From ketamine being denoted the new ‘campus killer’ to monkey dust being hailed as the UK’s new ‘zombie drug’, the media panic surrounding drugs is neverending. The latest substance stirring up a media frenzy? Kratom, a herb which offers opiate-like effects and is the target of numerous intense news reports, as well as a handful of “wrongful” lawsuits against vendors following suspected overdoses.

Most of this frenzy is confined to the US, where kratom is either legal or unregulated in most states. It can be bought in most smoke shops and gas stations in and around major cities, and in the UK, it’s sold and shipped online no questions asked. But the drug itself has mixed reviews. A scroll on the r/kratom subreddit will tell you a lot about this plant, which is native to Southeast Asia and offers either stimulant-like or sedative effects, depending on the dose. From people claiming that using kratom changed their life for the better to others suffering from intense withdrawals when trying to quit, it’s clear that the herb is controversial.

“I’m now going through 250 grams every five days,” wrote one Reddit user, who has been using kratom for at least a year. “I don’t have a job and every time I get money for things I need like food, it’s time to get more Kratom… I feel really trapped.”

What makes Kratom so tricky is that it’s often used by people trying to wean themselves off opioids (although this obviously isn’t advised). While some people feel the benefits, others get hooked – and the fact that it could cause dependency in some users is backed up by research, too. The drug has also been doing the rounds across IRL club scenes, and it’s not uncommon to hear stories of friends spiralling into kratom addiction.

That said, another Reddit user, who has been using kratom for a few months, said that “nothing helps like it”. “I was addicted to dihydrocodeine [an opioid] for many years and I used Kratom to help me through withdrawals, which was miraculous,” they wrote. “I’m now clean from opiates but I continue to use the Kratom daily... Within 20 minutes of ingestion I feel a mood lift (not euphoric per se) but enough to increase motivation and banish my anxiety and overthinking. I sleep well, have a very healthy lifestyle – the kratom has given me a much improved quality of life.”

WHAT IS KRATOM?

Kratom (sometimes called krantom in the UK), is a drug popular in Southeast Asian countries like Indonesia, Malaysia and Thailand. It’s a natural herb that comes from an evergreen plant indigenous to these nations, and is often consumed as capsules, in food, brewed into tea, or smoked, just like weed. Currently in the UK, the sale, import and export of kratom is prohibited under the Psychoactive Substances Act (2016). So while possession is legal, possession with intent to supply is illegal.

WHAT DOES IT ACTUALLY DO?

Kratom is an upper and a downer, depending on the dose. Lower doses (1-5g) produce a stimulant-like effect, whereas in higher doses, it does the opposite: pain relief and sedation. It can also make users feel relaxed and euphoric.

Some research suggests that kratom could be used in a medical context, potentially as a substitute for opioids and methamphetamine, for pain relief, as an antidepressant, or to help with opioid withdrawal. However, as mentioned above, it’s dangerous territory: while some claim it has helped wean them off opioids, others have raised alarms over how extremely addictive and debilitating it can be.

HOW DOES KRATOM WORK?

Kratom is made up of the leaves of the Mitrogyna Speciosa, a Southeast Asian tree in the coffee family. These leaves contain chemical compounds (or bioactive alkaloids) that have an effect on the body. According to NIDA, kratom contains mitragynine, which breaks down into 7-hydroxymitragynine when digested. Both of these compounds activate mu-opioid receptors (hence the dependency concerns), though the effects aren’t as strong as the likes of heroin. Some research suggests these compounds also bind to adrenergic receptors, serotonin receptors and dopamine receptors, which explains the stimulating effects of smaller doses.

HOW DANGEROUS IS IT, REALLY?

While it’s important to remember that the research on kratom is limited, there is some that suggests kratom can be harmful, but this is typically when it comes to higher doses. Less severe side effects can include vomiting, jerky movements, aggression and hostility. The more severe side effects are psychosis, seizures, abnormal heart rhythm, impaired memory function, coma, and death.

Regular use can also cause a cross-tolerance to morphine and other opioids commonly prescribed for pain relief. It’s important to remember this in case you do happen to need pain relief in hospital. Plus, it means you’ll need to take more to feel the effects, which could lead to an overdose. 

But the biggest concern around kratom is its dependency, and there has been some research to suggest that kratom is habit-forming. One 2014 study of Malaysian kratom users found that more than half of those who had used kratom regularly for more than six months had developed severe kratom dependency, while 45 per cent had developed a moderate dependence. Another study found that those who drank three glasses of kratom a day were at a higher risk of developing dependency. 

Kratom withdrawals can get pretty dark, too. According to the study, the physical withdrawal symptoms include muscle spasms and pain, fever, and diarrhoea. Meanwhile, restlessness, rage, sadness, nervousness and moderate depression are among the psychological withdrawal symptoms, which can incentivise users back into using again.

HOW TO USE IT SAFELY

DON’T TAKE IT EVERY DAY

Kratom is habit-forming, particularly if it’s used regularly. One study found that those who drank three glasses of kratom a day were at a higher risk of developing dependency. If you want to avoid getting addicted, then you need to be mindful about how often you take it – and how much of it you take. Ivan Ezquerra-Romano, director of drugsand.me and PhD student at University College London advises tracking your usage. “Track your use by logging each intake in a spreadsheet or in a calendar,” he tells Dazed. “By tracking your use, you can avoid taking kratom too often and also follow your progress if you end up taking too much.”

If you’re feeling hooked and struggling to stop using, Ezquerra-Romano advises tapering off rather than going cold turkey. “Again, track how often and how much you’re using, then take a little less each time. How much less you take every day depends on how much you are taking,” he says. “One strategy to tailor the tapering schedule to yourself is to take Xg less on one day and see how you feel, if you feel any of the withdrawal symptoms, then the next day you take a bit more until you find a dose in which you avoid withdrawal symptoms. Stick to that dose for a few days before taking less.”

WATCH YOUR DOSAGE

As with any drug, it’s important to simply be as careful as possible, especially if you’re trying something new. Ezquerra-Romano recommends starting with a low dose – “especially if you are new to the drug or testing a different strain for the first time”. As the old saying goes, start low, go slow: you can always take more of something, but you can never undo taking too much. 

He also recommends accurately weighing the drug to control how much of it you are taking, to ensure you don’t take too much and drinking water to stay hydrated and reduce the risk of nausea. “You should also swallow kratom gradually with small sips of water to further reduce the risk of nausea,” he adds.

DON’T MIX 

Another important note is that kratom doesn’t mix well with other drugs – almost all reports of those who tested positive for kratom overdose also tested positive for other substances. When combined with stimulants, it can cause high blood pressure, excessive sweating and palpitations. Mixing downers with downers is really not advised, either – taking kratom with other drugs like ket or alcohol can increase the likelihood of memory blackouts, and could even lead to fatal respiratory issues, so be warned.

It’s also a bad idea to combine kratom with psychedelics like LSD, DMT and shrooms. “It is considered a cautionary interaction and can cause unwanted side effects such as anxiety and mental block,” says Ezquerra-Romano. No one wants a bad trip!