What are the benefits of Kratom?

The main benefits of taking kratom include:

1. Pain relief: Kratom can help to relieve pain, and it has been used as a traditional medicine for centuries.

2. Anxiety relief: Kratom can help to reduce anxiety, and it is often used as a natural treatment for anxiety disorders.

3. Depression: Kratom can help to improve mood, and it has been used as a natural treatment for depression.

4. Addiction recovery: Kratom can help to reduce the cravings and withdrawal symptoms associated with addiction.

Kratom is often used by people who are withdrawing from heroin, morphine, and other opioids, as well as for cough, depression, anxiety, and other conditions. However, there is no scientific evidence to support these uses.

Kratom is a traditional Southeast Asian herbal medicine made from the leaves of the tropical tree Mitragyna speciosa. In recent years, it has gained popularity in the United States as a legal high. Almost two metric tons of kratom are imported from Southeast Asia monthly. A typical dose of kratom consists of three to five grams, suggesting over 15 million users in the United States. However, kratom is banned in some states and countries due to serious safety concerns. The US Food and Drug Administration (FDA) has warned consumers to avoid using products containing kratom.

In Southeast Asia, people have safely consumed kratom by chewing the leaves or brewing them into tea for centuries. But in the U.S., where it is widely available, the herb has been linked to many poison control center calls and even deaths. One reason for this difference may be that traditionally prepared kratom is from freshly harvested leaves, while kratom in the U.S. is often from dried leaf material. The drying and aging process can change the chemical composition of kratom, making it more potent and potentially more harmful.

Further potential benefits of kratom include:

1. Pain relief

2. Anxiety relief

3. Depression relief

4. Opioid withdrawal relief

5. Boost in energy levels

6. Improved focus and concentration

7. Increased libido

8. Increased appetite

9. Nausea relief

10. seizure prevention

11. Antioxidant properties

12. Anti-inflammatory properties

13. Immune system support

14. Wound healing

15. Diabetes management

16. Gastrointestinal support

17. Cardiovascular support

18. Cancer prevention

19. Addiction recovery

20. Stress relief

What are the risks of Kratom?

 The potential risks of kratom include:

1. Seizure
2. Liver damage
3. Kidney damag
4. High blood pressure
5. Hallucinations
6. Delusions
7. Psychotic symptoms
8. Addiction
9. Withdrawal symptoms
10. Constipation
11. Stomach upset
12. Weight loss
13. Dizziness
14. Dry mouth
15. Sweating
16. Increased urination
17. Skin darkening

Kratom is not regulated by the FDA and there is limited scientific research on the safety and effectiveness of kratom. Because of this, it is possible that kratom could have serious side effects. Some of the potential risks associated with kratom use include seizures, liver damage, kidney damage, high blood pressure, hallucinations, delusions, psychotic symptoms, addiction, withdrawal symptoms, constipation, stomach upset, weight loss, dizziness, dry mouth, sweating, increased urination, and skin darkening. If you are considering using kratom, it is important to speak with a healthcare provider first to discuss the potential risks and benefits.

Is Kratom Legal?

 Kratom is currently legal in most parts of the United States and banned in most countries. However, there are some exceptions. The state of Indiana has banned the sale and possession of kratom. In addition, the city of San Diego, California has banned the sale of kratom. There is also a bill pending in Florida that would make kratom a controlled substance.

What does the research say about Kratom?

 There is limited scientific research on the safety and effectiveness of kratom. However, there have been some studies that suggest kratom could have potential benefits for certain medical conditions. For example, one study found that kratom may be effective in treating chronic pain. Another study found that kratom may help to reduce anxiety and improve mood. However, more research is needed to confirm these potential benefits.

Who should not take Kratom?

Kratom is not recommended for use in children, pregnant or breastfeeding women, or people with liver or kidney disease. Kratom is also not recommended for use if you are taking medications that interact with kratom such as:

1. Antidepressants
2. Anti-anxiety medication
3. Anti-psychotic medications
4. Opioid pain medications
5. Sedatives
6. Blood thinners
7. Cancer medications
8. HIV/AIDS medications

If you are considering using kratom, it is important to speak with a healthcare provider first to discuss the potential risks and benefits.

