Assessing Mitragyna Speciosa (Kratom) in Opioid Withdrawal: A Comprehensive Review of its Efficacy and Associated Risks

Withdrawal symptoms are symptoms that occur mostly as a result of chronic drug use when individuals decide to stop using the drugs suddenly. Such drugs include nicotine, opioids, amphetamines, cannabinoids, and so on. These drugs are known to cause mind-altering states in the human brain and are, therefore, prone to abuse.

Red Vein Kratom

Red Vein Kratom Image Credit: Goldenmonk.com

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What happens to our bodies during this process is usually a result of the dependence of our bodies on these drugs. When one takes any of these drugs, what happens is that they go on to the receptors in the brain, attach themselves to those receptors, and then subserve their effects, which can include pain relief, altered state of consciousness, and so on. Over time, the brain becomes adapted to the usual regular doses, such that regular doses can no longer generate the same level of effect as before, so what these drug users do is increase the level of drug dosage so that the same level of effects can occur but at a higher dose.

When an individual can no longer do without these drugs, it is known as dependence. At this point, if an individual decides to quit these drugs suddenly, it leads to a phenomenon known as withdrawal symptoms. Although the symptoms can vary for different drugs, generally, these withdrawal symptoms can manifest as profuse sweating, intense anxiety, muscle aches, vomiting, diarrhea, and so on.

Kratom is a tropical evergreen leaf that is native to Southeast Asia. Its leaves are known to have opiate properties. The National Institute of Drug Abuse describes Kratom as a substance that can produce opioid and stimulant-like effects.

Why Kratom?

A study conducted by Marion A. Coe et al. sought to find out the reason behind the use of Kratom as a substitute for opioids. In this study, they conducted an anonymous online survey in 2017 in which 3024 kratom users aged 18 years and older living in the U.S. participated.

The results showed that over 90% of Kratom usage was majorly used to relieve pain, manage anxiety, post-traumatic stress disorders, or depression, increase energy or focus, and help cut down on opioid use or ease withdrawal. This data suggests many individuals self-prescribe Kratom for use as a substitute for opioids in many scenarios, including withdrawal symptoms.

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But why is Kratom the go-to substitute for opioids? Does the data support its function? In a study performed by L. Wilson et al., Lyophilized Kratom tea (LKT) was administered in mice, and it was confirmed that the LKT had a therapeutic effect in the treatment of pain and opioid dependence.

For the individuals who use Kratom, there seem to be many different variations of Kratom out there being sold to the public under various strains. In one study, Guido Huisman et al. explained that Kratom was sold under different strains based on the color of the leaf, for instance, Red Kratom (popularly known as Red vein Kratom), Green Kratom, and White Kratom, and the region where they were harvested from, such as Malaysia, Thailand and so on. It was discovered that a lot of marketers tried to sell these products by inferring that the color of the strains somehow played a role in the effects conveyed by Kratom. However, product analysis showed there was no significant difference between the different brands.

While it would seem that the data supports the idea of using Kratom as a substitute for Opioid usage in the treatment of opioid withdrawal, The Journal of Clinical Pharmacology, an official publication of the American College of Clinical Pharmacologists, has explained that Kratom usage has been associated with dependence with some individuals experiencing some classic symptoms of opioid withdrawal on abrupt cessation which paradoxically is the very effect, it is supposed to cure.

Clinical significance

Kratom has been shown to act as an effective substitute for opioids in the cases of opioid withdrawal. Therefore, it can be seen as a possible alternative to opioids for individuals who have become dependent on opioids and would like to be weaned off the opioids without triggering any withdrawal symptoms.

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Final thoughts

While the benefits of Kratom as an alternative to opioids have been enumerated, it is important to note that the Food and Drug Administration has not approved it for clinical usage, and some studies have shown that its use causes withdrawal symptoms as well. Therefore, caution and further studies are required to determine the actual safety profile of Kratom.

References

Abuse, N. I. on D. (2022, March 25). Kratom. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/kratom#why-use-kratom

Coe, M. A., Pillitteri, J. L., Sembower, M. A., Gerlach, K. K., & Henningfield, J. E. (2019). Kratom as a substitute for opioids: Results from an online survey. Drug and Alcohol Dependence, 202, 24–32. https://doi.org/10.1016/j.drugalcdep.2019.05.005

Hartley, C., Bulloch, M., & Penzak, S. R. (2021). Clinical Pharmacology of the Dietary Supplement, Kratom (Mitragyna speciosa). The Journal of Clinical Pharmacology, 62(5). https://doi.org/10.1002/jcph.2001

Huisman, G., Menke, M., Grundmann, O., Schreiber, R., & Mason, N. (2023). Examining the Psychoactive Differences between Kratom Strains. International Journal of Environmental Research and Public Health, 20(14), 6425. https://doi.org/10.3390/ijerph20146425

Wilson, L. L., Harris, H. M., Eans, S. O., Brice-Tutt, A. C., Cirino, T. J., Stacy, H. M., Simons, C. A., León, F., Sharma, A., Boyer, E. W., Avery, B. A., McLaughlin, J. P., & McCurdy, C. R. (2020). Lyophilized Kratom Tea as a Therapeutic Option for Opioid Dependence. Drug and Alcohol Dependence, 216, 108310. https://doi.org/10.1016/j.drugalcdep.2020.108310

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