Kratom safety & side effects: What you need to know

Kratom (Mitragyna speciosa) has gained popularity in the West recently due to its unusual biphasic effects. However, as with any substance, understanding its safety profile is essential if you are to use it in a way that isn’t detrimental to your health.

This article provides a balanced overview of kratom’s safety, potential risks, and side effects to help you make an informed decision.

Why do people use kratom?

Kratom, like most psychoactive drugs, is used for numerous reasons. Some people use it for energy, others for recreation, and others for wellness-related reasons. In fact, many people use kratom for more than one of these reasons.

One of the interesting characteristics of kratom is that it provides energy and focus at low doses, and more soporific effects at higher doses, giving it the properties of two drugs in one. Let’s take a look at some of the reasons people might take kratom:

• Energy and focus: As mentioned, lower doses of kratom are reported to have stimulant-like effects, enhancing energy and concentration, much like caffeine.
• Mood modulation: Higher doses are said to provide soporific and relaxing effects that some describe as euphoric.
• Pain management: Many use kratom in relation to pain. As it binds to opioid receptors, it is thought that it might be able to affect pain tolerance (Hossain, 2023).

Kratom Capsules - 45 mg Extract (Zamnesia)

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What are the dangers of kratom use?

While kratom is legal in some countries and regions, its safety remains a topic of debate. It is generally considered to be a fairly safe drug when used occasionally, but it has greater health-related concerns when used frequently over a longer period of time. Moreover, concerns over production, regulation, and quality exist.

The primary concerns about kratom include:

• Lack of regulation: Many kratom products are unregulated, meaning there is no guarantee of purity or consistency. This is especially worrying given that many kratom products are extracts, which are much stronger than the raw leaf. If these extracts are in fact stronger than they are advertised, then this poses a significant danger to users as they will not be able to dose these products appropriately.
• Contaminants and adulterants: Poorly manufactured kratom products may contain harmful substances, such as heavy metals, bacteria, synthetic additives, and pesticides. What’s more, poor extraction processes can leave products with high levels of solvent residue.
• Variability in potency: Different strains and batches can vary significantly in strength, increasing the risk of unintended effects. While most sellers will advertise different strains as having particular effects, it’s not always a given that these claims are true.
• Potential for dependency: Regular use of high does of kratom may lead to dependency, similar to opioids, making it challenging to stop use without experiencing withdrawal symptoms (Eastlack, 2020).
• Unknown long-term effects: Research on kratom’s long-term safety is still limited, leaving gaps in understanding potential health consequences. However, there is now much more scientific research being conducted into kratom, and hopefully this will shed more light on its long-term effects.

How does kratom interact with other medications and substances?

There isn’t a huge amount of research directly investigating how kratom interacts with other substances. However, given how it works, there are some interactions that can be inferred.

• Opioids: Combining kratom (especially high doses) with opioids can increase the risk of respiratory depression and overdose, as both have depressant qualities.
• Benzodiazepines: Using kratom with sedatives like diazepam or alprazolam may amplify drowsiness and impair cognitive function further. This can be inhibiting and extremely dangerous if you attempt to do anything that requires care, such as driving or navigating stairs.
• Alcohol: Combining kratom and alcohol may be dangerous, as it can lead to dizziness, nausea, inhibition, and an increased risk of overdose.
• Stimulants: Combining kratom with caffeine or other stimulants can cause increased heart rate and blood pressure, leading to cardiovascular risks. More likely, the combined effects of stimulants are likely to cause physical and mental discomfort, leading to anxiety.
• Antidepressants and psychiatric medications: Kratom may interfere with medications used to manage depression and anxiety, potentially reducing their effectiveness or causing adverse effects. Antidepressants (such as MAOIs) can have extremely dangerous effects when mixed with other drugs, so do thorough research and speak to a doctor before taking the risk.

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What are the side effects of kratom use?

Like most substances, kratom has side effects. These can vary depending on the dose, frequency of use, and individual tolerance.