Can Kratom be addictive?

Yes, kratom can be addictive. Kratom addiction is a serious problem that can lead to dependence and withdrawal symptoms. Some of the signs and symptoms of kratom addiction include:

1. Craving kratom
2. Taking larger doses of kratom than intended
3. Taking kratom more often than intended
4. Unable to reduce or stop kratom use despite wanting to do so
5. Continuing to use kratom despite negative consequences
6. Giving up important activities in order to use kratom
7. Using kratom to cope with anxiety or stress
8. Experiencing withdrawal symptoms when stopping kratom use

How can Kratom help with addictions?

Kratom may help with addictions by:

1. Reducing cravings for the addictive substance
2. Helping to reduce withdrawal symptoms
3. Acting as a replacement for the addictive substance
4. Helping to improve mood and reduce stress

Can Kratom can help with complex PTSD?

Research suggests that kratom may help to improve symptoms of complex PTSD. One study found that kratom was associated with reductions in:

1. Intrusive thought
2. Flashbacks
3. Avoidance behaviors
4. Negative mood states

The study also found that kratom was associated with improvements in:

1. Sleep quality
2. Social functioning
3. Quality of life

If you are considering using kratom for complex PTSD, it is important to speak with a healthcare provider first to discuss the potential risks and benefits.

What are the risks of taking Kratom?

The potential risks of taking kratom include:

1. Addiction: Kratom can be addictive, and people who take it regularly may experience withdrawal symptoms when they stop using it.
2. Liver damage: Kratom can cause liver damage, and people who take it regularly may be at risk for liver failure.
3. Seizures: Kratom can cause seizures, and people who take it regularly may be at risk for developing epilepsy.
4. Death: There have been reports of people dying from taking kratom, although the exact cause of death is unclear.

Because of the potential risks, it is important to speak with a healthcare provider before taking kratom.

What is the molecular structure of kratom?

The molecular structure of kratom is similar to that of other psychoactive drugs, such as:

1. Opiates: Kratom binds to the same brain receptors as opiates, and it produces similar effects.
2. Amphetamines: Kratom increases levels of dopamine in the brain, which produces stimulant-like effects.
3. Serotonin: Kratom increases levels of serotonin in the brain, which produces sedative-like effects.
What are the key chemicals in kratom?
The key chemicals in kratom include:

1. Mitragynine: This is the main psychoactive compound in kratom, and it produces both stimulant and sedative effects.
2. 7-Hydroxymitragynine: This is a more potent form of mitragynine, and it is responsible for the sedative effects of kratom.

Same Kratom but two different faces

Kratom has been used for centuries in Thailand and Malaysia as a tea to treat various conditions or increase stamina for outdoor laborers. It is difficult to determine when kratom first appeared in the United States, but interest grew due to reports of it being an opium substitute. There was no thought that kratom in the US could be different from kratom in Southeast Asia.

The DEA announced its intention to make kratom a Schedule 1 drug in 2016, due to concerns about public safety. This would have made the plant and two of its alkaloids, mitragynine and 7-hydroxymitragynine, illegal. However, after receiving thousands of public comments urging the DEA to reconsider, the agency withdrew its notice of intent. The DEA said it would conduct a scientific and medical evaluation of kratom before making any final decisions.

What new insights has science given us since this pause?

Since the DEA’s decision to list kratom as a Schedule 1 substance, science has taught us that there is a difference in the chemical composition of traditional kratom preparations and commercially sold dried leaf or extract products. Our recent analyses showed that traditionally prepared kratom tea does not contain detectable levels of 7-hydroxymitragyine, the alkaloid the DEA cited as being present in kratom. This difference in chemical composition may explain why kratom has different effects when consumed in different ways.

Kratom has a long history of use in Malaysia.

