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Kratom Capsules: 6 Facts You Need to Know

By Will Solomon, Jennifer Daluro
Kratom produces similar effects to opioids. And like opioids, kratom use can result in dependence. Read on to learn more about the effects and risks of kratom.

Kratom capsules have gained popularity as an herbal supplement for pain and depression. The substance is sometimes labeled as a dietary supplement, and it is not subject to stringent federal regulation. However, because kratom capsules can produce opioid-like effects, using them may lead to dependence. For these reasons and others, the Drug Enforcement Administration (DEA) considers kratom a “Drug and Chemical of Concern,” and the Food and Drug Administration (FDA) has specifically warned against its use. Read on for 6 facts about kratom capsules.

1. Kratom comes from a tropical tree.

“Kratom (mitragyna speciosa) is a powdered substance made from the leaf of a tropical tree in the coffee family,” Ashley Sullivan, RN, Director of Nursing at Harm Reduction Center in Boynton Beach, Florida, tells with WebMD Connect to Care.

This tree is commonly found in Southeast Asia, and the active ingredients extracted from its leaf include mitragynine and 7-hydroxymitragynine, according to the National Institute on Drug Abuse (NIDA). These are the compounds that produce kratom’s painkilling effects, especially when the substance is ingested in large amounts.

2. The effects of kratom are similar to those of opioids.

The active ingredients in kratom capsules interact with opioid receptors in the brain and can produce opioid-like effects, according to NIDA. So what exactly does kratom do? Its effects can include sedation, decreased pain, and increased pleasure or euphoria.

“The scientific consensus on kratom is that it produces stimulant effects,” Leah McMahon, LPC, EdD, adjunct professor of Psychology, and Chief Clinical Officer at Symetria Recovery tells WebMD Connect to Care. “[M]itragynine… interacts with opioid receptors in the brain to produce pleasurable and pain-reducing effects of opioids.”

NIDA also notes that some people use kratom in an attempt to control the withdrawal symptoms that result from opioid use disorder. It's important to note, however, that there is no scientific evidence supporting the efficacy or safety of kratom for this purpose. 

Ultimately, while anecdotal reports suggest kratom may have some utility in settings involving pain management, there is little clear study of how kratom might be effective in a controlled, medical environment.

3. Kratom comes in many forms besides capsules.

Kratom is frequently sold as capsules, but it comes in many forms--including pills, extracts, and powder. Some people also use dried leaves to smoke or add to foods and teas.

“Kratom use is becoming increasingly popular because it is easy to obtain,” says Sullivan.

As of the writing of this article, kratom technically remains federally legal, so it is readily available in many smoke shops, and you can even order kratom capsules or other forms of the substance online.  However, its legal status does vary by state: kratom is illegal in Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin, and has regulations or restrictions on its use in several other states.  

The U.S. DEA does not currently classify kratom as a controlled substance--although, as noted, the agency considers it a Drug and Chemical of Concern, and the FDA warns against its use. 

4. Using kratom capsules can lead to dependence.

Since kratom mimics opioid painkillers in so many ways, the drug can be dangerous. “It has a similar compound to opioids and is abused similarly,” Sullivan explains.

Experts also emphasize the role of dosage in evaluating the potency of its effects. “Many experts state that, in low doses, kratom has a stimulant effect, which results in increased energy and less need for sleep,” says McMahon, noting its particular use among young people. “This can lead to dependency for students, especially when they are giving exams and staying up till late to study. In high doses, kratom can have an effect similar to that of morphine, regulating pleasure by working on some of the brain's chemical messengers.”

According to NIDA, kratom’s opioid-like effects may also result in dependence—and there have been numerous reports of kratom addiction. At high doses, kratom can also induce a dreamlike state.

“Kratom can cause withdrawals similar to opioid withdrawals,” Sullivan continues. These symptoms include:

  • Runny nose
  • Insomnia
  • Mood and emotional changes such as irritability, aggression, and hostility
  • Muscle aches
  • Jerky movements

5. There is no scientific consensus about kratom’s safety and effectiveness.

You may have seen kratom capsules being legally sold in stores and online. But is kratom safe, and does it work? There are mixed reports.

