Is Kratom an Opioid?

Illustration of Kratom capsules mixed with opioid tablets.
Written by Livvy Ashton | Last updated: December 9, 2022

Kratom is often used as an alternative to opioids, and many people wonder whether it is an opioid itself. The answer is a bit complicated. While kratom does have some features that overlap with opioid medications, it also has some key differences.

Chemically speaking, kratom is not an opioid.

Let’s explore those similarities and differences in detail so you can decide whether kratom is right for you.

Is Kratom an Opioid?

No, kratom is technically not an opioid. While it does interact with opioid receptors, it is not an opioid itself. Kratom alkaloids have also been shown to interact with other systems in the brain, providing a variety of benefits that opioids do not.

How Is Kratom Similar to Opioids?

The primary cause of this common misconception is that kratom interacts with opioid receptors. When kratom is consumed, the compounds in the plant bind to opioid receptors, mimicking the effect that prescription painkillers have on the brain.

The two main alkaloids in kratom (mitragynine and 7-hydroxymitragynine) are responsible for their pain-relieving effects. According to research, kratom produces similar effects to stronger opioids like morphine [8].

Kratom also produces feelings of deep relaxation and euphoria, giving the user an experience similar to that of taking opioid drugs. Because of this, it is commonly used to help opioid addicts get through the first few weeks of withdrawal by functioning as a replacement for their drug of choice.

Kratom shares opioids’ pain relief mechanism by activating opiate receptors in the brain and spinal cord, effectively suppressing the central nervous system [1]. However, it is almost impossible to overdose on kratom, and it’s unlikely to cause respiratory depression when used alone [2].

How Is Kratom Different From Opioids?

As opposed to opioids, research also shows that kratom can potentially act as an effective antidepressant and anxiolytic due to its ability to interact with serotonin, dopamine, and adrenergic receptors [3].

Kratom’s unique muscle relaxing and inflammatory actions have also been recognized in clinical studies, further distinguishing kratom from opioids, which do not possess these properties [4].

Is Kratom a Safe & Effective Opioid Alternative?

As with any drug, herb, or medicinal remedy, kratom’s safety is dependent on responsible use and administration. That said, most people experience very few problems when using it correctly. Side effects include dizziness, headaches, nausea, vomiting, and lethargy. These are more common with larger doses but are relatively short-lived and pass quickly.

Here are a few things to keep in mind that will help you stay safe when using kratom.

Proper Dosing

Using too much kratom can cause unpleasant side effects, as mentioned above. These typically don’t last long and fade as the kratom passes through your system.

To avoid side effects, start with a small amount — about 2 grams — and work your way up half a gram to a gram at a time. Until you find the effects you’re after. Allow thirty minutes to pass before consuming more to make sure the kratom’s full effects have kicked in.

Kratom & Drug Interactions

One of the biggest risks of kratom use is its interactions with other substances. There is a high risk of it causing adverse reactions with certain drugs — especially opioids and other central nervous system depressants. Most deaths involving kratom included other drugs, such as opioids, cocaine, or benzodiazepines.

Kratom is metabolized by cytochrome P450, the same enzyme that metabolizes many other drugs. This can slow down the process, causing the drug to remain in the body longer than usual, leading to severe side effects.

Don’t use kratom with anything else until a doctor has okayed it.

Kratom Tolerance, Overdose, & Addiction

It’s important to note that kratom can be addictive. However, this addiction is far less dangerous than addiction to opioids or other substances, and overdose is incredibly rare [6, 10].

Opioid use is an epidemic that continues to cause deaths nationwide. Respiratory depression caused by the activation of mu-opioid receptors is the most common cause of opioid fatalities [9]. These receptors have a strong dampening effect on the respiratory system. In comparison, kratom has a milder effect on the receptors and is not likely to cause an overdose or respiratory depression.

While kratom’s alkaloid mitragynine interacts with mu-opioid receptors, research shows a “ceiling effect” due to mitragynine’s conversion to 7-hydroxymitragynine. This conversion limits the likelihood of respiratory depression since the alkaloid can only suppress the receptor so much [7].

Constant use and using too high of doses can also lead to building a tolerance, where you eventually have to up the dose to get the same results.

To avoid addiction and tolerance, only use kratom when necessary, avoid using it for a few days every week, and stick with as small a dose as possible.

Kratom for Opioid Withdrawal

Kratom powder on a saucer and some Kratom capsules

Current research shows that kratom is generally safe and effective for treating depression, anxiety, and opiate withdrawal symptoms [5].

While the literature on kratom’s efficacy as a treatment for opioid addiction is still thin, many individuals who have used kratom to quit opioids report that it has helped them significantly. Kratom is commonly used as opioid replacement therapy to help reduce cravings and withdrawal symptoms while providing users with a sense of well-being.

Some of the benefits of using kratom in opioid replacement therapy include:

  • Reduced cravings for opioids
  • Mood enhancement
  • Improved focus and concentration
  • Pain relief
  • Muscle relaxation
  • Anti-inflammatory effects
  • Antioxidant properties

In addition, kratom’s safety profile is relatively favorable when compared to other opioid replacement therapies:

What Is Kratom?

Kratom (Mitragyna speciosa) is an herbal plant that grows in Southeast Asia. It’s related to the coffee family and has been used for centuries by the indigenous people for its stimulant effects.

