From the Guidelines
Kratom use is associated with significant adverse effects, including opioid- and stimulant-like properties, withdrawal syndrome, neurologic effects, and seizures, and therefore, its use is not recommended, as stated by the Society for Perioperative Assessment and Quality Improvement (SPAQI) consensus statement 1. The adverse effects of Kratom (Mitragyna speciosa) can be severe and include:
- Opioid- and stimulant-like properties
- Withdrawal syndrome if taking more than 5 to 15 g per day
- Neurologic effects, including seizures, with chronic use
- The FDA warns against the use of Kratom due to its potential health risks The SPAQI consensus statement recommends discontinuing Kratom use due to these adverse effects 1. It is essential to consider the potential interactions between Kratom and other medications, as well as its unregulated status, which can lead to varying potency and purity between sources. The risks associated with Kratom use, as outlined in the SPAQI consensus statement, highlight the importance of avoiding its use, especially in the preoperative period, to minimize potential complications and ensure patient safety 1.
From the Research
Adverse Effects of Kratom
The adverse effects of Kratom (Mitragyna speciosa) are numerous and can be severe. Some of the reported adverse effects include:
- Intrahepatic cholestasis, seizure, arrhythmia, impaired memory function, coma, and death 2
- Psychological manifestations such as euphoria, feeling relaxed, aggression, hostility, and psychosis 2
- Medical manifestations such as polyuria, dry mouth, vomiting, and jerky movements 2
- Hepatic, cardiac, and CNS effects, with the potential to cause fatalities, primarily as part of polydrug exposures 3
- Respiratory depression, although not commonly reported 4
- Drug interactions as both a cytochrome P-450 system substrate and inhibitor 4
- Gastrointestinal related negative effects, including nausea and constipation, mainly presenting at high and more frequent dosing 5
- Kratom-induced seizures, as reported in a case study of a 27-year-old Caucasian male with a psychiatric history 6
Health Impact and Risks
The health impact and risks associated with Kratom use are significant. Some of the reported health impacts and risks include:
- Kratom preparations have raised concerns of public health and safety in the US 5
- Kratom use has been linked to 44 deaths, as reported by the U.S. Food and Drug Administration in 2018 6
- The Centers for Disease Control and Prevention has reported 91 deaths directly linked to Kratom use in 2019 6
- Kratom use can lead to withdrawal signs/symptoms, and its high abuse liability, potential for drug interactions, and adverse events are concerning 4