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What is kratom?
Kratom is a tree native to Southeast Asia (Thailand, Malaysia, Indonesia, Borneo, etc.). Its botanical name is Mitragyna speciosa. Kratom is in the same family as the coffee tree (Rubiaceae). The leaves of kratom have been used as an herbal drug from time immemorial by peoples of Southeast Asia. It is used in folk medicine as a stimulant (at low doses), sedative (at high doses), recreational drug, pain killer, medicine for diarrhea, and treatment for opiate addiction. Many people report that kratom is an effective treatment for arthritis, restless legs syndrome (RLS), and fibromyalgia as well as chronic pain.


How does one measure dosage?
The best way to measure dosage is with a scale. Since a typical dose of kratom is just a few, or several, grams, one should ideally use a scale that can measure down to a single gram and is accurate to at least 1/10th of a gram. Low-cost, highly accurate, digital scales are widely available, and purchasing one is a great investment, since they can last a lifetime and are useful for many other things besides weighing kratom. These can be obtained from Sage Wisdom Botanicals, as well as many other suppliers.


Measuring kratom by volume is less accurate than measuring by weight because the amount contained in a given volume depends on how finely ground the material is. Obviously, a teaspoon of finely powdered kratom will weigh more than a teaspoon of loosely crushed or coarsely ground leaves. That said, here are some rough guidelines. On average, 1 LEVEL teaspoon of most commercially available, finely powdered kratom will weigh about 2 grams (very finely powdered kratom may weigh closer to 2.25 grams). Since there are 3 teaspoons in a tablespoon, that means that a LEVEL tablespoon of finely powdered kratom will weigh, on average, about 6 to 7 grams. That is a mid-sized dose for kratom of average potency (possibly a strong dose for high-potency kratom, or a mild dose for low-potency kratrom).


Coarsely ground leaves weigh less than finely powdered leaves (when measured by volume). A LEVEL teaspoon of typical, commercially available, coarsely ground leaves typically weighs about 0.8 grams. If the leaves are loosely crushed they will weigh less, possibly much less, depending on how finely (or coarsely) crushed they are.


What are the effects?
Kratom is a rather unique drug in that a low to moderate dose will usually (but not always) be stimulating, while a high dose is almost always quite sedating. This is apparently because the active alkaloids have both stimulant and sedative effects. Which predominates probably depends both on dosage and individual differences between users. Many people report that the effects are very similar to opiate drugs. From a pharmacological perspective this is not surprising because kratom contains alkaloids that act as opiate receptor agonists. Interestingly, although kratom has a similar mechanism of action as many opiate pain medications it does not appear to be nearly as addictive. In fact many people use kratom to overcome opiate addiction.


The stimulant level: At the stimulant level, the mind is more alert, physical energy (and sometimes sexual energy) is increased, one feels more motivated to get things done, ability to do hard, monotonous physical work may be improved, there is an elevation of mood (it has an antidepressant effect), one is more talkative, friendly, and sociable. The stimulant effects of kratom are different from typical CNS stimulants, such as caffeine or amphetamine drugs. Kratom is more of a cognitive stimulant tnan a physical stimulant.


The sedative-euphoric-analgesic level: At this dosage you will be less sensitive to physical or emotional pain, feel and look calm, have a general feeling of comfortable pleasure, and may enter a pleasant dreamy reverie. You may experience some itching or sweating. Your pupils may be constricted (small). It is possible you may feel nauseated, but if you lie down and relax the nausea should quickly subside. You may find your appreciation of music is increased. It will be very pleasant to lie down on your back in a semi-darkened room, with eyes closed, and just listen to your favorite music. If you do this you may be fortunate enough to enter the delightful mixed-state of ‘waking-dreaming’ where you have one foot in dreamland and the other foot in the real world. This state was much prized by the 19th century Romantic writers, who, lacking knowledge of kratom, resorted to the much more habit-forming narcotic, opium, to achieve it.


What effects are associated with different doses? (dosage guidelines)
That depends on the potency of the kratom; .5g to 4g is a typical dose. Dose depends on what causes the pain and how long the pain has been present.


Threshold = The effects are clearly apparent, but subtle.
Mild = Typically the effects are stimulant-like.
Moderate = The effects can be stimulant-like or sedative-euphoric-analgesic.
Strong = Sedative-euphoric-analgesic effects; too strong for highly sensitive people.
Very Strong = Sedative-euphoric-analgesic effects (TOO STRONG FOR MOST PEOPLE)


Caution: People vary in sensitivity to kratom, and kratom from different sources can vary in potency (sometimes quite a lot), so these dosage estimates should be regarded as loose approximations. One should always start with a low dose when experimenting with a new batch of kratom. One can then increase the dose gradually with subsequent experiments until one obtains the desired level of effects. DO NOT take a strong, or very strong dose, the first time you are sampling a new batch of kratom. Most people experience nausea when using very strong doses. Sensitive individuals may experience nausea at lower doses. For this reason, it is best to take kratom on an empty stomach when using strong doses (i.e. wait about 3 hours after eating). Some people are hypersensitive to kratom, and may experience adverse reactions (such as severe and prolonged vomiting) when using very strong doses.


