Kratom: An Opium Substitute from Asia Is the Latest "Legal" Drug to Hit the U.S.

At first glance, the dark green leaves of the Mitragyna speciosa tree look no more remarkable than mint leaves. They're large (up to seven inches long and four inches wide), somewhat oval in shape, and smooth to the touch. The trees are indigenous to Southeast Asia, and their leaves, known as "Kratom," are the latest popular consumables in the "legal drug" market of the U.S. Users describe the effects of ingestion as similar to a high from heroin.

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"The reason it's drawn some attention is because traditionally, some natives in Thailand and Asian countries would use it as an opium substitute when opium wasn't available," says Ramona Sanchez, spokeswoman for the Drug Enforcement Administration's Phoenix branch.

There are several naturally-occurring alkaloids in Kratom leaves, but the two believed to be most active on opium receptors in the human brain are mitragynine and 7-hydroxymitragynine. A December, 2010 report published by the DEA (which lists Kratom as a "Drug and Chemical of Concern") says that limited research indicates these alkaloids have "opiod-like activity in animals," relaxing muscles, inhibiting diarrhea, reducing pain, and producing euphoric effects.

Reported negative side effects were "nausea, itching, sweating, dry mouth, constipation, increased urination, and loss of appetite." Effects are said to occur within five to ten minutes after ingestion, and reportedly last from two to five hours.

Wikimedia Commons
Dried Kratom leaves

​One point of allure for Kratom users is that it won't show up on a drug screen for heroin or opiates, according to Dr. Frank LoVecchio, co-medical director of the Banner Good Samaritan Poison & Drug Information Center in Arizona.

"The drug will be missed on drugs of abuse screens," he says, but adds, "Let the buyer beware, we can find this on a urine comprehensive drug screen."

However, such tests are not always done, LoVecchio says, because they're so expensive.

Kratom is sold as raw or crushed leaves that can be smoked or steeped for tea, and also in gel caps. Potencies and strains vary, as do prices (generally from $15 to $50 per five-gram packet, or $18 to $25 for a bag of 50 capsules). Doses generally range from two to ten grams. It's widely available online through sites like thekratomking.com, kratom.pro, and the Phoenix-based site kratommarket.com, and at various head shops around the Valley and U.S..
Though it is currently uncontrolled in the states, Kratom has been banned in Thailand, Bhutan, Australia, Finland, Denmark, Poland, Lithuania, Malaysia, and Myanmar (Burma).

​To date, there have been no reported fatal overdoses of Kratom, but substance abuse experts and DEA representatives say that, like heroin and other opiates, Kratom can be addictive. Dr. LoVecchio says he's treated five patients who used Kratom, and two of them (both younger men) "said they really wanted to get back on it. The withdrawal is described as similar to opiate withdrawal," he says. "They were jonesing for it."

But, LoVecchio adds, "For every one or two patients I see that come in, there are probably dozens who do it and don't get into trouble ... In the few cases I've seen, it doesn't cause crazy symptoms. People get a little sleepy. I'm not sure what would happen if somebody O.D.'d. But the withdrawal is similar to opiates."

Kratom itself is not currently illegal in the U.S., but as DEA spokeswoman Ramona Sanchez points out, it could be prosecuted under the Federal Analog Act because chemicals in Kratom mimic the effects of controlled substances (opiates).

"It is not good at all," Sanchez says. "This is one of those drugs that lures people because it's not illegal...but these kinds of 'licit' drugs lack regulatory oversight and control in production."

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