Kratom is traditionally consumed in Malaysia by boiling the leaves and drinking the resulting tea. This practice is done daily, and the tea is typically divided into three glasses to be consumed throughout the day. Kratom is also used recreationally in Malaysia, much like coffee or tea. It has also been traditionally used to help with withdrawal symptoms when opium users run out of their supply. This led to its use in the United States as people sought alternative methods of pain relief or ways to wean themselves off of opioids. Researchers are still trying to determine if kratom is a legitimate treatment or simply a replacement for other drugs.

Kratom contains varied levels of opioid action in the United States.

The concentration of 7-hydroxymitragynine in commercial kratom products can vary significantly, according to scientific reports. This compound is not present in freshly harvested kratom leaves, leading to speculation about why this is the case.

The plant does not produce 7-hydroxymitragynine, but the alkaloid is generated after the leaves are harvested and dried. According to previous scientific literature, 7-hydroxymitragynine has been found in up to 2% of the total alkaloid content of dried plant material.

Kratom products that are sold commercially in the United States are typically made from dried kratom leaves, or concentrated extracts of the dried leaves. 7-hydroxymitragyine is an opioid compound that has been shown to have potential for abuse. It is also known that mitragyine, the major alkaloid found in kratom, is converted to 7-hydroxymitragyine by the body’s intestine and liver.

In contrast, purified mitragynine has demonstrated little to no abuse potential and does not increase the desire to consume addictive opioids in rodents. These studies suggest that mitragynine could be used as a harm-reduction tool for opioid addiction.

The key question is how much 7-hydroxymitragyine is too much in a kratom product. This remains unanswered, but the wide variation of 7-hydroxymitragynine content may explain why there is more harm seen in the U.S. from kratom. The dietary supplement market is poorly regulated in the U.S., so it is important for consumers to be aware of the potential risks associated with kratom products.

The most recent discoveries

Kratom tea has the potential to help people who are addicted to opioids and to wean them off the drugs. However, more research is needed in humans to evaluate the safety and effectiveness of this treatment.

There is a lot of uncertainty around kratom products sold in the US, because there is no standardized product. This means that it’s difficult to know what the risks and benefits are of taking kratom. Some people may become addicted to kratom, but this is likely due to taking an inferior quality or quantity of the product. More research is needed to understand the risks and benefits of kratom so that we can make an informed decision about whether or not to take it.

Anecdotal reports suggest that kratom use can produce a variety of effects, including increased alertness, physical energy, talkativeness, sociability, sedation, changes in mood, and pain relief. Common side effects include appetite loss, erectile dysfunction, nausea and constipation. More severe side effects may include respiratory depression (decreased breathing), seizure, addiction, and psychosis. Other possible side effects include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity. If use is stopped suddenly, withdrawal symptoms may occur. Deaths have been reported with kratom both when used alone and when combined with other substances. Serious toxicity is relatively rare but can occur at high doses or when kratom is used with other substances.

As of 2018, kratom is a controlled substance in 16 countries. In 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use. In 2021, the World Health Organization’s Executive Committee on Drug Dependency investigated the risks of kratom and declined to recommend a ban following a scientific review. The committee, however, recommended kratom be kept “under surveillance.” In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts.

Uses

Kratom leaves

Kratom leaves have been used for centuries by people in Southeast Asia for their stimulant and medicinal properties. Kratom has only recently been studied in the United States, and there is currently no clinical evidence to support its use. The U.S. Food and Drug Administration (FDA) has said that there is no evidence that kratom is safe or effective for treating any condition. Kratom leaves are usually chewed, made into a tea, or taken in capsules or pills. Kratom is not typically smoked. The different varieties of kratom contain different alkaloids in different proportions. Mitragynine is the most well-known alkaloid in kratom.