Mental side effects

• Mood changes: While some users report an improved mood, others experience emotional instability.
• Anxiety and irritability: Some individuals report increased anxiety, particularly at higher doses or with prolonged use.
• Cognitive impairment: Kratom can lead to confusion, difficulty concentrating, and brain fog.
• Hallucinations and delusions: In rare cases, especially with high doses, some users have reported experiencing hallucinations or delusional thoughts.

Physical side effects

• Nausea and vomiting: One of the most common complaints among new users, this is often dose-dependent and a typical side effect of opiate drugs.
• Dizziness and drowsiness: Higher doses can cause extreme drowsiness, increasing the risk of accidents. You must be very careful when taking high doses of kratom.
• Constipation: Due to its alkaloids binding to opiod receptors, regular use of kratom can lead to digestive issues.
• Loss of appetite: Some users experience decreased appetite, leading to unintended weight loss that can become dangerous over time.
• Increased heart rate and blood pressure: High doses may lead to cardiovascular strain, especially in those with pre-existing conditions.

Are there any long-term effects of using kratom?

As mentioned, since research on kratom is still emerging, the long-term effects are not fully understood. However, existing reports suggest the following potential risks:

• Tolerance and dependency: Frequent use may lead to increased tolerance, requiring higher doses to achieve the same effects, which can result in dependency. Although not as severe as opioids, ceasing use of kratom can result in unpleasant withdrawals (Singh et al., 2014).
• Liver toxicity: There have been reports of liver damage in chronic kratom users, although the exact mechanism remains unclear (Botejue, 2021).
• Hormonal changes: Kratom may influence hormone levels, particularly testosterone, leading to potential reproductive health concerns. However, whether this is the case is uncertain, and some research has not found evidence to support this claim (Singh, 2018).
• Mental health issues: Long-term use has been linked to depression, anxiety, and even psychosis in some individuals, raising significant concerns (Awad, 2024).

Do people experience kratom withdrawal?

It appears that kratom can cause dependency, and as such can lead to withdrawal symptoms when people stop using it. It is unclear how often a person needs to use kratom to develop a dependency, but symptoms include:

• Irritability and mood swings: Users may experience heightened anxiety and depression when stopping kratom.
• Fatigue and lethargy: Withdrawal often leads to low energy levels and difficulty concentrating.
• Muscle aches and pain: Similar to opioid withdrawal, kratom withdrawal can cause body aches.
• Insomnia: Many users report difficulty sleeping when discontinuing kratom use.
• Nausea and digestive issues: Some people experience gastrointestinal discomfort during withdrawal.

While kratom withdrawal is generally considered milder than opioid withdrawal, it can still be uncomfortable. Gradually reducing intake rather than quitting abruptly may help ease symptoms. If you feel you are having issues stopping your kratom use, don’t be afraid to seek help.

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What safety precautions should you take when using kratom?

If you choose to use kratom, taking the following precautions can help reduce risks:

• Start with a low dose: Avoid high doses to minimise side effects and dependency risks.
• Choose reputable suppliers: Purchase kratom from trusted vendors that provide third-party lab testing to ensure product purity.
• Avoid mixing with other substances: Refrain from combining kratom with alcohol, opioids, or other drugs to reduce harmful interactions.
• Monitor your body’s response: Pay attention to how your body reacts and discontinue use if you experience adverse effects.
• Limit frequency of use: Avoid daily use to prevent dependency and withdrawal symptoms.
• Stay informed: Keep up with new research and legal developments regarding kratom use in your country or region.

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Kratom: Responsible use is key

Kratom is a strange plant with many effects and side effects. Though it has a relatively good safety profile, it is not without its risks, and these must be understood and acknowledged if you are to use it safely.

By using kratom responsibly and being aware of its potential risks, you can make informed choices about its role in your lifestyle and mitigate its negative effects. Knowledge is power!

Max Sargent

Max has been writing for over a decade, and has come into cannabis and psychedelic journalism in the last few years. Writing for companies such as Zamnesia, Royal Queen Seeds, Cannaconnection, Gorilla Seeds, MushMagic and more, he has experience in a broad spectrum of the industry.

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