Chemical Components of Kratom

The herbal medicine kratom is a leaf from the tropical Southeast Asian tree Mitragyna speciosa in the coffee plant family Rubiaceae. It's traditionally chewed, brewed or crushed into a bitter green powder. A small dose can perk you up, while a large one can numb your pain or create feelings of relaxation or euphoria. It's sometimes marketed as an alternative to opioids and has been used by people recovering from addiction. In recent years, kratom's popularity has grown in the United States as many doctors have restricted prescription opioids.

Kratom's stimulant effects are due to alkaloids in the leaves. These are absorbed in the bloodstream and travel to brain receptors that control pleasure and energy levels. When used correctly, kratom can help with chronic pain and anxiety. It can also reduce opiate withdrawal symptoms and ease opioid dependence. Some people who struggled with a heroin or other drug addiction swear kratom saved their lives and their relationships.

But the lack of regulation around kratom has raised concerns. Despite its legal status in the United States, federal agencies have warned of health risks. Those include liver damage, seizures and hallucinations — as well as 91 deaths reported by the Centers for Disease Control in 2017.

Most of the reported kratom-related deaths involved other drugs in the victims' systems — including cocaine, fentanyl and alcohol. And experts caution that it's not possible to make a definitive cause-and-effect link between the kratom and the deaths.

Researchers are studying kratom to learn more about its effects and the conditions it helps treat. Currently, most research is focused on in vitro testing to find out how individual kratom alkaloids work on the brain and body. Several laboratories at the University of Massachusetts Lowell are conducting those studies.

In the meantime, some experts urge those struggling with chronic pain or anxiety to seek treatment from their doctor instead of turning to a substance that may be unsafe. Cohen and Dwenger suggest acupuncture, yoga, exercise and other natural remedies as alternatives to kratom for pain relief. They say CBD products can be helpful for anxiety, but only if they're sourced from a reputable brand.