Traditional Usage

Kratom has been used traditionally in medicine in cultures where the plant grows. The leaves are chewed to relieve pain, increase energy and appetite, and improve sexual desire. They are also used to treat wounds, coughs, diarrhea, and intestinal infections. Kratom is often used by workers in labor-intensive or monotonous jobs to prevent fatigue, as well as to improve mood and alleviate pain. In Thailand, kratom was used as part of religious ceremonies and to welcome guests. The herb is bitter, so it is usually combined with a sweetener before consumption.

Opioid withdrawal

There is no formal clinical evidence to support the use of kratom for treating opioid addiction. However, some people report that the withdrawal effects of kratom are less severe than traditional opioids, and so they use it in an attempt to manage their addiction. There is limited data on how often kratom is used worldwide, as it is not typically detected by drug tests. It is believed that kratom use is increasing among people who self-manage chronic pain with opioids purchased without a prescription. Kratom has a long history of being used as an opium substitute in countries like Malaysia and Thailand.

Recreational uses

At low doses, kratom produces effects similar to those of cocaine. At higher doses, kratom can produce opioid-like effects. The effects of kratom usually begin within 5-10 minutes and last for 2-5 hours. Some people have reported feeling more alert, talkative, sociable, and sexually aroused after taking kratom, as well as feeling a general sense of well-being and euphoria.

Kratom is a plant that is used by people to relieve pain, anxiety, depression, or opioid withdrawal, according to the U.S. DEA and a 2020 survey.

According to a 2007 survey, kratom was the most widely used drug in Thailand. The lifetime, past year, and past 30 days of kratom usage rates were 2.32%, 0.81% and 0.57%, respectively, among respondents aged 12–65 years.

Kratom may be combined with other psychoactive substances, such as caffeine or codeine, to produce a tea-based cocktail known as “4×100.” This drink became popular among young people in Southeast Asia and Thailand in the 2010s. Those who consumed the 4×100 were often viewed more negatively than users of traditional kratom, but not as negatively as users of heroin. As of 2012, the use of this cocktail was a severe problem among youth in three provinces along the border of Malaysia and southern Thailand.

Kratom is a plant that people use for its psychoactive effects. In the United States, kratom is widely available in head shops and online. Use of kratom has increased rapidly in the US between 2011 and 2017. By 2020, it is estimated that 15 million people in the US use kratom. Kratom effects include sedation, pleasure, and increased alertness.

Adverse effects

Kratom may cause a variety of adverse effects. In November 2017, the FDA issued a public health advisory for the drug due to its potential side effects. These side effects appear to be dose-dependent and are more common with high doses of kratom. While the exact incidence of adverse effects in kratom users is unknown, a 2019 review of 935 kratom exposures reported to U.S. poison control centers over a seven-year period found that the following signs and symptoms were common: agitation, tachycardia, drowsiness, vomiting, confusion, seizure, withdrawal, hallucinations, respiratory depression, coma, and cardiac or respiratory arrest. The study also reported two deaths and four cases of neonatal abstinence syndrome. Another 2019 review found that common side effects of kratom use include decreased appetite, anorexia, weight loss, temporary erectile dysfunction, insomnia, sweating, hyperpigmentation, hair loss, tremor, and constipation.

Kratom products in the U.S. are commonly used in doses ranging from 2–6 g of dried leaf per dose, and doses exceeding 8 g are relatively uncommon. However, there is no standard dosing system as kratom products may vary greatly in potency. At relatively low doses (1–5 g of raw leaves), at which there are mostly stimulant effects, side effects include contracted pupils and blushing; adverse effects related to stimulation include anxiety and agitation. At moderate to high doses (5–15 g of raw leaves), at which opioid effects generally appear, additional adverse effects include tachycardia (an increased stimulant effect) as well as the opioid side effects of constipation, dizziness, hypotension, dry mouth, and sweating. Kratom products can also cause vomiting, seizures, and liver damage.

Long term use of kratom can lead to developing tolerance, dependence, and withdrawal symptoms. These symptoms may include loss of appetite, weight loss, decreased sexual drive, trouble sleeping, muscle spasms, muscle and bone pains, jerky movement, watery eyes, hot flushes, fever, diarrhea, restlessness, anger and sadness.

