Cultivation Practices of Kratom

The plant kratom (Mitragyna speciosa) is traditionally uses in Southeast Asia for its stimulant properties. It contains alkaloids, including mitragynine and 7-hydroxymitragynine, that have opioid-like effects and are converted to the active metabolites of kratom in the liver and intestines. Because of the potential for dependence and addiction, kratom is not approved by the FDA as a drug or dietary supplement. Its use as a substitute for prescription opioids has led to a number of deaths and hundreds of calls to poison control centers. Despite this, many people report that kratom reduces pain, anxiety and depression, as well as improves quality of life in general.

Preclinical and anecdotal data suggest that kratom may have therapeutic potential in several domains, such as (i) pain management without anxiogenic side effects; (ii) opioid use disorder, withdrawal, and addiction treatment with minimal tolerance, craving, or unpleasant side effects; and (iii) opioid-dependence rehabilitation by reducing opiate withdrawal symptoms and underlying addiction, including reduction of withdrawal severity and duration.

Scientific studies are needed to understand kratom’s molecular mechanisms of action, safety, and therapeutic benefits. Until then, it is important that consumers use only high-quality products with consistent levels of standardized ingredients.

Currently, kratom is sold in the US as powders, tablets, capsules, raw leaves, and concentrated liquid extracts. Most of these products contain varying amounts of ethanol and, because of this, have variable concentrations of the putative active ingredients, mitragynine and 7-hydroxymitragynine. During my recent trip to Malaysia, I was able to visit a kratom farm and see the plant in its natural environment. Traditionally, the leaves are picked and placed in boiling water for a few hours. Afterward, they are strained and consumed several times a day in doses of 3-5 g.

A typical kratom dose produces stimulant effects in 10 to 15 minutes and lasts for one to a half hours. Users commonly experience increased work capacity, alertness, and sociability, and may also feel euphoria. The pupils may become constricted, and blushing is common. At higher doses, sedation and opioid-like effects occur. At very high doses, kratom can cause seizures and death. The US Drug Enforcement Administration is considering scheduling kratom as a Schedule 1 drug, which would make it more difficult to obtain and could make it more dangerous. This is unfortunate, since the evidence suggests that kratom has substantial therapeutic utility and is safer than current opioids for treating pain and withdrawal. Moreover, the DEA’s proposed classification is at odds with the views of millions of Americans who benefit from this herbal remedy.