It was a traditional remedy for many ailments, including:

  • Cough
  • Diabetes
  • Fever
  • Low libido
  • Parasitic infection
  • Wounds, scratches, and skin allergies

In recent years, kratom has become increasingly popular in the West as people have begun using it as an alternative to opioids. Kratom is generally sold in powder form or as capsules. It can also be consumed as a tea by boiling or dissolving kratom in hot water.

Kratom is not an illegal substance in the U.S., although some states and cities have banned it. There has been some controversy over its use and regulation. In 2016, the Drug Enforcement Administration (DEA) proposed making kratom a Schedule I drug, which would have effectively banned it. However, after significant public outcry, the DEA withdrew its proposal, and kratom remains legal at the federal level. More recently, in 2021, the World Health Organization reviewed it and stated kratom is not a danger to public health and recommended not scheduling it.

Kratom is most commonly used to treat various forms of pain, including relief from chronic pain. It also works best in managing depression and anxiety, insomnia, fatigue, and helps mitigate opioid withdrawal symptoms.

What Are Kratom Strains?

There are three main varieties — or strains — of kratom:

  • White-vein kratom: This variety is said to have energizing and stimulating effects and is often used for increased productivity or as an alternative to coffee.
  • Red-vein kratom: This variety is said to have sedating and pain-relieving effects. It is typically used for chronic pain or to ease opioid withdrawal symptoms.
  • Green-vein kratom: This variety is said to have effects somewhere between those of white- and red-vein kratom, providing both energy and pain relief.

Kratom’s Effects

The effects of kratom vary depending on the dose and the individual. Effects may also differ based on the dosage, with lower doses giving users more energy and higher doses resulting in more relaxation.

The effects of kratom usually last for three to five hours, although some people report that the effects last longer. Finding the appropriate dosage that suits your requirements is usually all it takes to have a good experience with kratom.

Final Thoughts: Kratom Can Be a Safe Alternative to Opioids

Kratom leaves in white background

Kratom is a relatively safe and effective herbal remedy with many benefits, including treating the symptoms of opioid withdrawal. It can help manage cravings and promote feelings of well-being and euphoria. It has a low risk of addiction and side effects when used responsibly.

When used irresponsibly, kratom can be habit-forming with severe negative effects. It’s critical to use kratom judiciously. Kratom should never be mixed with other drugs, medications, or alcohol.

Overall, kratom has the potential to be dangerous, and adverse reactions are common with abuse or impure products. However, most people don’t experience any adverse effects from kratom; even if they do, the effects are typically mild and only happen when taken in large doses.

References Used

  1. Chakraborty, S., Uprety, R., Daibani, A. E., Rouzic, V. L., Hunkele, A., Appourchaux, K., … & Majumdar, S. (2021). Kratom alkaloids as probes for opioid receptor function: pharmacological characterization of minor indole and oxindole alkaloids from kratom. ACS Chemical Neuroscience, 12(14), 2661-2678 [1].
  2. White, C. M. (2019). Pharmacologic and clinical assessment of kratom: An update. American Journal of Health-System Pharmacy, 76(23), 1915-1925 [].
  3. Johnson, L. E., Balyan, L., Magdalany, A., Saeed, F., Salinas, R., Wallace, S., … & Grundmann, O. (2020). Focus: Plant-based Medicine and Pharmacology: The Potential for Kratom as an Antidepressant and Antipsychotic. The Yale Journal of Biology and Medicine, 93(2), 283 [3].
  4. Firmansyah, A., Sundalian, M., & Taufiq, M. (2021). Kratom (Mitragyna speciosa korth) for a new medicinal: A review of pharmacological and compound analysis. Biointerface Research in Applied Chemistry, 11(2), 9704-9718 [].
  5. Domnic, G., Narayanan, S., Mohana-Kumaran, N., & Singh, D. (2022). Kratom (Mitragyna speciosa Korth) an overlooked medicinal plant in Malaysia. Journal of Substance Use, 27(1), 1-6 [5].
  6. Wilson, L. L., Chakraborty, S., Eans, S. O., Cirino, T. J., Stacy, H. M., Simons, C. A., … & McLaughlin, J. P. (2021). Kratom alkaloids, natural and semi-synthetic, show less physical dependence and ameliorate opioid withdrawal. Cellular and molecular neurobiology, 41(5), 1131-1143 [6].
  7. Hill, R., Kruegel, A. C., Javitch, J. A., Lane, J. R., & Canals, M. (2022). The respiratory depressant effects of mitragynine are limited by its conversion to 7-OH mitragynine. British Journal of Pharmacology [7].
  8. Suhaimi, F. W., Yusoff, N. H., Hassan, R., Mansor, S. M., Navaratnam, V., Müller, C. P., & Hassan, Z. (2016). Neurobiology of Kratom and its main alkaloid mitragynine. Brain research bulletin, 126, 29-40 [].
  9. Shook, J. E., Watkins, W. D., & Camporesi, E. M. (1990). Differential roles of opioid receptors in respiration, respiratory disease, and opiate-induced respiratory depression. Am Rev Respir Dis, 142(4), 895-909 [].
  10. Behnood-Rod, A., Chellian, R., Wilson, R., Hiranita, T., Sharma, A., Leon, F., … & Bruijnzeel, A. W. (2020). Evaluation of the rewarding effects of mitragynine and 7-hydroxymitragynine in an intracranial self-stimulation procedure in male and female rats. Drug and alcohol dependence, 215, 108235 [].

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.