Kratom: Methadone Alternative or Lethal?

Dr. Robin Barnett, EdD, LCSW, LCADC, CSAT

It’s likely you’ve never heard of kratom. Certainly, the West Coast E.R. doctor whose patient showed up suffering from kratom withdrawal never had. And when she looked it up, she discovered it is a leaf from Asia with opiate-like properties that was popular for both alternative medicine purposes and as an underground way to get high.

A quick internet search further yielded information that its medicinal properties boasted treating depression, pain, and fatigue, and—even more intriguingly—heroin addiction.

More problematically, kratom is also emerging as a way for teens to get high, yet more often than not, lands them in the E.R.

NBC News reports that:

“The leaf, which is indigenous to Southeast Asia, has been around for thousands of years, and proponents argue that it is safe and effective for many maladies, while having fewer side effects and being less addictive than pharmaceutical alternatives, such as oxycodone. In small doses, they say, kratom provides an energy boost—the plant is in the coffee family—and in larger doses it creates a mellow, sedating effect, acting on the opioid receptors.”

Often the herb is crushed, dried, and made into “kratom bars” that are sold in general stores throughout the country and online. And it’s entirely legal to sell in nearly every state.

Since it’s an herbal substance, it is not currently classified as a controlled substance, but the FDA did ban it due to its addictive properties, and sent an alert to the DEA to confiscate any shipments that may contain the substance.

The problem with kratom is closely tied to its healing properties…making the issues around its regulation more convoluted than clear.

Because kratom’s properties mimic that of other opioid plants, it can help more safely relieve typical heroin withdrawal symptoms, such as pain, nausea, and depression. However, with long-term kratom use, physical dependence often forms, including withdrawal symptoms when a person stops using it. Ironically, kratom’s withdrawal symptoms are nearly identical to heroin’s: depression, anxiety, chills, goosebumps, and aching muscles.

Though rare, kratom overdoses can happen and often include intense symptoms such as hallucinations, aggression, and tremors—and it’s these symptoms that often precipitate an E.R. visit.

Since kratom is newer to the drug abuse scene, it has yet to be thoroughly researched for efficacy and danger, yet it has plenty of clinicians concerned as they encounter more and more people suffering from its ill effects.

Still, its proponents say kratom is perfectly safe and effective in relieving painful symptoms when taken properly. However, with relatively few people aware of the drug at all, knowing how to take it properly is a problem in and of itself. But having a potentially safer alternative to methadone and, obviously, heroin, is certainly appealing to many people who suffer from addiction to dangerous opioid.

Clearly, more research needs to be conducted to yield more useful information about kratom. Until then, as with any new drug or substance that is being abused, do your homework. Find out about its origins, its proven uses, its side effects and potential dangers, and if it is banned or illegal to purchase and use in your state.

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