Magazine article Addiction Professional

Kratom Use Poses Significant Dangers: Use of the Drug That Resembles Opiates Could Increase, Absent an Outright Federal Ban

Magazine article Addiction Professional

Kratom Use Poses Significant Dangers: Use of the Drug That Resembles Opiates Could Increase, Absent an Outright Federal Ban

Article excerpt

This year, there has been more and more news about a drug called "kratom," which is used as both an opiate substitute and for opiate withdrawal in some substance abuse treatment programs in Florida. One Florida company that sells it previously sold synthetic marijuana (also known as "K2," "Space," or "Spice") and continued to do so even after it was federally banned in 2012. The owner eventually served 10 months in jail.

The drug is also sold in other states in a variety of forms. A tavern sells it in a nonalcoholic drink called "Ketum" to customers in North Carolina. VivaZen is a drink sold in Alabama gas stations and head shops--its maker claims that "it's a plant" and that "VivaZen is non-habit forming."

Treatment providers and companies that sell it for recreation employ various marketing terms such as "safe," "plant," "natural" and "legal high."

I first heard about kratom in September 2013. A new student had moved into the Rutgers Recovery House just before the start of school, and multiple residents called me throughout the Labor Day weekend to tell me that they thought he was high on opiates. I had him report to the Rutgers Counseling Center, and we sent him to get drug tested. He passed. A few days later, multiple students called me again to tell me that the young man in question seemed high. I had him tested again. He passed.

Another male resident who had been clean from heroin for about 18 months pulled me aside and said he suspected the young man was using kratom. He told me that it was made from Thai leaves and it had effects that were similar to those from opiates.

The lab that Rutgers used did not test for kratom, nor did any other lab in New Jersey that I contacted. A few months later, the young man tested positive for opiates, and before we sent him away to treatment, he admitted that he had been using kratom interchangeably with heroin for a few months.

Origins, properties

Kratom is made from leaves from the mitragyna speciose tree in Southeast Asia. It has been used by the natives of Southeast Asia for hundreds of years, but the first written description of it hails from Dutch botanist Pieter Korthals in 1839. It is a relative of the coffee tree, and it works as a stimulant in small doses and a sedative in larger ones.

The leaves from the tree contain more than 40 different chemical compounds. The one that scientists believe causes the euphoric effects is named mitragynine. Tests have confirmed that mitragynine content is strongest in trees that naturally grow in Southeast Asia, rather than ones that have been grown in greenhouses around the world.

Kratom users report euphoric sensations similar to those from opiates, without the same level of intensity. When they use it during opiate withdrawal, some users state that it lessens craving and pain. For those who use it just to get high or as an opiate substitute, the reported immediate side effects include insomnia, nausea, sweating, runny nose, constipation and a loss of appetite. Common kratom withdrawal effects are muscle aches, diarrhea, mood swings, delusions and hallucinations.

Kratom has been used in Thailand for centuries as both a recreational drug and as medicine. Natives near the border of Malaysia used it to treat coughs, diarrhea and muscle aches (heroin was similarly marketed in the United States in the late 1890s and early 1900s). …

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