What is duration of kratoms effects?
The effects of kratom usually last 5-6 hours. When taken on an empty stomach, the onset of effects is typically felt 30-40 minutes after ingestion. If there is much food in the stomach, it may take 60-90 minutes before it begins to take effect. When taken in capsules (gelatin or vegetarian), the onset of effects may be delayed a little because it takes time for the capsules to dissolve in the stomach.


What are the risks? How safe is it?
When kratom is taken by itself (without mixing it with other drugs), the greatest risk is falling asleep while engaged in hazardous activities. NEVER drive while under the influence of kratom, even if you feel stimulated, rather than sleepy, for sleepiness may come on you without warning. Use common sense. Do not use power tools or climb ladders while under the influence of kratom. Be careful not to leave a pot on a lit stove and then fall asleep.


Pregnant women should not take any drug or medication except on medical advice. Since there have been no studies of the risks of kratom use by pregnant women, it is not known whether it could cause birth defects or fetal death. We strongly recommend that any woman who could possibly be pregnant NOT use kratom.


Is kratom an effective pain medication?
Yes, kratom is an effective pain medication (analgesic). In fact, except for opium, kratom is probably the most effective herbal analgesic available. Many people use kratom to alleviate aches and pains, and to help manage painful conditions such as arthritis and fibromyalgia.


Is kratom an effective treatment for opiate addiction?
One of the traditional uses of kratom in Thailand is as a treatment opiate addiction. Opiate addiction is a widespread problem. Not just for people who use opiate drugs illegally, but also for people who are prescribed opiate pain medications. Unfortunately, people who use opiate drugs daily often become addicted. Understandably, many people do not like being addicted to these drugs and are looking for ways to overcome their addiction. Many people report that kratom is effective for this purpose. Because it contains alkaloids that act as opiate receptor agonists it can be used as a substitute for opiate drugs, both as a pain medication and to avoid opiate withdrawals. After switching to kratom for a while, people say that they are able to reduce and then end their kratom use completely without suffering through difficult opiate withdrawal. This suggests that although it contains opiate receptor agonists, the pharmacology of kratom differs from opiate drugs in an important and potentially useful way. Before using kratom to overcome opiate addiction, it is obviously a good idea to discuss this with an open-minded physician.


Is kratom habit forming?
Kratom is not habit forming when it is used responsibly. If used occasionally as a recreational drug, rather than daily, there is virtually no risk of becoming dependent on it. But it is very important not to get into the habit of using it every day. For kratom, like many drugs [e.g. alcohol, coffee, tobacco, etc.] if used on a daily basis for a prolonged period of time, could become a habit hard to break. Before starting to experiment with it set yourself usage guidelines. If you ever find it is hard to stay within your usage guidelines immediately quit using kratom. Of course, people who are using kratom to overcome a preexisting opiate addiction may need to use kratom daily to avoid opiate withdrawal. People suffering from chronic pain may need to take pain medications on a daily basis, and some people choose to use kratom instead of pharmaceutical pain killers. Interestingly, studies have found that opiate drugs (morphine and its relatives) are rarely addictive for pain sufferers except among people with a history of substance abuse. This is probably also true for kratom, because like opiate drugs, the effects of kratom are due to opiate receptor agonist activity.


Is it possible to develop tolerance to kratom?
Yes. Like many drugs, if kratom is used on a daily basis one will eventually develop some tolerance to its effects and will gradually need to take increasingly larger doses to obtain the same level of effects. Tolerance does not develop when kratom is taken occasionally (no more than twice a week). Since the active constituents in kratom are opioid receptor agonists, there is likely to be cross-tolerance with other opioid drugs. This means that people who have developed tolerance to other opioid drugs will probably need to use higher doses of kratom than people who have not. Tolerance is not permanent. Normal sensitivity resumes after a few weeks of abstinence.


I have heard that tolerance can be avoided by taking different varieties of kratom on different days. Is that true?
No. Mixing up different kinds of kratom is not going reduce tolerance. All varieties of kratom contain the same active constituents, although their concentration varies with different batches.


I have heard that the potency and quality of kratom's effects is correlated with the color of the central leaf vein. Is that true?
The color of the central leaf vein ranges from various shades of green to various shades of red. This is partly determined by genetics, but it also varies depending on how mature the leaf is, how much sunlight the tree receives, and other environmental factors. The same tree can have leaves with pale green, dark green, and red veins. Usually the young leaves have red veins, but the red color disappears as the leaves mature, changing to green. Eventually the leaves fade to yellow, then to brown. Since the leaves cycle through these various colors as they mature, they can all occur on a tree at the same time. Obviously, one can select a particular color when harvesting the leaves. Some trees do not produce leaves with red coloration, so that is probably a genetically variable trait. We have not seen any consistent connection between vein color and potency or type of effects. It appears that such correlations are mostly marketing hype invented by kratom merchants. We do see variations in potency between different batches of leaves, but those differences do not correlate with color in any consistent way. Since the effects of kratom do vary based on dosage, differences in potency will cause a week batch of leaves to seem like it has different effects than a stronger batch, when the same amount of both are compared.