A 2021 study published in the journal Drug and Alcohol Dependence found that substance use disorder and serious adverse effects associated with kratom were uncommon among study participants. Study participants reported using the substance for pain relief, anxiety, depression, and opioid withdrawal symptoms. However, the study does note that additional research regarding the safety and efficacy of kratom is needed, especially in light of the ongoing opioid epidemic.

Other studies and experts take a darker view of kratom. Mayo Clinic considers kratom unsafe and ineffective, while highlighting the fact that some kratom users experience cravings so severe that they require treatments normally administered for opioid use disorder. Salmonella bacteria, which can result in fatal poisoning, has also been found in kratom products. 

Other evidence also suggests dangers surrounding kratom use. A 2021 case study in the journal Chest profiled a 69-year-old woman with suspected kratom-induced pneumonitis. The study also noted that there had been 1800 calls to poison control centers related to kratom use from 2011-2017.

A 2019 review in the American Journal of Health-System Pharmacy came to similar conclusions, noting that “[k]ratom exerts opioid and alpha-2 agonistic effects, as well as anti-inflammatory and mild stimulant effects” and may have a role to play in pain management—but that the drug also has clear adverse effects, and its overall profile of use is not well-studied. In fact, this review found that kratom use can result in several troubling outcomes, such as:

  • The substance may not appear in standard drug screens and may not be recognized as an agent of harm—especially if it’s ingested with other substances of abuse. 
  • There are numerous reports of death in kratom users—although many of these fatalities involved the ingestion of multiple substances. 
  • There are records of patients becoming unable to stop using kratom.
  • Withdrawal symptoms have been reported in patients or their newborn babies after kratom cessation.

Some experienced experts note negative side effects of kratom use. These include “nausea, hallucinations, liver damage, less oxygen to the brain, leading to brain damage, [and] palpitations,” McMahon says.

Other experts concur. Kratom use can also lead to "heart attack and abnormal heartbeat, kidney and liver damage, brain disease and seizures, [and] hallucinations," Pareen Sehat, MC, RCC and registered clinical counsellor and certified mental health professional at Well Beings Counselling in Vancouver, Canada, tells WebMD Connect to Care.

One noteworthy 2021 paper published as a conference proceeding by the College of Business at Digital Commons, Texas A&M University-San Antonio attempted to evaluate the experience of kratom users on a larger scale. The paper’s authors studied the kratom-related posts of nearly 37,000 social media users. The study found high correlations with negative emotions—including anger, fear, and disgust—and high reports of negative side effects, including rashes, nausea, seizures, dry mouth, and more.

In short, the current body of research on kratom is clearly insufficient, but there are considerable warning signs that suggest it may be hazardous. It is best to consult with your doctor if you're considering using it.

6. Kratom addiction is treatable.

Despite limited study, there is considerable evidence that kratom is likely addictive and can lead to substance abuse disorder. However, like other addictions, kratom addiction can be treated. According to the American Addiction Centers, treatment is most effective in a controlled setting. It will include detox, which may involve gradually tapering off use of the drug. Antidepressants, anxiolytic medications, and other drugs may be part of the kratom withdrawal process.

A comprehensive review published in 2020 in the journal Current Drug Targets examined a range of existing material on kratom dependence and addiction treatment options; it found that kratom withdrawal leads to common withdrawal symptoms including "depressed mood, anxiety, restlessness, irritability," and others, and includes physical symptoms, as well as neonatal symptoms in babies born to mothers who use kratom. The study also noted that sublingual buprenorphine-naloxone, intravenous clonidine, and a combination of oral dihydrocodeine and lofexidine were all potentially useful components of kratom addiction treatment.

Kratom use can also be compounded by co-occuring addictions to alcohol or other drugs, in which case treatment may differ somewhat in its approach

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