From the Guidelines
Yes, kratom (mitragynine) is considered an intoxicant. Kratom contains compounds called alkaloids, primarily mitragynine and 7-hydroxymitragynine, which bind to opioid receptors in the brain and produce effects that can alter consciousness, mood, and perception 1. At lower doses, kratom typically produces stimulant effects, while higher doses tend to cause sedative and euphoric effects similar to opioids. These mind-altering properties qualify kratom as an intoxicant, as it can impair cognitive and physical functioning. The intensity of intoxication varies based on dosage, individual sensitivity, and the specific strain of kratom used.
According to the Society for Perioperative Assessment and Quality Improvement (SPAQI) consensus statement, kratom has opioid- and stimulant-like properties, and its use is not recommended due to the potential for serious adverse effects, including withdrawal syndrome if taken in high doses (more than 5 to 15 g per day) 1. The FDA has also warned against the use of kratom, citing its potential for abuse and harm 1.
Some key points to consider about kratom's effects and risks include:
- Opioid-like effects, including sedation and euphoria at higher doses
- Stimulant effects at lower doses
- Potential for withdrawal syndrome with chronic use
- Interaction with other neurotransmitter systems, including serotonin and norepinephrine
- Regulatory concerns and warnings from the FDA due to its potential for abuse and harm
Given the potential risks and the lack of strong evidence supporting its safe use, kratom should be approached with caution and considered an intoxicant. Its use can have significant implications for morbidity, mortality, and quality of life, particularly in the context of surgical patients or those with pre-existing medical conditions 1.
From the Research
Definition and Effects of Kratom
- Kratom, also known as Mitragyna speciosa, is a botanical substance with psychoactive and opioid properties 2, 3, 4, 5.
- Its active compounds, mitragynine and 7-hydroxymitragynine, act on mu- and delta-opioid receptors, producing analgesia and a sense of euphoria 6, 5.
- Kratom has stimulant effects at low doses and opioid-like effects at higher doses 3, 4, 5.
Kratom as an Intoxicant
- Kratom is considered an intoxicant due to its psychoactive properties and potential for abuse 2, 3, 6, 4, 5.
- The substance can lead to addiction, adverse side effects, and even death, particularly when combined with other drugs 2, 3, 4, 5.
- Kratom use disorder is a growing concern, with symptoms consistent with opioid use disorder, and can be treated with buprenorphine and naloxone 2, 6.
Risks and Consequences
- Kratom use is associated with medical toxicity, death, and polyintoxications, particularly when combined with other substances 2, 3, 4, 5.
- The lack of regulation and monitoring of kratom sales and distribution contributes to its potential for abuse and adverse effects 5.
- Healthcare professionals should be aware of the risks and consequences of kratom use, particularly among chronic pain patients and those with a history of substance abuse 5.