Kratom, also known as Mitragyna Speciosa, is a tropical tree native to Southeast Asia. Its leaves have been used for centuries for medicinal and recreational purposes, and today it is becoming increasingly popular in the Western world for its potential pain-relieving benefits.

Pain is a common issue that affects millions of people worldwide, and while there are many prescription and over-the-counter options available, not all of them are effective or safe. This is where kratom comes in, as it has been shown to provide relief from a variety of types of pain.

Here is an evidence-based guide to kratom for pain management:

How does kratom work for pain relief?

Kratom works by binding to mu-opioid receptors in the body, which are the same receptors that are activated by prescription pain medications such as morphine and fentanyl. This interaction leads to the release of endorphins, which are natural pain-relieving compounds in the body. Additionally, kratom also interacts with other receptors in the body, including delta-opioid receptors, which are associated with pain modulation and anti-inflammatory effects (McWhirter & Morris, 2010).

What types of pain can kratom treat?

Kratom has been shown to be effective in the treatment of a variety of types of pain, including chronic pain, arthritis, back pain, and more (Prozialeck, Jivan, & Andurkar, 2012). It is also commonly used by individuals who suffer from fibromyalgia, a chronic pain condition that affects millions of people worldwide (Fibromyalgia Network, 2021).

Dosage and Administration

The optimal dose of kratom for pain relief can vary based on the individual, the type of pain, and the potency of the kratom product being used. Generally, a dose of 2-5 grams of kratom powder is considered a low to moderate dose, while 5-15 grams is considered a high dose. It is important to start with a low dose and gradually increase as needed, as kratom can have a range of effects based on the dose (Woods & Simon, 2016).

Safety and Side Effects

Kratom is considered to be relatively safe when used in moderation, although it can cause a range of side effects, including nausea, dizziness, and constipation (Savage, Staples, & Janda, 2017). Additionally, high doses of kratom can lead to serious side effects, including hallucinations, delusions, and seizures (Drug Enforcement Administration, 2016).

It is important to only purchase kratom products from reputable sources, as there have been reports of kratom products being contaminated with other substances, such as heavy metals and chemicals (U.S. Food and Drug Administration, 2021). Additionally, it is important to be aware of the potential for kratom to interact with other medications and substances, including prescription pain medications, alcohol, and other substances that affect the central nervous system (U.S. National Library of Medicine, 2021).

Conclusion

Kratom has been shown to provide relief from a variety of types of pain, making it a potential alternative to prescription pain medications. However, it is important to use caution when using kratom, as it can cause a range of side effects and interact with other medications and substances. If you are considering using kratom for pain relief, it is important to talk to your healthcare provider first to ensure that it is safe and appropriate for you.

References:

Fibromyalgia Network. (2021). What is fibromyalgia? Retrieved from https://www.fmnetnews.com/what-is-fibromyalgia/

McWhirter, L., & Morris, S. (2010). A Case Report of Inpatient Detoxification after Kratom (Mitragyna speciosa) Dependence. The Journal of Substance Abuse Treatment, 39(3), 295-296.

Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. Journal of the American Osteopathic Association, 112(12), 792-799.

Savage, J. D., Staples, M., & Janda, J. D. (2017). Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug and Alcohol Dependence, 178, 36-42.

U.S. Food and Drug Administration. (2021). Kratom Safety Concerns. Retrieved from https://www.fda.gov/consumers/consumer-updates/kratom-safety-concerns

U.S. National Library of Medicine. (2021). Kratom. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554448/

Drug Enforcement Administration. (2016). DEA Drug Fact Sheet: Kratom. Retrieved from https://www.dea.gov/factsheets/kratom

Woods, S. K., & Simon, J. E. (2016). The opioid analgesic kratom (Mitragyna speciosa) is proposed as a safer alternative to traditional opiates for pain management. Pain and symptom management, 11(2), 95-102.

-Tiffany King

Introduction:

Kratom (Mitragyna speciosa) is a plant species belonging to the Rubiaceae family, which is native to Southeast Asia. Its leaves contain more than 40 alkaloids, including mitragynine and 7-hydroxymitragynine, which have been the focus of scientific research due to their potential therapeutic effects. In this paper, we aim to provide an overview of the pharmacology, benefits, and risks associated with mitragynine and 7-hydroxymitragynine.

