Through 2016 I saw a growing number of patients at Urgent Care dealing with the effects of Kratom. Some came in sick; others called worried about withdrawal or side effects. Because it came up so often, I think it’s worth sharing what I’ve learned.
Kratom comes from the leaves of a tree native to Southeast Asia. People there have used it for a long time as a painkiller, for diarrhea, or recreationally. In Washington State, it’s sold in capsules filled with powdered leaf material. Some people also brew it into tea or smoke it.
The United Nations Office on Drugs and Crime places Kratom in a group called “New Psychoactive Substances.” That same group includes Khat from East Africa, Salvia divinorum, and certain synthetic drugs such as ketamine analogs and mephedrone. As of 2016, Kratom wasn’t illegal at the federal level in the U.S., though it was illegal in countries like Thailand, where thousands of people had been arrested for related offenses (United Nations Office on Drugs and Crime, 2013). Despite that, it could be found for sale in some recreational marijuana shops here.
Kratom’s effects show up quickly and can last about five to seven hours. People use it for both stimulation and sedation. At lower doses, it may make someone feel more energetic, talkative, or sociable. At higher doses, it often causes lethargy and a sense of euphoria. Not every user finds it pleasant, and the side effects can be significant.
Some patients report nausea and vomiting, sometimes severe enough to bring them to Urgent Care. Others describe nervousness, sweating, itching, constipation, or tremors. I’ve also seen reports of hallucinations, paranoia, and even aggressive behavior.
With longer-term use, addiction becomes a real concern. People can develop cravings, lose weight, notice skin changes on the face, and report a loss of sexual desire. When they stop, withdrawal can be difficult. Symptoms may include diarrhea, muscle pain, tremors, trouble sleeping, depression, anxiety, and sudden mood swings (Drug Enforcement Administration, 2016).
In 2016, the Drug Enforcement Administration announced plans to classify Kratom as a Schedule I drug, the same category as heroin or LSD. That decision was paused after a public comment period, and at the time of writing Kratom hadn’t been rescheduled. The DEA had called it a potential “imminent hazard to public safety” (Federal Register, 2016).
If you or someone you know is using Kratom and experiencing health problems, talk with a healthcare provider.
Board Certified in Obesity Medicine and Family Medicine
This blog is for educational purposes only and does not constitute individual medical advice. Always consult your own physician before making changes to your health, medications, or treatment plan.
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