Kratom for Pain
Many patients, doctors and government officials are asking, does kratom help with pain? Others wonder, is kratom addictive?
There are 10 to 15 million people in the United States who consume kratom for self-treatment for treating things such as pain, anxiety, depression, addiction, and lethargy.
Potentially 83% of all Americans taking kratom use it to overcome opioid dependence and addiction , presenting kratom as a potentially powerful aid to overcome America's opioid crisis.
How is kratom used to manage pain? Why is it a heated issue? Let's get into the details.
Kratom In Traditional Medicine
Although new to the western world, kratom has been used in traditional medicine for millennia in Southeast Asia to self-treat common medical problems, including chronic pain.
Historically, manual laborers (such as farmers, fisherman, and builders) in Northern Malaysia and Southern Thailand used kratom leaves to improve their work productivity and reduce joint pain and physical fatigue . It has also been used as a treatment for coughing, diabetes, diarrhea, pain, and lethargy. In rural communities, people also used it as a deworming agent and cataplasm for wounds
For centuries, a common use for kratom in Thailand was to reduce Morphine dependence.
Studies on Kratom as a Self-Treatment for Pain
In an online survey of 6,150 kratom consumers by Pain News Network and the American Kratom Association, nine out of ten said that kratom was a "very effective" treatment for pain, anxiety, depression, insomnia, opioid addiction and alcoholism. Fewer than one percent said it did not help.
What Kinds of Pain Can Kratom Help Manage?
The respondents in the survey above claimed that kratom helped them treat pain for the following causes: Cancer, Multiple Sclerosis, Irritable Bowel Syndrome, Migraine, Fibromyalgia, Rheumatoid Arthritis, Back Pain, Acute Pain, Lupus and other autoimmune diseases, Osteoarthritis, Neuropathy, Trigeminal Neuralgia, RSD or CRPS, and Ehlers Danlos Syndrome.
In another study, researchers at the John Hopkins University School of Medicine found that 91% of participants reported taking kratom to alleviate pain on average a couple times a day for back, shoulder and knee pain.
Is Kratom Addictive?
While any pain-relieving medication has the capability to be addictive, fewer than 3% of the Pain News Network survey's responses met the criteria for moderate or severe substance use disorder for abusing kratom.
While the DEA has cited fears that kratom is similar to an addictive recreational drug, recreational use is not a primary reason for consumption in any leading study.
Kratom's ability to enhance one's mood shouldn't be equated with a "high." Christopher R. McCurdy, PhD, a professor of medicinal chemistry at the University of Florida in Gainesville compares it to coffee:
"It is probably addictive, but its addictive equivalent is something like coffee, which isn't surprising because the leaf is in the coffee family."
How Does Kratom Work To Reduce Pain?
As mentioned in our previous article, kratom contains compounds called alkaloids. Its most abundant alkaloid, mitragynine, binds to the opioid receptors in the brain.This reduces the pain messages that get sent to the brain, so you don't feel it as much.
Additionally, mitragynine also interacts with Noradrenergic and Serotonergic Pathways to reduce the sensation of pain.
Other alkaloids, though in smaller abundances, also act to counteract pain in different ways; some of them are even more powerful than mitragynine (red strains often contain more of these alkaloids, which is why they're more popular for reducing pain).
While smaller amounts of kratom can have a more stimulating effect, the opioid effects are stronger with larger servings.
Kratom vs. Opioids and Opiates
Is kratom an opioid? Or is kratom and opiate? Despite all of the confusion around it, the answer is simple: kratom is not an opioid nor an opiate. It's only compared to an opioid because of the way it binds to the brain's opioid receptors.
An opioid is a narcotic analgesic derived from the poppy, while an opiate is a synthetic narcotic analgesic that resembles an opioid.
In 2019, FDA commissioner Scott Gottlieb, MD, tweeted about kratom, calling it "an opioid" that is "inherently addictive." This label is medically and scientifically false, yet the misinformation around kratom continues to be spread by even those who claim medical expertise.
Kratom For Opioid Addiction and Withdrawal
Approximately 2.1 million Americans have an addiction to opioids, and only 10% of them get treatment. Alcohol and drug addiction costs the U.S. economy over $600 billion every year, and roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
In 2019, the overall opioid dispensing rate was 46.7 prescriptions per 100 people, and some counties had rates that were six times higher than that.
Because kratom binds to the brain's opioid receptors, it makes it easier for patients who are addicted to opioids to stop taking their prescription and shift to something they believe to be safer.
While the FDA states that there's not enough evidence to prove that kratom is a safe alternative for pain treatment, studies like this one from 2019 show that the risk of death from overdose is over 1000 times more likely with opioids than kratom. Furthermore, there are no proven deaths from kratom overdose.
Kratom for Pain: The Ultimate Takeaway
While the FDA doesn't recommend kratom as a treatment for pain, and even indicates that it may be addictive, the majority of their stance is based on the lack of research on kratom.
Hopefully, recent studies like the ones mentioned in this article will shed light on kratom's potential as an herbal medicine. Ideally, kratom should be regulated by the FDA for quality control.
Whether or not you wish to try kratom to help treat your pain will be a personal decision, but either way, it's important to educate yourself properly on it. The stakes are high:
When kratom was almost banned in 2016, over 142,000 Americans signed a petition to keep kratom legal. 1,174 doctors, vets, scientists and law officers also petitioned the DEA to keep kratom legal.
The number of Americans who depend on kratom to keep them off of opioid dependence should be enough to prevent a ban on kratom simply due to lack of research.
In our next article, we'll explore the other benefits that kratom consumers say it provides.
Mitchell Cohen, M.D. is Board Certified doctor specializing in Orthopedic Medicine and Spinal Surgery. Graduated from Hahnemann University in Philadelphia, PA with a degree in Human Physiology (1983) and subsequently achieved his medical degree in 1987 from Case Western Reserve University School of Medicine. Dr Cohen did his Surgical Residency at the University of New Mexico in 1992 as well as a Spine Fellowship in 1993. Dr. Cohen has published the following medical journals: "Biomechanical Efficiency of Spinal Systems in Thorocolumbar Fractures" (1993), "Kaneda Anterior Spinal Instrumentation" and "Spinal Fusion Stabilization amongst many others. View Dr Cohen's Twitter Page.
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