Kratom use has been linked to reports of psychosis, although it’s still not clear if using the drug actually caused the illness or only masked it. Serious toxicity is comparatively uncommon and typically manifests at high doses or when kratom is used in combination with other drugs. When kratom is mixed with alcoholic beverages, tranquillizers, benzodiazepines, opioids, caffeine, cocaine, yohimbine, or monoamine oxidase inhibitors, herb-drug interactions may occur (MAOIs). One of the uncommon side effects of this plant at high dosages is rhabdomyolysis. Rhabdomyolysis is a condition where muscle tissue breaks down and is released into the bloodstream. Symptoms of rhabdomyolysis include muscle pain, weakness, and swelling. If not treated promptly, rhabdomyolysis can lead to kidney failure. Although rare, kratom use has also been linked to seizures and heart rhythm problems.

According to a report from the Centers for Disease Control, there were 660 reported cases of kratom exposure between 2010 and 2015. Of those, 49 (7.4%) were classified as major (life-threatening with some residual disability), 162 (24.5%) as minor (minimal symptoms that resolved quickly with no residual disability), and 275 (41.7%) as moderate (non-life-threatening, but requiring some form of treatment). In total, 92.6% of people who were exposed to kratom had no lasting effects.

In addition to kratom, one person was also found to have died after being exposed to the drugs lamotrigine and paroxetine. Lamotrigine is an anticonvulsant, while paroxetine is a mood stabilizer. No effects were recorded for 173 (26.2%) exposure calls, or poison centre staff members were unable to follow up on effects.

According to the American Association of Poison Control Centers (AAPCC), kratom use has been rapidly increasing in recent years. In 2019, there were 1807 kratom exposures reported, which is a 52-fold increase from 2011. Most of these exposures occurred in the homes of adult males and 32% of them required hospitalization. Of those who were hospitalized, 50% had a serious medical condition.

Multiple-substance exposures were related to more hospitalizations and 11 deaths, including two from kratom alone. In almost every case where multiple compounds were found during postmortem toxicology testing, fentanyl and fentanyl analogues were the most often found co-occurring chemicals. Therefore, it is important to be aware of the dangers of taking multiple substances, especially when fentanyl is involved.

If someone overdoses on kratom, the treatment is similar to what would be done for an opioid overdose. Naloxone may be used to try to counteract the effects of the kratom, although there is not yet clear evidence that it is effective.

28 people in 20 different states in the United States contracted salmonella from October 2017 to February 2018. The outbreak was likely caused by kratom pills, powder, tea, or other sources of kratom. Samples from the affected people were analyzed using a technique called whole genome sequencing. The results suggested that the salmonella outbreak was probably caused by a common kratom source.

Respiratory depression

The most common cause of death from opiate addiction is respiratory depression. Although there is not much data available, it seems that using Mitragyna speciosa (kratom) carries a moderate risk of causing respiratory depression. In 2016, the Food and Drug Administration (FDA) recognized this as a potential concern. However, the alkaloids in kratom do not seem to cause respiratory depression, according to a 2018 review.

Liver toxicity

Kratom usage has been linked to liver damage in some cases. Symptoms of liver damage include abdominal pain, black urine, itching, and jaundice. There is usually a lag time of several weeks between when kratom is first used and when symptoms appear. Blood tests can reveal different patterns of liver damage, but most users do not appear to experience any liver damage. It is not known who is more at risk for liver damage from kratom use. The exact process by which kratom damages the liver is not well understood, but one possible explanation has been put forth.

Death

Chronic kratom use can lead to increased hospitalizations and fatalities. Clinical reviews have shown that kratom overdoses can result in liver damage, convulsions, coma, and death. Kratom use was a factor in forty-four fatalities between 2011 and 2017. However, due to a lack of information, many instances could not be evaluated properly. Kratom users who pass away frequently combined it with other drugs or had preexisting medical issues.

