Kratom is all over the news, but there is a lot of misinformation out there. Today, we’re answering your questions about kratom.
In just a few short years, kratom has gone from a little-known supplement to a so-called “natural” mood-lifter sold at the gas station to a recognized public health risk. With the increased availability of 7-OH, we’re now seeing more warnings and new laws about kratom emerging. Let’s talk about kratom and 7-OH.
What is kratom?
Kratom is an extract from an evergreen tree, the Mitragyna speciosa Korth [Rubiaceae]. It is native to Southeast Asia, where it has been used for centuries for its psychological effects. Kratom causes stimulant-like effects at low doses and opioid-like effects at higher doses. Because kratom is not clearly regulated by the FDA, kratom products contain unpredictable concentrations of the kratom plant, or even none at all, at various levels of purity.
How is 7-OH different from kratom?
7-OH is a concentrated form of one of the alkaloid compounds found in the kratom leaf. (There are more than 40 alkaloids in kratom that may contribute to its effects.) The name, 7-OH, stands for its chemical name, 7-hydroxymitragynine. 7-OH can be 15-40x as potent as leaf kratom, and has a higher addiction risk. It binds to opioid receptors as morphine does—except much more strongly—and activates them.
When you buy a “kratom” powder, pill, tincture, tea, etc., you may be getting 7-OH instead of kratom, even if the label doesn’t make that clear.
How dangerous is kratom?
Both kratom and 7-OH have the potential to be addictive. The term used in the medical field is “kratom use disorder.” Learn more about how substance use disorders are diagnosed on our blog. The chance of becoming addicted can be pretty devastating. You can read one woman’s account of the impact kratom had on her husband’s life and her family’s well-being here.
Kratom and 7-OH can cause withdrawal symptoms, mood swings, increased tolerance, cravings, and overdose, and even death in severe cases.
Kratom’s health risks include liver toxicity and seizures. And because it is largely unregulated, kratom products may be contaminated with other drugs and impurities.
In recent years, there has been increasing awareness of the dangers of kratom.
If kratom is dangerous, why was it legal and unregulated for so long?
Kratom use has a long history in Asia, but has only been on the rise in the US for a relatively short period of time. While it was relatively unknown, it is understandable (but not great) that regulatory agencies weren’t focused on it. Kratom has been receiving research attention in the past decade, and laws and regulations have been following quickly on the heels of better understanding the negative effects of this substance.
It’s also important to note that in the US, dietary supplements do not have to be evaluated by the FDA for effectiveness. They can’t legally claim to treat or cure any diseases, but a lot of supplements skirt around this. The FDA has now declared that, “Kratom is not appropriate for use as a dietary supplement. FDA has concluded from available information, including scientific data, that kratom is a new dietary ingredient for which there is inadequate information to provide reasonable assurance that such ingredient does not present a significant or unreasonable risk of illness or injury.” So it is being treated now as an untested drug instead of as a dietary supplement.
Is kratom still legal?
This is a complicated question. Leaf kratom is currently still legal at the federal level, but it’s not approved as a dietary supplement or as a drug. The FDA has recommended that 7-OH be categorized as a Schedule I controlled substance, but the DEA has not yet ruled on this.
Most regulations on kratom and 7-OH are taking place at the state level. In some states, there are no regulations on kratom or 7-OH at all. In others, it is restricted by age (to purchasers over 18, like tobacco, or over 21, like alcohol). In still others, it is considered a controlled substance. Here is a list of current kratom regulations by state.
Isn’t leaf kratom safe since it’s natural?
Natural does not and never has been the same thing as “safe.” Many substances that are dangerous or bad for us occur naturally in minerals or plants. Opium is extracted from poppies. Cocaine is derived from the coca plant. The fact that they come from natural sources doesn’t change the fact that they are addictive and bring many health risks.
What is kratom withdrawal like?
It’s hard to predict when kratom withdrawal will start or how long it will last, because it is hard for people to get a clear idea of how much they’ve actually been taking. Some people experience such significant, fast-onset cravings that they re-dose every 2-3 hours to try to stay on an even keel. These individuals can begin feeling cravings and withdrawal very shortly after discontinuing use.
Kratom withdrawal symptoms can feel similar to the kind of symptoms people have from opioid withdrawal, like runny nose, body aches, irritability, and diarrhea. Some people experience kratom withdrawal symptoms similar to those of sedatives or stimulants, like lethargy, depressed mood, and anxiety.
Withdrawal symptoms tend to be worse among those who use kratom heavily and/or for a long time. Because it is more potent, 7-OH tends to cause more intense withdrawal symptoms.
What is the treatment for kratom use disorder?
Most medical providers and current research supports treating kratom use disorder with buprenorphine/naloxone. This is the same medication that is widely used to treat opioid use disorder. You may have heard of this medication as Suboxone. Buprenorphine/naloxone bonds tightly to the opioid receptors in the brain that kratom and 7-OH have been activating, relieving cravings and withdrawal symptoms.
Workit Health has many members in treatment for kratom use disorder. Click here to learn more about our online kratom program.