A Rare E.R. that Treats Opioid Addiction on Demand
nytimes.com
nytimes.com
More to the point—a typical dose of kratom is less than $1; it’s hard to abuse since taking too much will just make you dizzy/nauseated/anxious, a mistake most users only make once; it doesn’t cause respiratory depression (doesn’t recruit β-arrestin2) so it (EDIT: probably, although we don’t know for certain) won’t kill you if you overdose; and if you’re in withdrawal, it will take you from “not fine” to “fine” within an hour without getting you particularly high or keeping you dependent like methadone/suboxone.
There are certainly downsides—e.g., it’s moderately addictive itself and can interfere with testosterone like any opioid—but its potential utility in fighting the opioid addiction epidemic is clear. If I had my way, it’d be guaranteed to remain legal and available over the counter to people over 18, thoroughly studied for side effects and drug interactions, and recommended/prescribed as an alternative PRN treatment for withdrawal symptoms—and other conditions like anxiety, if you don’t want to get hooked on benzos.
I know this: it saved multiple people in my life from opioid abuse, and myself from alcohol. That’s got to be worth something.
This is dangerous misinformation. It is known to cause seizures, psychosis, and liver toxicity, and some medical authorities say it does cause respiratory depression. It has been linked to several deaths. As with any drug, more research is needed, e.g. to isolate the effects from those of other drugs that users commonly take with it. But no one should be encouraged to put this stuff in their body.
It’s my understanding that there are no records of deaths that were clearly caused by kratom alone—but there are a few dozen cases that the FDA has published where someone has died with kratom in their system, usually alongside other drugs such as opiates, alcohol, benzos, or steroids—but also (and here’s where I call “junk science”) from a fall and a gunshot wound. We currently don’t know to what extent it interacts with other drugs—it’s a bad idea to take it with anything else that affects your breathing, or an MAOI.
As for the “won’t kill you” claim: β-arrestin2 recruitment is responsible for the main deleterious side effects of traditional opiates, including respiratory depression, constipation, and tolerance buildup. These are reduced but not eliminated when taking kratom, similar to how morphine behaves in knockout mice lacking this protein. It could still certainly kill you, although the best estimate we have right now is “you’d have to take an awful lot of it”—probably via extracts, unless you want to eat a few pounds of leaves.
Mitragynine and 7-OH-mitra are metabolised by the liver, and yes, there are some reports of liver toxicity. I have heard of seizures in cases where someone was already detoxing and susceptible. I had not heard of kratom-induced psychosis—do you have a citation handy?
Warner ML, Kaufman NC, Grundmann O (2016). "The pharmacology and toxicology of kratom: from traditional herb to drug of abuse". Int. J. Legal Med. (Review). 130 (1): 127–38. doi:10.1007/s00414-015-1279-y. PMID 26511390.
I will see if I can locate the findings of the journalist that scoured the reports that were giving to the FDA.
What I've seen in the press is several accounts of deaths where it was present in the bloodstream but there along with many other drugs:
https://www.huffingtonpost.com/entry/kratom-deaths-georgia_u...
Interesting France has been doing this since the mid 90s.