Lately there have been concerns about the safety of kratom, a withdrawal aid that has been gaining in popularity. Are these concerns valid?
If you’re in recovery from an opioid use disorder, chances are you’ve heard about kratom. Maybe you’ve even tried it yourself. Kratom has gained popularity in recent years as an alternative to traditional opioids, which some people are using as a withdrawal aid, or simply on its own for relaxation. But lately there have been some concerns that the psychotropic plant, which is native to Southeast Asia, could be dangerous or liable to cause addiction on its own. How valid are these concerns? And does using kratom still count as recovery?
Is Kratom Dangerous?
When ingested, usually orally, kratom activates some of same opioid receptors in the brain as drugs like morphine or heroin, and can share some of the same pain relieving and euphoric effects, but is not itself an opiate. Kratom’s effects are a little different than those of an opiate or a more conventional opioid such as fentanyl or methadone. The analgesic and euphoric effects are typically less pronounced than with the natural opiates and synthetic opioids that people have been using to get high for years. It also has some stimulant effects, and does not cause the same kind of respiratory depression that is often the cause of opioid overdose fatalities. For these reasons, kratom has traditionally been considered a safe substance, relative to other opioids. It is not currently scheduled in the United States, although that may change in the near future.
In April, however, the Centers for Disease Control released a report stating that kratom was responsible for 152 deaths in the United States between 2016 and 2017. News outlets were quick to report these findings. After all, if a legal substance is being touted as safe but quietly killing people, the public should know! But the CDC report merits a closer look. For example, the study looked at 27, 338 overdose deaths, meaning kratom-involved deaths only accounted for .56%. And, of those 152 deaths, only seven came back without other drugs in the system. As the report notes, that negative toxicology doesn’t fully rule out the possibility that other drugs were involved, since drug testing is an imperfect science. In the case of 145 of those kratom-involved deaths, the deceased had consumed other substances, which means the fatal event could have been caused by a negative interaction between kratom and that other substance, for example. Fentanyl and heroin were the additional substances most commonly found in the deceased, and we know that combining opioids is dangerous and can lead to increased respiratory depression, even if overdose with just one of those substances would have been unlikely.
Finally, even if we assume the seven people who only tested positive for kratom had, in fact, only consumed kratom—the report does not specify how they died. That leaves open the possibility that the person had an allergic reaction, or had some other medical condition that left him more vulnerable to the effects of kratom, or opioids in general. Essentially, the media reaction to the CDC report was likely overzealous. That doesn’t mean kratom is safe, but there is not currently any strong data pointing toward it being unsafe, either. As with any substance (peanuts kill some people), caution and attention to one’s own personal reaction is warranted.
Can Kratom Help With Opioid Addiction?
Anecdotally, some people report using kratom to help ease the pain of opioid withdrawal. Of course, because kratom activates those same opioid receptors in similar ways as more conventional opioids, using this plant to ease withdrawal is, in some ways, similar to using a milder opioid to ease withdrawal from a stronger opioid. Eventually, if your plan is to no longer have any kind of opioid dependence, you will have to stop using kratom. At that point, you can expect to experience some withdrawal. But some users report that the withdrawal from kratom is milder. Because kratom doesn’t have the same powerful euphoria as heroin or pills like oxycodone, users may find themselves better able to regulate their use—allowing them to perform a gradual tapering down that would have been considerably more difficult with their drug of choice.
Kratom and Methadone?
Of course, kratom doesn’t have the large body of research backing its efficacy enjoyed by methadone and buprenorphine. But it is legal and might be easier and cheaper to obtain for some people. So, for those who cannot access methadone and buprenorphine, kratom might serve as an alternative withdrawal aid. As with any substance, it’s up to you to pay attention to your unique reaction to the drug. If you find yourself engaging in compulsive use similar to that of other opioids, then kratom may be psychologically harmful for you. And—if you are not able to abstain from other opioids, be careful mixing in kratom as the combination could be dangerous.