From the Research
Kratom is not recommended for pain management or mood enhancement due to significant safety concerns. Kratom contains compounds (mitragynine and 7-hydroxymitragynine) that act on opioid receptors and can cause dependence, addiction, and withdrawal symptoms similar to opioids 1. The FDA has not approved kratom for any medical use, and it carries risks including nausea, itching, sweating, dry mouth, constipation, increased urination, and in severe cases, seizures, liver damage, and respiratory depression 2. These risks are heightened because kratom products lack standardization, with widely varying potency and potential contamination with harmful substances. Additionally, kratom can interact dangerously with other medications, alcohol, and substances, as it inhibits CYP2D6 and CYP3A, as well as P-glycoprotein-mediated efflux activity 3.
Some of the key points to consider when evaluating the safety of kratom include:
- Kratom use is associated with medical toxicity and death, although causality is difficult to prove due to the frequent involvement of other psychoactive substances 1
- Daily, high-dose use may result in kratom use disorder and opioid-like withdrawal on cessation of use, which can be treated with buprenorphine 1
- Kratom dependence is a significant concern, with symptoms including depressed mood, anxiety, restlessness, irritability, and feeling tense, as well as physical symptoms such as myalgia and body ache, joint pain, and lacrimation 4
- Treatment options for kratom dependence include sublingual buprenorphine-naloxone, intravenous clonidine, and a combination of oral dihydrocodeine and lofexidine 4
For pain management, better options include over-the-counter medications like acetaminophen or NSAIDs, or prescription medications under medical supervision. For mood enhancement, evidence-based approaches such as therapy, exercise, proper sleep, and prescribed medications when appropriate are safer alternatives. Anyone currently using kratom should consult a healthcare provider before stopping, as withdrawal symptoms may occur 2, 1, 4.