Kratom, a drug that has been used in Southeast Asia for centuries, has been gaining ground in the U.S., slowly catching up to the commercial popularity of cannabidiol products.
While cannabidiol, or CBD, is extracted from marijuana, kratom is an herbal drug from the Mitragyna speciosa tree that can be chewed, taken as a capsule or consumed as a tea. CBD mostly acts as a pain reliever and relaxant, while kratom can act as a stimulant at low doses and as an opiate in higher doses.
Using national data, Joseph Palamar, an associate professor at New York University Langone Medical Center, estimated that 0.7 percent of the U.S. population has used kratom in the past year.
"Given that people who use opioids are underrepresented in national survey data, I further estimate that still only about 1 percent of the U.S. has used kratom in the past year," he told Newsweek.
CBD is still more popular, however. According to a 2019 Consumer Reports CBD survey, 40 percent of people aged 18 to 29 have tried CBD in the U.S.
Uses of Kratom and CBD
Kratom has a thriving community of fans online. Jenn Lauder, the director of marketing and advocacy at kratom company PDX Aromatics, told Air Mail that there may be upward of 10 million kratom buyers.
While some take it as a stand-in for other drugs like Xanax or Adderall, others report that kratom helps to alleviate their opiate withdrawal symptoms and manages mental health problems.
"It seems to really have become pervasive across [New York] in the last year," one kratom user told Air Mail. "I got really into it immediately. It's just such a treat."
The effects of the drug depend on the dosage and the type of kratom the user consumes. Kratom bars, which can be obtained in New York City and Los Angeles, come in red, gold, white and green colors, all with different types of high.
CBD is self-administered to treat a raft of different ailments, including chronic pain, anxiety, acne, insomnia, Parkinson's disease and even cancer symptoms.
How Do They Work?
According to Albert Garcia-Romeu, an assistant professor at the Johns Hopkins University School of Medicine's Behavioral Pharmacology Research Unit, the dosage-dependent effects of kratom are due to a variety of different alkaloids contained in the drug.
"Different drugs can have dose-dependent effects [such as] having a buzz from one or two drinks versus being passed out and vomiting from nine or 10 drinks. So this is part of the different effects people report based on how much they use," he said.
"However, kratom contains varying levels of over 40 different alkaloids, each of which can have different pharmacological activity, including on the opioid, serotonin and adrenergic systems; can occur at different levels in different plants; and can degrade or become more potent over time," Garcia-Romeu said.
Kratom is the agonist, or activating chemical, of adrenergic and opioid receptors, while CBD works on a different set of receptors in the brain, the endocannabinoid system.
Effects of Kratom and CBD
The long-term effects of kratom usage are not known, according to the National Institute on Drug Abuse, although it is an area of active research.
Other types of commonly used recreational drugs, like cocaine or nicotine, are known to be addictive and can be very difficult to stop using after a person gets hooked.
"There are reports of dependence development with high-dose and chronic kratom use," said Oliver Grundmann, a clinical professor in the Department of Medicinal Chemistry at the University of Florida.
"Although this is not as well established as for alcohol, opioids or stimulants, some case reports suggest that kratom dependence and withdrawal resemble that of opioids. But the caveat here is that we do not have a lot of data to date," he said.
However, according to Garcia-Romeu, experiences of drug tolerance (i.e., needing to take more to feel the effects) and withdrawal (i.e., feeling ill or uncomfortable after stopping use) happen less with kratom than with other drugs like opioid medications.
CBD, on the other hand, is recognized by the World Health Organization as a safe substance both for humans and animals. Humans are able to tolerate 1,500 milligrams of CBD daily for several weeks without any dangerous side effects.
Dangers: Do They Cause Seizures?
With increased drug usage comes the risk of overdose, especially with drugs like opioids. According to the U.S. Centers for Disease Control and Prevention, 91,799 drug overdose deaths occurred in the United States in 2020, of which 74.8 percent were the result of opioid overdose.
"To date, there is little data to suggest that consuming kratom itself, in the absence of any other substance such as alcohol, benzodiazepines, opioids, can lead to a fatal overdose," Grundmann said.
Garcia-Romeu said that "people have died while taking kratom in combination with other drugs like alcohol, opioids and benzodiazepines, and we know because of the way it's metabolized it can interact with these substances in ways that could cause risks."
There are also fears that kratom may cause seizures. Studies have found that after a single exposure of kratom, seizures can occur, with an incidence of 6.1 to 9.6 percent.
If taken in too high a dose, CBD may lead to dry mouth, drowsiness, lightheadedness, nausea and vomiting. CBD is not associated with seizures and, in fact, has been used to treat them.
Legality of Kratom and CBD
The Food and Drug Administration (FDA) has not approved CBD for medicinal use, but 33 states have legalized it for medical purposes and 11 have approved it for recreational use by adults 21 and older.
Kratom is legal in the U.S. at the national level, but the Drug Enforcement Administration (DEA) considers it a "drug of concern." It is also not approved as safe for consumption by the FDA.
"The DEA intended to ban kratom a few years ago but backed off after a lot of public pushback," Palamar said. "Kratom is also illegal in some U.S. states. As of now, it seems like kratom will remain legal, but you never know what will happen in the future."
Some say that making kratom illegal will only worsen the war on drugs and its effects on society.
"My sense is that banning kratom could lead to worsening of the current opioid epidemic, which is already at record high overdose levels, mainly by forcing people who are using kratom for pain or other health reasons to go back to using opioids or other substances with known risk of addiction and fatal overdose," Garcia-Romeu said.
Uncommon Knowledge
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Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
About the writer
Jess Thomson is a Newsweek Science Reporter based in London UK. Her focus is reporting on science, technology and healthcare. ... Read more
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