152 people died from kratom overdoses in the US between 2016 and 2017. Of these, 91 deaths were caused by kratom as the main overdose agent, and 7 deaths were caused by kratom as the only substance found. In Sweden, nine people died after using Krypton, a combination of kratom, caffeine, and the prescription opioid painkiller O-desmethyltramadol.

Chemistry

Mitragynine

M. speciosa contains a variety of psychoactive compounds, most notably the indole alkaloids mitragynine and 7-hydroxymitragynine. These two compounds make up a significant proportion of the natural products isolable from M. speciosa leaves. In addition, at least 40 other compounds have been isolated from M. speciosa leaves, including alkaloids, terpenes, and flavonoids. These compounds produce a variety of effects on the human body, including analgesia, sedation, and stimulation. M. speciosa has a long history of use in traditional medicine and continues to be used by many people today for its unique effects.

M. speciosa produces many other secondary metabolites in addition to alkaloids. These include various saponins, iridoids, monoterpenoids, triterpenoids (such as ursolic acid and oleanic acid), and polyphenols (including the flavonoids apigenin and quercetin). Although some of these compounds have shown antinociceptive, anti-inflammatory, gastrointestinal, antidepressant, antioxidant, and antibacterial effects in cells and animal studies, there is insufficient evidence to support the clinical use of kratom in humans.

Detection in body fluids

The active compounds in kratom are not detected by a standard drug test, but can be detected by more specialized testing. Blood concentrations of mitragynine are usually 10-50 micrograms per liter in people who use the drug recreationally. Body fluids are usually tested for kratom using liquid chromatography-mass spectrometry.

Pharmacology

Kratom contains at least 54 alkaloids, which are responsible for the plant’s complex effects. The two main alkaloids, mitragynine and 7-hydroxymitragynine, are thought to be responsible for most of kratom’s effects, though other alkaloids may contribute as well.

The compounds found in kratom, mitragynine and 7-HMG, interact with the mu-opioid receptor. This partial agonist activity is what contributes to kratom’s pain-relieving effects. In addition, these compounds also block the delta-opioid receptor. Unlike traditional opioids, kratom does not cause respiratory depression or constipation. These compounds easily cross the blood-brain barrier, which allows them to quickly take effect.

Mitragynine is a compound found in kratom that seems to have several effects on the brain. It may inhibit the release of norepinephrine, block certain types of calcium channels, and interact with other receptors in the brain. This activity may explain why kratom can be dangerous when used in combination with other sedatives. Kratom also contains rhynchophylline, which is a substance that can block the activity of a certain type of brain receptor.

Mitragynine is metabolized in humans by both phase I and phase II mechanisms, with the resulting metabolites being excreted in urine. In laboratory experiments, kratom extracts were found to inhibit CYP3A4, CYP2D6, and CYP1A2 enzymes, which could potentially lead to drug interactions.

Regulation

As of January 2018, the plant and its alkaloids were not listed in any of the Schedules of the United Nations Drug Conventions. This means that they are not currently regulated by international drug control treaties.

ASEAN

As of 2013, kratom is not allowed to be included in traditional medicines and health supplements that are traded across ASEAN nations.

Australia and New Zealand

As of January 2015, kratom is classified as a narcotic in Australia and New Zealand. This means that it is illegal to possess or sell kratom in these countries.

Canada

As of October 2020, Health Canada does not allow companies to market kratom for ingestion. Kratom could be marketed for other uses, such as incense.

Europe

Since 2011, the plant has been controlled in Denmark, Latvia, Lithuania, Poland, Romania and Sweden. In the UK, the sale, import and export of kratom have been prohibited since 2016. In 2017, kratom was designated a Schedule 1 illegal drug in the Republic of Ireland. This means that it is considered to be as harmful as drugs like heroin and cocaine.

