Could the next person please source their comment. Kratom seems a bit controversial.
I don't have the time to beyond Wikipedia, but there are sources cited in the article. A simple Google search would solve the problem here as well.
The main active substances in Kratom are Mitragynine and 7-HO-Mitragynine. According to Wikipedia[0]:
> Mitragynine is an indole-based opioid and the most abundant active alkaloid in the plant Mitragyna speciosa, commonly known as kratom[1] and biak-biak.[2] Dry kratom leaf contains roughly 1.2–2.1% mitragynine.[3]
> Mitragynine itself acts primarily via μ-opioid receptors, though its oxidation product mitragynine pseudoindoxyl, acts as an even more potent and selective μ-opioid agonist but with less affinity for δ or κ receptors.[9][10] Another alkaloid with a major contribution to the μ-opioid activity of the kratom plant is the related compound 7-hydroxymitragynine, which, while present in the plant in much smaller quantities than mitragynine, is a much more potent μ-opioid partial agonist.
Mu-opioid receptor agonism is how opioid drugs of abuse work.
Kratom contains opioids that bind to mu-opioid receptors in the brain and opioids that bind to mu-opioid receptors in the brain cause opioid addiction.
Take Kratom every day for two weeks and get back to me.
These are side effects you experience under Kratom intoxication:
> respiratory depression, constipation, histamine release and build up of tolerance (which is what leads to withdrawals upon cessation)
Each and every one of those.
Anyway[0]:
>RESULTS: More than half of the regular users (>6 month of use) developed severe Kratom dependence problems, while 45% showed a moderate Kratom dependence. Physical withdrawal symptoms commonly experienced include muscle spasms and pain, sleeping difficulty, watery eyes/nose, hot flashes, fever, decreased appetite, and diarrhoea. Psychological withdrawal symptoms commonly reported were restlessness, tension, anger, sadness, and nervousness. The average amount of the psychoactive compound, mitragynine, in a single dose of a Kratom drink was 79mg, suggesting an average daily intake of 276.5mg. Regular users who consumed ≥3 glasses Kratom per day, had higher odds of developing severe Kratom dependence, withdrawal symptoms, and inability to control Kratom craving.
> CONCLUSIONS: The findings from this study show that regular Kratom use is associated with drug dependency, development of withdrawal symptoms, and craving. These symptoms become more severe with prolonged use and suggest a stronger control of the drug.
I've been taking it almost every day for over a year.
There is no respiratory depression, and no build up of tolerance - the dose that was originally effective still is. I am not addicted; there is no compulsion to take it other than to reduce my pain.
I also stop taking it every now and then, just to check if the condition I have is showing any signs of going away - I get a very mild cold-like feeling, nothing more. Honestly, when I've stopped caffeine before, that was harder.
I was also in your shoes and told myself the same things for a long time. I had quit a few times, for long periods of time, and told myself it wasn't that bad. But each time I quit, withdrawals got worse. It won't be a mild cold-like feeling forever.
If Kratom use isn't negatively impacting your life, your dose isn't escalating and it works for you, then I'm genuinely glad that you've found something to manage your pain.
My mom has been on low doses of hydrocodone for degenerative disk disease for decades now, that works for her as well.
However, both are opioids and they carry the same risks all opioids do: opioid addiction. It would be unfair to those who are opioid and Kratom naive to pretend that addiction and all the fun facets of opioid abuse are not something inherent to Kratom. I bought into the "Kratom is safe and non-addictive" sales pitch as a teenager and suffered immensely for my naivety.
You mention tolerance, nodding, respiratory depression, histamine response and constipation... this is odd.
Constipation from kratom is nothing compared to other opioids; I just take magnesium and everything works fine. Sometimes I have to go out of the country with work, in which case I take dihydrocodeine (which is prescribed to me, but kratom works much better) - that causes far more constipation (and I also have to go through rather unpleasant withdrawals after very such trip as I switch back to kratom :(
Histamine response from kratom is also much less than other opioids - and I say that as someone with symptomatic dermographism.
And the oddest of all, respiratory depression - I'm on mobile so don't have sources to hand, but kratom has been shown to absolutely not cause respiratory depression. I know there have been cases of kratom being spiked with potent opioids such as O-desmethyltramadol, and honestly it sounds like you've had something like that. Did you buy from a head shop?
I was completely opioid-naive at the time. A teaspoon or two of Kratom had the potential to knock me out for a few hours at that point in my life.
> Histamine response from kratom is also much less than other opioids - and I say that as someone with symptomatic dermographism.
I don't have much to compare Kratom with, but I would end up scratching myself all day and night without realizing how hard I was doing it because of the analgesia.
> And the oddest of all, respiratory depression - I'm on mobile so don't have sources to hand, but kratom has been shown to absolutely not cause respiratory depression.
At that time, I would combine Kratom with the benzodiazepine I was prescribed and noticed a difficulty breathing and a drop in my breathing rate. On its own, it was pretty insignificant.
> I know there have been cases of kratom being spiked with potent opioids such as O-desmethyltramadol, and honestly it sounds like you've had something like that. Did you buy from a head shop?
I bought from different online bulk suppliers and vendors, sourced from different communities and referenced with independent rating systems. Plain leaf was pretty consistent across the better vendors.
The biggest factor in how it affected me was my complete opiate-naivety. I had never once taken an opiate before, therefore Kratom was subjectively powerful to me. Much like someone taking their first drink or smoking their first joint, I became very intoxicated.
I think the latter is a likelier explanation than a multi-national, multi-continental conspiracy between 14 disparate supply chains to adulterate only my supply of Kratom and no one else's.
> seven years almost every day
After two years, my initial doses of Kratom felt much like a cup of coffee because of tolerance.
Someone who has never taken an opiate before is going to have vastly different responses to Kratom than someone who is well into their 7 year Kratom habit.
Once you've built tolerance and gone through the dependence / withdrawal cycle, you will never have the same consistent response to opiates as you did when you were opiate-naive. Last year, I had the rest of my wisdom teeth taken out. I was prescribed 5mg Vicodin. It helped with the pain, which was very bad, but it honestly wasn't noticeable that I took anything narcotic. 7 years prior I had the same operation and was given the same medication. One 5mg Vicodin has me on my ass for hours back then.