Is it true that some kratom products are adulterated or mislabeled?
Chemical analysis has shown that some kratom products are adulterated with other substances. In some cases the kratom has been "cut" with less expensive herbs to reduce the seller's cost and increase profits. In some cases synthetic drugs have been added to enhance the effects. In some cases products labeled as kratom or as a kratom extract don't contain any kratom, but other, less expensive, substances instead. Disturbingly, some products labeled as kratom extracts have been found to contain the "designer drug" O-desmethyltramadol, which is a dangerously potent synthetic opioid drug. Sadly, products containing this compound have resulted in several deaths (first reported in Sweden). Similar compounds have been detected in some other kratom products. Analysis has also found kratom laced with hydrocodone and morphine. Since these are opioid compounds, the effects they produce would be somewhat similar to those of kratom, but obviously far dangerous (there is not a single case in which a death could be attributed to kratom by itself). Obviously, it is important to obtain kratom from a trustworthy source, preferable someone who routinely tests the kratom obtained from his or her own suppliers before reselling it. Kratom is a tremendously helpful and relatively safe herb. It is sad that some unscrupulous merchants are acting so recklessly.


What are safe usage guidelines?
It is best to err on the side of caution. Therefore, we recommend that people not use Kratom more than once or twice a week. Preferably, no more than once or twice a month. This will insure that Kratom does not become a habit. In other words, kratom should be reserved as a special, but OCCASIONAL treat. By using it infrequently, you will avoid habituation and get more pleasure from it.


Are there any reported health problems?
Health problems are unlikely unless one is consuming large quantities of kratom every day. In Thailand, where there are some people who use kratom every day, those dependent on it can develop weight loss, dark pigmentation of the face, and have physical withdrawal symptoms if they quit abruptly. The withdrawal symptoms may include muscle aches, irritability, crying, runny nose, diarrhea, and muscle jerking. Health problems are unlikely to occur in occasional kratom users. Like any drug or medicine, people's reactions vary and some people could possibly have an allergic or other unusual reaction to kratom, even if they used it responsibly.


Can kratom be combined safely with other substances?
In general, combining drugs can be risky. We recommend that kratom not be combined with yohimbine, cocaine, amphetamine-like drugs, or large doses of caffeine, because of the possibility of over-stimulation or increased blood pressure. We recommend that kratom not be combined with large amounts of alcohol, with benzodiazepines, opiates (other than possible use with red poppy tea—see below), or any other drugs that depress the nervous system. This is because of the possibility that such combinations might cause over-sedation or even possible respiratory depression (slowed breathing, or possibly death), We recommended that kratom not be combined with Syrian rue, Banesteriopsis caapi, or any other MAO inhibitor drug. Serious, even fatal, reactions can occur if MAO inhibitor drugs are combined with monoamine drugs. The combination of MAO inhibitor drugs with kratom, which contains monoamine alkaloids, has not been studied.


Certain combinations have been reported by users to be pleasant and supposedly safe. Kratom can certainly be combined with ordinary tea without risk. It has been used with a tea made from red poppy flowers (Papaver rhoeas), which itself has an extremely mild narcotic effect, and with a sedating-euphoriant tea made from ‘blue lotus’ (Nymphaea caerulea). It has been safely combined with SMALL quantities of alcohol, however large quantities of alcohol must be avoided. Some people report they like to smoke tobacco or cannabis while under the influence of kratom. But anyone smoking under the influence of kratom must be very careful not to nod off and drop lit smoking materials.


What is kratom's legal status?
Kratom is illegal in Australia, Denmark, Malaysia, Myanmar (Burma), and Thailand. It is legal in most of the United States (it is only illegal in Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin). Some of these countries impose sever penalties for possession of this herb. It is legal in most other countries. Laws can and do change, so be sure that kratom is legal where you live before using it.


What are kratom's active constituents?
There are many closely-related tryptamine alkaloids in kratom. The most important ones are mitragynine and 7-hydroxymitragynine. These are primarily responsible for kratom’s pain relieving, sedative, euphoric, and stimulating effects. These alkaloids resemble yohimbine in structure, but do not have the same effects.


Is kratom use detected on drug tests?
Although kratom does contain alkaloids that bind to opiate receptors, they are structurally unrelated to opiate drugs and therefore would not be detected by opiate drug tests. It is technically possible to detect the alkaloids in kratom in body fluids, but since kratom is a legal herbal drug (in most places), it is not normally tested for. This may change, especially if kratom becomes a controlled substance in the United States. 


Can kratom be cultivated?
Kratom can be grown as a house plant (but will have to be cut back because they can grow quite large). They prefer a humid environment. They dislike cold weather and do not tolerate frost. Potted plants can be grown outdoors in temperate climates when the weather is sufficiently warm, and grown indoors the rest of the time. Kratom can be grown outdoors all year in tropical climates. Potted plants should be lightly fertilized every few weeks, but only when actively growing. They can be propagated from cuttings.


Reference: The Kratom User's Guide