Indonesia

The Indonesian National Narcotics Agency has announced that Kratom will become an illegal substance in Indonesia in 2024. This ban has been in place since 2019, but the date of the ban going into effect was pushed out to 2024 to give Kratom farmers time to switch to other crops. If this ban goes into effect, it would likely devastate the Kratom supply in the United States, since almost all of America’s Kratom is supplied via Indonesian exports.

Malaysia

The use of kratom leaves is illegal in Malaysia. Although it is against the law, many people still use it because it grows naturally in the country and is easy to get. Some people want the government to punish those who use kratom under a different law that has harsher penalties.

Thailand

Possession of kratom leaves was illegal in Thailand until 2018, when the Thai government passed the Kratom Act 2486. The Act made planting the tree illegal, in response to a rise in its use when opium became very expensive in Thailand and the Thai government was attempting to gain control of the opium market. In 1979, the Thai government placed kratom, along with marijuana, in Category V of a five category classification of narcotics. Kratom accounted for less than two percent of arrests for narcotics between 1987 and 1992.

The Thai government has considered legalizing kratom several times, most recently in 2020. In 2018, Thailand became the first Southeast Asian country to legalize kratom for medical purposes. In 2021, Thailand fully legalized kratom and removed it from the list of Category V narcotics. This means that more than 12,000 people who had been convicted for kratom-related offences when it was still considered a narcotic were granted an amnesty.

United States

The FDA has warned consumers that kratom is unsafe and unapproved for interstate commerce. There is controversy among the public and scientific community about whether or not to make kratom a Schedule I drug.

FDA assessment

In 2019, the FDA issued a statement declaring that kratom was not approved for any medical use. They also said that kratom could be unsafe and that it remained on an import alert where imported supplies would be confiscated. In 2018, the FDA issued a mandatory recall because of concerns that some kratom-containing products could be contaminated with salmonella. Samples of the products tested positive for contamination and the manufacturer did not comply with federal requests for a voluntary recall. FDA Commissioner Gottlieb stated that the recall was based on the risk of contamination and not related to other regulatory concerns. Consumers were advised to immediately discard any such products to prevent serious health risks.

The FDA has warned against using kratom for any medical or recreational purposes, citing its potential to cause opioid-like effects. In 2018, the FDA supervised the destruction of kratom dietary supplements by a nationwide distributor in Missouri and encouraged all companies involved in kratom commerce to remove their products from the market.

The FDA has raised serious concerns about the marketing and effects of kratom in the United States, citing evidence of significant safety risks associated with its use, including death. There is currently no reliable evidence to support the use of kratom as a treatment for opioid use disorder, and the FDA does not approve any therapeutic uses of kratom.

DEA scheduling

In 2016, the DEA announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act. This drew strong protests among those using kratom to deal with chronic pain or wean themselves off opioids or alcohol. A group of 51 members of the U.S. House of Representatives and a group of nine Senators each sent letters to acting DEA administrator Chuck Rosenberg protesting the listing and around 140,000 people signed an online White House Petition protesting it. In October 2016, the DEA withdrew its notice of intent while inviting public comments over a review period ending on December 1, 2016. As of July 2016, Alabama, Arkansas, Indiana, Vermont, and Wisconsin had made kratom illegal, and the US Army had forbidden soldiers from using it. U.S. law-enforcement authorities “encountered 55 tons of kratom,” or roughly “50 million individual doses,” according to the International Narcotics Control Board between February 2014 and July 2016.

Public response

The FDA’s decision to ban kratom has been met with both criticism and support. Commissioner Gottlieb has responded to criticism by saying that the agency has done a thorough review of available evidence. However, some researchers have argued that the evidence is not strong enough to warrant a ban. The FDA’s position on kratom has also been criticized by the American Kratom Association. former commissioner Gottlieb has defended the agency’s position, stating that kratom is contributing to the U.S. opioid epidemic.

Research

Kratom is being studied for its potential benefits for certain medical conditions, including pain, opioid use disorder, and depression. However, there is no scientific evidence that kratom is safe or effective for any medical condition as of 2021. Therefore, there are concerns about its safety.