Then in 2016, DeMott learned about kratom from a friend taking it for lupus symptoms. She decided to give the herbal supplement a try. She ordered some online and brewed it into a tea. Relief came with the first cup, she says.
DeMott says she still has chronic pain and health issues, but kratom dulls the pain enough that she can function. That’s why she’s organized two rallies — one in California and one in Washington, D.C. — to push the government to keep the herb legal. She and other kratom users and advocates are growing more concerned about news that the Drug Enforcement Administration (DEA) is considering labeling it as a Schedule I drug — a category that includes heroin, ecstasy, marijuana, and LSD. It would also make the drug illegal on a federal level.
Federal officials have said they are concerned that kratom can be abused because of its opioid-like effects. It’s now illegal in six states and the District of Columbia, and it’s been on the DEA’s list of drugs and chemicals of concern for several years.
Talk of a ban worries DeMott. “That would be devastating to me,” she says. “If anything, kratom just makes me feel more like my old self, before I was diagnosed with so many conditions, and that is what has been such a blessing about it to me.”
What Is Kratom?
Kratom is a tropical tree in Southeast Asia. Its leaves have been used for hundreds of years to relieve pain. They can be eaten raw, but more often are crushed and brewed as tea or turned into capsules, tablets, and liquids.
In low doses, kratom is a stimulant. In large amounts, it’s a sedative, and the National Institute on Drug Abuse (NIDA) says it can lead to symptoms of psychosis and dependence. The DEA notes that its use appears to be going up. U.S. poison control centers received 263 calls about kratom in 2015, ten times the amount in 2010, the CDC says.
According to the CDC, about 42% of cases of kratom use reported between 2010 and 2015 involved non-life-threatening symptoms that required some treatment. About 7% of cases were classified as major and life-threatening. The DEA warns health risks in kratom abusers can include seizures, hallucinations, and death. Government agencies say there have been 44 deaths related to kratom and say at least one is being investigated as involving “pure kratom.” But NIDA says most deaths linked to kratom seemed to have happened when people used it along with illegal drugs or prescription medications.
In terms of how it works, a 2016 study found that in mice, kratom targets a part of the brain that responds to opioid drugs like morphine, codeine, and fentanyl. But that study found that unlike morphine, it does not lead to harmful side effects like slowed breathing — called respiratory depression — constipation, and physical dependence. Since most deaths from opioid overdose are because of respiratory depression, some believe kratom merits further study to see if some of its compounds can be harnessed for medical benefits that may be less addictive.
He says unscientific reports suggest kratom is less addictive than opioids, but he says many companies in the U.S. advertise it as a legal high. Several Southeast Asian countries have outlawed it.
“By any measure, kratom would be less harmful and less addictive than something like heroin. If you look at the evidence, you have to conclude that,” Prozialeck says. “But kratom can induce a state of physical dependence.”
“It is probably addictive, but its addictive equivalent is something like coffee, which isn’t surprising because the leaf is in the coffee family,” says Christopher R. McCurdy, PhD, a professor of medicinal chemistry at the University of Florida in Gainesville. His research on mice shows that kratom may be able to treat opioid withdrawal with few side effects, and he says people who use kratom for this purpose typically don’t have withdrawals or, if they happen, they are mild.
Dijon Evans, 55, of Sacramento, CA, turned to it 3 years ago to manage chronic pain from nerve damage. “There was no high. I just felt better. I could move. I could breathe without all the pain. I felt alive again. I didn’t feel buried by the pain,” she says.
For that reason, some scientists say kratom may hold the key to treating chronic pain and may even be a tool to combat addiction to opioid medications. McCurdy and his colleagues just received a $3.5 million grant from the NIDA to study the plant’s components over the next 2 years to better understand how it works how it can be abused.
“It’s very clear that the National Institute on Drug Abuse wants to understand the science of this plant and the components of this plant because of the anecdotal stories and community of users showing this is working well to keep them off of opiates and the historical usage of this plant to wean people off opium or prescription drugs,” McCurdy says.
Kratom is used for self-treatment of mood and anxiety disorders, pain, and withdrawal symptoms that come with prescription opioid use, but research about its effects is mixed.
Studies published in 2017 and 2018 found it to have few negative effects, including nausea and constipation, but those were generally only present at high doses or when taken frequently. Another 2018 study found that among those taking higher amounts, it didn’t affect how well they moved, or their memory, attention, or mental control skills.
But other new studies suggest that as use of kratom rises, so do reports of dependence, tolerance, and withdrawal when people try to stop taking it.