Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, where its leaves have been used in traditional medicine for centuries. It is a psychoactive substance that can produce both stimulant-like effects at low doses and opioid-like effects at higher doses.
Key Facts About Kratom
- Active Ingredients: The primary active compounds (alkaloids) are mitragynine and 7-hydroxymitragynine. These compounds interact with the same opioid receptors in the brain as opioids like morphine and heroin.
- Effects:
- Low Doses (1-5 grams): Typically produce stimulant effects such as increased energy, alertness, and talkativeness.
- High Doses (5-15 grams): Tend to produce sedative effects, including pain relief, relaxation, and euphoria.
- Usage: People commonly use kratom to self-treat chronic pain, anxiety, depression, and symptoms of opioid withdrawal. However, there is no scientific evidence to support these uses, and the FDA has not approved kratom for any medical condition.
- Legal Status: Kratom is not a federally controlled substance in the U.S.; however, its legal status varies by state and locality. The FDA has restricted it from being marketed as a drug, supplement, or food additive.
- Regulation: Kratom products are largely unregulated by the FDA, meaning there is no guarantee of a product’s purity, potency, or safety. Products have been found to contain contaminants such as heavy metals (lead, nickel) and harmful bacteria like Salmonella.
Key Traditional Uses
- To combat fatigue: Manual laborers chewed fresh leaves to increase energy and endurance during long work hours.
- Pain relief: Used as an analgesic to alleviate musculoskeletal pain.
- Opium substitute/withdrawal management: Historically used as a cheaper, more readily available alternative to help manage opium withdrawal symptoms and dependence.
- Medicinal applications: Applied as a local anesthetic, to heal wounds (poultices), and to treat symptoms such as coughs, diarrhea, and intestinal infections.
- Sociocultural practices: Used during social gatherings to receive guests and in religious or ancestral worship ceremonies in rural villages.
Timeline of Traditional Usage
| Time Period | Traditional Usage in Southeast Asia |
| Centuries Ago (Pre-1800s) | Indigenous communities in Southeast Asia (including Thailand, Malaysia, and Indonesia) began using kratom as a natural remedy and as a stimulant. The practice was deeply ingrained in the local culture, though specific documentation is unavailable. |
| 19th Century (1800s) | |
| 1831 | The Dutch botanist Pieter Willem Korthals documented the plant for the first time for Western science. |
| 1836 | Kratom was reported in scientific literature as being used in Malaysia as a substitute for opium during a period when opium addiction was a significant issue. |
| Throughout 19th Century | Manual laborers (farmers, fishermen, rubber tappers) commonly chewed the fresh leaves or brewed them into a tea to boost energy, enhance productivity, fight fatigue, and alleviate muscle pain in physically demanding conditions. It was also used in traditional medicine for various ailments like diarrhea, coughs, and as a wound poultice. |
| Mid-20th Century (1900s) | |
| 1950s | The potential for dependence and addiction became apparent, leading to its regulation or banning in some native regions, such as Malaysia under the Poisons Act 1952. |
| 21st Century (2000s-Present) | |
| 2018 | Thailand lifted the ban on the production, use, and possession of kratom for medicinal purposes, a significant shift in its native region’s policy. |
| Present Day | Traditional uses persist in rural Southeast Asian communities. Concurrently, kratom has gained significant popularity in Western countries, where it is often sold as a powder, capsules, or extracts for self-treatment of pain, anxiety, and opioid withdrawal symptoms. |
Legal Status and Grassroots Advocacy
In 2016, the Drug Enforcement Administration (DEA) issued a notice of intent to place kratom’s active components into Schedule I of the Controlled Substances Act, but ultimately withdrew the plan due to significant public and congressional backlash.
The DEA’s Initial Intent
On August 30, 2016, the DEA announced its intention to use its emergency scheduling authority to temporarily classify the main psychoactive constituents of kratom, mitragynine and 7-hydroxymitragynine, as Schedule I substances.
- Reasoning: The DEA justified this action by citing an “imminent hazard to public safety,” an increase in drug seizures, and a lack of any currently accepted medical use in the United States.
- Implications: A Schedule I classification would place kratom in the most restrictive category, alongside drugs like heroin and LSD, effectively criminalizing its manufacture, distribution, and possession.
The Reversal
The announcement generated an immediate and overwhelming negative response from various stakeholders led by a very strong grassroots advocacy movement.
- Public Response: Kratom users, who often rely on it to self-treat chronic pain, anxiety, and opioid withdrawal symptoms, organized protests, including large protest at the White House, while also creating a White House petition that garnered over 145,906 signatures, and threatened legal action.
- Congressional Response: A bipartisan group of over 50 members of Congress sent a letter to the DEA, calling the decision “hasty” and urging the agency to follow the standard procedure that includes a public comment period and scientific review.
- Scientific Concerns: Researchers expressed concern that a Schedule I status would halt federally funded research into the plant’s potential therapeutic uses, particularly as an alternative for treating opioid addiction.
Outcome
Facing intense criticism, the DEA took the unprecedented step of withdrawing its notice of intent, THE FIRST TIME IN HISTORY, on October 12, 2016. Instead of an immediate ban, the agency opened an official public comment period, which ran until December 1, 2016, to gather more information and requested that the Food and Drug Administration (FDA) expedite its scientific evaluation of kratom.
Since then, kratom has remained unscheduled at the federal level, though a handful of states have implemented their own bans. The debate over its regulation continues, with health officials periodically recommending a ban on its active components. This is what makes continuing grassroot advocacy necessary.
KRATOM STUDIES
Numerous studies are available on both Pubmed Central and Pubmed.