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Comment by woah | Hacker News Reader

You would see the same level of harm reduction if other opiates were legal. My guess is that what makes kratom less harmful is the legal status.

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False. Kratom (mitragyna speciosa) is unique in that it does not seem to trigger respiratory depression. So it’s not just the legal status.

However it is true that drugs like heroin (when pure) are quite safe overall - aside from the respiratory depresssion overdose scenario.

Does Kratom have other undesirable side effects? How is it on the liver? If the population present opiate users switched to Kratom, what would we see?

Instant end to opiate overdose deaths, for one.

I've heard it causes pretty significant constipation in some cases. I guess that's undesirable.

It does cause some constipation, but it's nothing compared to that caused by even 'weak' opioids like tramadol or dihydrocodeine.

Wikipedia explicitly mentions respiratory depression as a side effect of kratom: https://en.wikipedia.org/wiki/Mitragyna_speciosa

I haven't checked their sources, though.

It may be a side effect of taking huge amounts of extract, but is not possible when consuming the leaves, as far as I know. I’ve known people who claim to take an ounce (28g) of leave per day without issue. (I take btw 2-8 grams in a day myself so I can’t speak to higher doses)

In general taking excessive amounts triggers vomiting, similar to when you eat too many psilocybin mushrooms (well, some say it’s ideal to vomit shroom-wise, but I’m not a fan). So mitragyna speciosa is incredibly safe.

Unfortunately Wikipedia’s treatment of the topic could be improved, but there is very little existing literature out there. I read one review study I was pretty happy with but I’m not on a laptop so i can’t go dig up the link unfortunately

I take a muscle relaxer that is non drowsy, yet it’s listed side effects include the same statements of drowsiness seen on all muscle relaxers. They slap the same side effects on drugs of the same class.

> They slap the same side effects on drugs of the same class

They spend billions on developing and promoting these, and they can't figure out the side effects for a specific drug? Maybe they should spend just a little bit more.

Somewhat true, but that's only part of the picture. An extremely significant distinction is that, much like with cannabis, it is pretty much physically impossible to overdose to death on mitragyna speciosa by itself. It will make you feel terrible to the point of being non-functional, but it almost certainly will not kill you.

So it’s a painkiller that works as well as an opiate with a maximum dose that dwarfs the opiates. Sheesh. That alone should be enough to research its use for pain management

Back when the potential kratom ban was scaring everyone, I remember seeing a sign advertising clinical trials for those dealing with opioid addiction. The cynic in me wondered whether the trials were for some medication that mimicked kratom or any individual alkaloid

I don't think it has the same binding affinity as more powerful opiods which reduces it's addictive potential, as well the risk of overdose.

It activates mu-opioid quite strongly but not the other receptors as much (I forget their names).

Interestingly, it has a mix of opioid antagonists and agonists. I’m not sure if that specifically is why tolerance doesn’t build aggressively, or if it’s some other MoA like nmda receptor antagonism

> You would see the same level of harm reduction if other opiates were legal

We see huge harm from legal opioids which are widely mis-prescribed. They cause addiction and fail to treat the pain for which they are prescribed.

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