With the exception of Sarasota County, it is currently legal to purchase and consume kratom in the state of Florida. Although a few states either have banned or have pending legislation regarding kratom, the herb is legal in most states. The most recent Florida legislation seeking to determine whether kratom should be re-classified as a controlled substance died in subcommittee in 2017. Nonetheless, there remains widespread controversy about the use, effectiveness and possible risks associated with kratom.
What is kratom?
Mitragyna speciosa is the scientific name for kratom, a tropical evergreen tree indigenous to Southeast Asia, where it’s leaves have been used for centuries for their stimulant, sedative and psychoactive effects. Traditionally, fresh kratom leaves are chewed or dried and made into a tea to achieve the desired effects. In smaller amounts or dosages, the belief is that kratom energizes workers and improves productivity, while larger amounts produce a more sedative like effect. Often purchased in pill or capsule form, as well as made into tea, kratom can also be consumed by eating or smoking.
How does kratom work?
According to the National Institute on Drug Abuse (NIDA), “Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure and decreased pain…Mitragynine can also interact with other receptor systems in the brain to produce stimulant effects.” After ingestion, the effects of kratom are felt within a few minutes and may last up to five hours.
Side effects of kratom
NIDA states that some kratom users have reported adverse health effects like nausea, seizures and psychotic symptoms. Because it is classified as an herb, kratom can be sold as a dietary or herbal supplement without FDA approval. The NIDA warns that kratom may be laced with other compounds, some of which can cause life-threatening health effects.
The most commonly reported side effects of kratom include nausea, vomiting and constipation. Other possible side effects may include:
- Agitation
- Confusion
- Lethargy
- Aggression
- Delusions
- Hallucinations
- High blood pressure
- Tachycardia (an irregular or rapid heart rate)
WebMD warns that kratom “in large doses may cause trouble breathing, brain swelling, seizure, liver damage and death.” They also state that when regular users of kratom stop taking it, they may experience uncomfortable or serious side effects, including anxiety, sleep problems, hot flashes, and anger. According to WebMD, there is an increased risk of suicide when kratom is used by those with alcohol dependency or a mental health disorder.
A study published in the medical journal Clinical Toxicology evaluated U.S. poison control reports regarding kratom use. There has been an increasing number of reports to poison control centers regarding adverse reactions linked to kratom use. Of the 1,807 exposure reports documented, 65% were reported during 2016-2017, indicating an increase over previous years. Many of these reports cited multiple-substance exposure, not solely kratom, and those resulted in the highest number of serious medical outcomes, including death. Of the 11 deaths reported, only 2 were linked to kratom use alone. The study concluded, “kratom is associated with a variety of serious medical outcomes, especially when used with other substances.”
A report released by the U.S. Centers for Disease Control and Prevention (CDC), found that in 152 of the 27,388 overdose deaths between July 2016 to December 2017, the deceased had kratom in their system. In 91 of the 152 overdoses, kratom was listed as the cause of death, although the CDC could not rule out the presence of other substances.
Ongoing research into kratom
Researchers at the University of Florida College of Pharmacy were recently awarded two grants from NIDA to study kratom. The first grant is for the study of kratom alkaloids, while the second grant is to determine the overall effectiveness of kratom.
Another focus of the studies will seek to determine why traditional kratom use in Eastern countries has not resulted in the same adverse side effects as in Western countries. “We want to find out why we are seeing more harm in the Western world when we don’t see it in Southeast Asia,” said the study’s principal investigator, Chris McCurdy, Ph.D., a professor of medicinal chemistry. The studies will look at such questions as to whether kratom use from fresh leaves versus use from dried leaves yields different effects, and whether Westerners more frequently mix kratom with other drugs or alcohol.
While kratom is legal in most of Florida, the FDA has not approved it for medical use. In fact, in November 2017, the FDA issued a warning “related to the FDA’s mounting concerns regarding risks associated with the use of kratom.” Other agencies, including the DEA, consider kratom to be a “drug of concern.” The FDA and other health agencies continue to evaluate research, studies and safety statistics related to kratom.
Meanwhile, they urge consumers not to use kratom, citing the potential for adverse health effects, and the risk for abuse, dependence, and addiction.
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