Kratom

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Help American Kratom Association fight to keep Kratom legal.

"A well-organized, coordinated campaign from the FDA and Big Pharma is threatening access to the supplements you depend on. Using the false premise that supplements are unsafe, the FDA is working to gain more power over the regulation of supplements in order to further solidify Big Pharma’s monopoly over medicine. These efforts must be opposed.

If this passes, the FDA would have the power to ban kratom by denying supplement registrations.

Please write to your Congressional representatives and tell them to oppose efforts to establish a "mandatory filing" for supplements."

We are not doctors and we aren't giving out medical advice. We are patient advocates who are passing along valuable information and we hope it helps you.

We've received many questions about Kratom. Many of you have been cut off of your pain medication or have been tapered to a dose that no longer helps. Kratom can be a good option for some, but we know it can be overwhelming to figure it all out. We've included information and links to help you get started in case Kratom is an option you'd like to explore.

Throughout the article, we will link to several websites about Kratom. Kratom IQ and American Kratom Association are two of the main sources we will cite. 

What Is Kratom?

  • From Kratom IQ: "Kratom is a leafy plant native to Southeast Asia, namely Indonesia, Thailand, Malaysia and Bali, that’s actually part of the coffee family. The leaves can be chewed (what Thai workers do to work long hours in the heat) but for the typical end user, the leaves are most commonly crushed and processed to form a fine powder."
  • From American Kratom Association: "Kratom is not a drug. Kratom is not an opiate. Kratom is not a synthetic substance. Naturally occurring Kratom is a safe herbal supplement that behaves as a partial mu-opioid receptor agonist and is used for paiWn management, energy, even depression and anxiety that are common among Americans. Kratom contains no opiates, but it does bind to the same receptor sites in the brain. Chocolate, coffee, and exercise hit these receptor sites in a similar fashion."

What Can Kratom Treat?

Please understand Kratom is not FDA approved, but there have been some studies done. People have claimed Kratom has helped them with the following:

  • Pain
  • Opioid Withdrawal
  • Anxiety/Depression
  • Lack of Energy
  • Insomnia

How Do I Take Kratom?

  • There are three main ways to take Kratom:
    • Steep the powder in tea-this is why you sometimes hear it referred to as "tea."
      • Watch this tutorial by Kratom IQ
      • "You boil up the powder with some water for 30 minutes or so, let it sit, then strain off the liquid. Some people feel this results in better and more consistent effects but it’s obviously more time consuming to produce. The taste isn’t too bad and you can drink it hot or cold. It’s quite nice chilled actually."
    • Take the powder straight, also called "toss and wash."
      •  Some tips on how to do this by Kratom IQ
      • The steps are pretty simple
        • Measure out power (it can be helpful to use a measuring spoon so you know exact amount of dose)
        • Put it in your mouth
        • Swallow it using something to drink.
    • Taking them in capsules

What Do The Different Strains Mean?

  • There are three main strains:
    • Red- This is usually best for pain and relaxation. It's also recommended for those going through opioid withdrawal. It can make some people sleepy. Not everyone is the same and some people actually get energy from red stains.
    • Green- This is usually best for anxiety. Some greens are relaxing and some energizing. Again everyone responds differently to different strains.
    • White- This is usually best for energy. Often people will take a little white with red when they need pain relief but need to counteract the sedating effects of a red. Not everyone is the same and some people get sleepy from whites or even anxious.
  • It is ok to mix the strains, and each strain also has many different varieties. Kratom is a lot of trial and error to find what dose and strain work for you.

What Dose Should I Start With?

This varies from person to person. It does take time to find the right strain and the right dose for your body. Don't give up after trying a few times. Keep at it, and you should be able to find a therapeutic dose for you. This dose is often referred to as the "sweet spot."

Most vendors and Kratom organizations will suggest you weigh your kratom instead of measuring it with a spoon because it's more exact. One teaspoon is approximately 2-2.5 grams of kratom. The following are the steps we suggest you take when beginning Kratom taken from Kratom IQ. Keep in mind a typical beginner dose of Kratom is anywhere from 3 grams (1 tsp) - 10 grams (about 1 tbsp):

  • Step 1: Take 2 or 3 grams (or I suggest 1/2-1tsp). You should start to feel some relief after 20 minutes or so.
  • Step 2: Assess how you feel after 30 – 45 minutes. If you think you need some more, take another 1 to 2 grams.
  • Step 3: Assess how you feel after 15 – 30 minutes. Remember you might have a bit of a higher tolerance if you've taken daily opioids.
  • Step 4: If you still don't feel relief add another 1/2 tsp.
  • Step 5: If you don't feel relief yet, wait another 4-5 hours to try again. 
  • Step 6: After 4 or 5 hours have passed and you want to take more, repeat this process with the SAME strain you used earlier in the day (starting with the dose you ended with).
  • VERY IMPORTANT to remember that just because you found your dose with one strain it doesn't mean it will be the same with all strains. Any time you start a new strain, always repeat this process.

