Key Takeaways
- Kratom is an unregulated product taken for energy, pain relief, reducing anxiety, and recreational use.
- A product called 7-OH mitragynine derived from kratom is much more potent and can lead to more intense withdrawal symptoms.
- Experts say 7-OH mitragynine acts like an opioid and is being reviewed for tighter FDA regulation.
At roadside smoke shops and wellness stores across the U.S., you can find signs advertising various types of vaping and cannabis products, as well as another substance that may not be quite as familiar: kratom.
Kratom (pronounced KRAY-tum) is a plant from southeastern Asia that is taken for its stimulant and analgesic effects. While kratom is offered as a recreational substance, there is not a great deal of awareness when it comes to its effects on users and its withdrawal symptoms.
Andre Biscaye, MD, is an addiction medicine physician at RRH Addiction Recovery Services - Greece with Rochester Regional Health, and explains how it is used, why it can be difficult to stop using, and when to seek help.
What does kratom do?
Kratom is used for two main effects: energy and pain relief. People will usually ingest it as a tablet, gummy, drink mix or shot; it is not smoked, inhaled, or injected. Since kratom is not regulated by the FDA or recognized by the DEA as a controlled substance, it is widely available.
People with a history of using opioids tell addiction medicine providers like Dr. Biscaye that they will use kratom as a safer alternative. Patients say they take it for chronic pain, depression, anxiety and recreational use.
Kratom is not typically part of routine drug screening, so unless someone is being tested specifically for mitragynine, it will not appear on most standard drug screens.
The effects of kratom wear off within 2-3 hours, but depending on the amount ingested, other side effects can occur, including:
- agitation
- confusion
- drowsiness
- rapid heartbeat
One of the more challenging parts of kratom use is going through withdrawal symptoms, especially for people who use it for longer periods of time. Symptoms may include:
- muscle spasms
- difficulty sleeping
- watery eyes/nose
- fever
- diarrhea
- restlessness
- anger/sadness
- nervousness
Kratom and 7-OH
When broken down into chemical components, kratom contains several compounds that are very active. The most active is 7-OH-mitragynine, which is synthesized from kratom plant extract to become a more potent form of what people would get naturally from the plant. 7-OH is only detectable in trace amounts in kratom products and is not thought to significantly affect those who consume it.
Marketed and sold as 7-OH in bright packaging and sugary flavors, this substance has effects are about 13 times more potent than morphine, according to researchers. These factors combined are a cause for concern for potential overdose.
“Most people don’t realize that 7-OH is an opioid – the same family as morphine, oxycodone, and fentanyl,” Dr. Biscaye said.
While deaths from 7-OH or kratom are rare, there is potential for abuse and addiction. The FDA recently issued a public warning about 7-OH products, adding that it is taking steps to restrict the sale and availability of the synthetic opioid product.
Looking for help with kratom or 7-OH
Experts like Dr. Biscaye are worried that people do not fully understand the risk and harms of products like kratom that are often marketed as ‘natural’ or ‘plant-derived’.
“Just because something came from a plant doesn’t mean it has no risks,” Dr. Biscaye said. “I want people to make informed decisions about their lives and their health.”
Talking with an addiction medicine specialist about getting help in moving past withdrawal symptoms is a good first step. Experts in chemical dependency can help people by prescribing medications, identifying new ways to change their behavior, or addressing cravings and compulsive use.
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