The leaves of the tropical plant Mitragyna speciosa, also known as kratom leaf, are chewed for energizing and uplifting effects or used to make tea. Kratom has dozens of active compounds and its effects can range from stimulant-like to opiate-like. Its two main chemicals, mitragynine and 7-hydroxy mitragynine, bind to opioid receptors in the brain, producing morphine-like effects.
At higher doses, kratom can cause sedation and feelings of euphoria, but at lower doses it can result in alertness, physical energy, talkativeness and increased heart rate. The onset of these effects can take 10 minutes and last up to one and a half hours. The FDA states that people may experience varying effects depending on the type of kratom, strain and method of use.
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A CDC report published in the Morbidity and Mortality Weekly Report (MMWR) found that 660 calls to poison centers reported exposure to kratom between 2010 and 2015. Among these cases, 49 resulted in life-threatening signs and symptoms and one death. The kratom exposures were typically associated with combinations of multiple drugs, including acetaminophen, benzodiazepines and other botanicals, as well as narcotics.
Despite this, many patients with chronic pain and anxiety do not have viable treatment options and are turning to kratom leaf to ease their suffering. Cohen and White say doctors should encourage their patients to seek other sources of pain relief and anxiety management, such as exercise, yoga, acupuncture and CBD products. They can also find help through the three FDA-approved medications for opioid use disorder—buprenorphine, methadone and naltrexone.