Notes on What May Happen When Exceeding the High Dose
Exceeding high doses of kratom can lead to severe side effects, including respiratory depression, seizures, and even death.³ There is also a risk of experiencing extreme nausea and vomiting.⁵

Users report a range of effects such as increased energy, focus at low doses, and opioid-like effects such as euphoria and sedation at higher doses.⁶

The onset of effects can vary based on the method of consumption, but generally, the effects are felt within 5-15 minutes when taken orally.⁶

The duration of effects can last from a few hours up to half a day, depending on the dosage and individual metabolism.⁷

The risks associated with kratom use include liver damage, changes in urination, and the aforementioned risk of overdose leading to respiratory depression and death.³

There is a potential for dependency and addiction, especially with frequent and high-dose use. Withdrawal symptoms can include irritability, insomnia, and aggression.⁵

Kratom is currently not classified as a controlled substance under the UK’s Misuse of Drugs Act 1971, making it legal to buy, possess, and import for personal use. Nonetheless, the selling of kratom for human consumption is considered illegal under the UK’s Food Safety Act 1990.⁸ Kratom in the UK is usually labelled as “not for human consumption” to abide by this regulation.⁹ The lack of specific regulations for kratom has led to concerns about the lack of quality control and potential health risks, as indicated by a study on kratom legislation and its implications.¹⁰

Mixing Kratom with other drugs such as opioids, benzodiazepines, or alcohol has been reported to pose risks, including respiratory depression and death.^1,5  These combinations can amplify the sedative effects of Kratom, leading to dangerous outcomes.

1. The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BioMed Research International, 2015.https://www.hindawi.com/journals/bmri/2015/968786/
2. The medicinal chemistry and neuropharmacology of Kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse. Neuropharmacology, 134, 108–120. https://pubmed.ncbi.nlm.nih.gov/29248450/
3. FDA. (n.d.). FDA and Kratom. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom)
4. From Kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction. Neuroscience & Biobehavioral Reviews, 37(2), 138–151. https://pubmed.ncbi.nlm.nih.gov/23206666/
5. DEA. (2020). Kratom Drug Factsheet.https://www.dea.gov/sites/default/files/2020-06/Kratom-2020_0.pdf
6. NIDA. (n.d.). Kratom DrugFacts. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/kratom
7. WebMD. (n.d.). Kratom: Uses, Side Effects, Interactions, Dosage, and Warning. https://www.webmd.com/vitamins/ai/ingredientmono-1513/kratom
8. The Mix. (n.d.). Kratom. https://www.themix.org.uk/drink-and-drugs/drugs-a-z/kratom-9850.html
9. Maryland Department of Drug and Alcohol. (2016). United Kingdom Emerging Supplier of Kratom. https://mddre.maryland.gov/wp-content/uploads/sites/17/2016/12/Bulletin-United-Kingdom-Emerging-Supplier-of-Kratom-1.pdf
10. User demographics, use patterns, and implications for the opioid epidemic. Drug and Alcohol Dependence, 201, 13–20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373705/