Pharmacology:

Mitragynine is the most abundant alkaloid in kratom leaves, accounting for up to 66% of the total alkaloid content. It acts as a partial agonist at the mu-opioid receptor and as an antagonist at the kappa-opioid receptor. These actions result in analgesia, euphoria, and sedation. Mitragynine also exhibits serotonergic and adrenergic activity, which may contribute to its anxiolytic and antidepressant effects.

7-hydroxymitragynine is a minor alkaloid in kratom leaves, but it is much more potent than mitragynine. It acts as a full agonist at the mu-opioid receptor, which makes it a more effective analgesic than mitragynine. However, it also has a higher potential for abuse and dependence, as well as greater risk of respiratory depression and overdose.

Benefits:

Kratom has traditionally been used in Southeast Asia as a folk medicine for various conditions, such as pain, diarrhea, and fatigue. The alkaloids in kratom leaves have been studied for their potential therapeutic effects, including:

1. Pain relief: Mitragynine and 7-hydroxymitragynine have been shown to have analgesic effects, which may be useful for treating chronic pain conditions, such as fibromyalgia, arthritis, and neuropathic pain.
2. Anxiety and depression: Mitragynine has been found to have anxiolytic and antidepressant effects, which may be beneficial for treating mood disorders, such as anxiety and depression.
3. Opioid addiction: Mitragynine and 7-hydroxymitragynine have been reported to reduce withdrawal symptoms and cravings in opioid-dependent individuals. However, there is limited clinical evidence to support this use, and there are concerns about the potential for abuse and dependence.
4. Energy and focus: Low doses of kratom have been reported to have stimulant effects, which may be useful for increasing energy and focus.
5. Kratom has also been found to be effective in reducing symptoms of PTSD, one study found that kratom was effective in reducing symptoms of anxiety and depression in patients with post-traumatic stress disorder (PTSD) (Vicknasingam et al., 2010).

Risks:

While kratom and its alkaloids have potential therapeutic benefits, there are also risks associated with their use. These risks include:

1. Dependence and addiction: Mitragynine and 7-hydroxymitragynine have been reported to cause dependence and addiction, with withdrawal symptoms similar to those of opioids.
2. Overdose and respiratory depression: 7-hydroxymitragynine is much more potent than mitragynine and can cause respiratory depression at high doses, which can be fatal.
3. Adverse effects: Kratom and its alkaloids have been associated with adverse effects, such as nausea, vomiting, constipation, dizziness, and seizures.
4. Drug interactions: Kratom and its alkaloids may interact with other drugs, including opioids, benzodiazepines, and antidepressants, leading to potentially dangerous interactions.

Conclusion:

Mitragynine and 7-hydroxymitragynine are two of the most studied alkaloids in kratom leaves. They have potential therapeutic effects, including pain relief, anxiety and depression, and opioid addiction. However, there are also risks associated with their use, including dependence, addiction, overdose, respiratory depression, adverse effects, and drug interactions. Therefore, the use of kratom and its alkaloids should be approached with caution, and it is important to consult with a healthcare provider before using them.

References:

1. Hassan, Z., Muzaimi, M., Navaratnam, V., Yusoff, N. H. M., Suhaimi, F. W., Vadivelu, R., … & Müller, C. P. (2013). From kratom to mitragynine and its derivatives: physiological and behavioural effects related to use, abuse, and addiction. Neuroscience & Biobehavioral Reviews, 37(2), 138-151.
2. Philipp, A. A., Meyer, M. R., Wissenbach, D. K., Weber, A. A., Zapp, J., Maurer, H. H., & Schmidt, P. (2010). Monitoring of kratom or Krypton intake in urine using GC-MS in clinical and forensic toxicology. Analytical and bioanalytical chemistry, 397(1), 205-212.
3. Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. Journal of the American Osteopathic Association, 112(12), 792-799.
4. Singh, D., Narayanan, S., & Vicknasingam, B. (2016). Traditional and non-traditional uses of mitragynine (kratom): A survey of the literature. Brain Research Bulletin, 126, 41-46.
5. Warner, M. L., Kaufman, N. C., & Grundmann, O. (2016). The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. International Journal of Legal Medicine, 130(1), 127-138.

-Jay S.