What Happens If I Take Too Much?

  • You'll know if you take too much Kratom because you may feel nauseated or even throw up. This is why we suggest starting small and taking it in increasing small increments until you find your "sweet spot." Many pain patients start out with too large of a dose out of desperation for pain relief, they end up vomiting, and then think they're allergic to it.
  • There is also something Kratom users refer to as "the wobbles."
    • What is it?: You may feel dizzy, have brain fog, feel like you can't focus your eyes.
    • How can I avoid it?:  It's pretty easy to avoid. Don't take huge doses of kratom. Follow the instructions we've listed and you should be fine.
    • How can I treat it?:  There are varying opinions on the internet on how to treat this. Mostly, just know it's not dangerous and it will pass. Drink a lot of water and lie down if you can.

What Happens If My Dose Is Too Small?

Nothing. You'll get little to no relief. So, keep trying increasing your dose slowly until you find the right dose for you.

Where Should I Buy Kratom?

We highly suggest you don't buy Kratom at a local smoke shop, but instead use a reputable online vendor. Here are some tips on how to pick a vendor:

  • Talk to other CPP's and ask them what they use.
  • Read reviews.
  • Some vendors test their product and list what is in it. This is always a positive thing to look for.
  • American Kratom Association has the following programs:
    • GMP standard program (Good Manufacturing Practice Standards Program). 
    • Truth in labeling program. "The AKA strongly opposes unscrupulous vendors who use illegal health claims to increase sales of kratom products. This new self-regulation program will encourage consumers to report potential marketing violations so that the FDA can investigate and, when appropriate, take needed enforcement actions against kratom vendors who use impermissible health claims to mislead consumers about the actual benefits of using this otherwise safe food product. This new program is a valuable addition to the current AKA vendor GMP program that requires participating vendors to adhere to good manufacturing practices (GMPs) and to submit to an independent 3rd party audit to verify compliance."
    • Here is a list of vendors that qualify for these programs with American Kratom Association

How Does Kratom Help CPP's?

  • Pain- Kratom can help treat pain. It varies from person to person how much it actually helps, but it definitely can help some people manage their pain.
  • Opioid withdrawal - Many CPP's are being abandoned, cut off their opioid medication completely, or quickly tapered causing not only increased pain but also horrific withdrawal. Kratom can definitely help mitigate some of the symptoms of withdrawal.

Will It Help My Pain As Much As Opioids?

For some people it will and for others it won't. It's worth trying to see if you can get some relief using Kratom.

Will My Doctor Test For It At The Pain Management Clinic?

We have heard of some doctors testing for Kratom in their UDT's. Check your pain contract to see if it's listed. Depending on how much you trust your doctor, you may want to discuss it to see what their policy is on Kratom. Since Kratom is considered a supplement and isn't a controlled substance, it shouldn't be against a pain contract unless it's specifically stated. That isn't to say a doctor won't consider it a breach of contract. We've heard of that happening. 

Is Kratom Legal?

Kratom is legal in most states. There are currently 6 states where Kratom is banned, and some others with varying laws.

Other Important Information About Kratom:

  • Since Kratom interacts with receptors in the brain, it's suggested that you put about four hours between taking Kratom and prescription opioids. Some people who don't get enough prescription opioids to treat their pain use Kratom in between doses of medication. It won't be dangerous to take with opioids, but if you don't leave enough time between taking opioids and Kratom, they can cancel each other out.
  • It's important to make sure you stay hydrated by drinking extra water while taking Kratom.
  • You can build a tolerance to Kratom if you take it daily. 
  • Less seems to be more with Kratom. If your dose stops working, instead of taking more, try to cut your dose a little. For some reason this seems to work well.
  • Rotate strains so you don't develop tolerance as quickly.
  • Kratom is considered a Harm Reduction resource since it can prevent patients from purchasing medication illicitly to self-treat their pain or withdrawal.

The Doctor Patient Forum

Claudia A. Merandi 5 Chedell Ave, E Providence, RI 029141.401.523.0426

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