HomeMy WebLinkAboutKratom PresentationWhat is
Kratom?
Kratom tree (Mitragyna Speciosa) is indigenous to Southeast Asia.
Traditionally used for pain relief and energy by agricultural workers.
Kratom and coffee are members of the Rubiaceae family of plants.
Strains: Red, Green, White
This Photo by Unknown Author is licensed under CC BY-ND
Nature’s Symphony Orchestra
Kratom has over 40 alkaloids. The
most abundant is mitragynine. 7-
hydroxymitragynine (7OH) is found
in less than 2% of the plant (most
often in trace amounts).
Kratom is most stimulating (similar
to coffee) at low doses. Higher
doses can cause relaxing and
analgesic effects.
Kratom is a partial opioid agonist,
unlike full agonists like oxycodone,
fentanyl and heroin.
Who Uses Kratom & Why?
61% Women
Avg Age is 40 yrs old
84% College Educated
91% for Pain Relief
67% Anxiety
64% Depression
41% Opioid Dependence
Of those using it for opioid withdrawal,
87% reported relief from withdrawal
symptoms.
35% were free from Opioids for >1 year. (14)
A Pain & Mental Health Perspective
Low serving amounts have been reported to alleviate or control
chronic pain, improve anxiety symptoms and even aid in depression.
Higher doses are often used for acute pain or more severe mental
health challenges.
Serving sizes vary between individuals due to varying levels of pain
and other symptoms.
Less is more with Kratom. Consumers should take the lowest dose
possible to achieve the desired effects. Breaks are suggested to
avoid tolerance.
Kratom produces effects within 15-20 minutes of consumption and
lasts 3-6 hours.
Consumers select strains to achieve desired effects:
Red – Pain
Green – Pain & Mood
White – Energy
Higher Kratom consumption, especially if consumed due to
addiction tendencies, may cause withdrawals to be more
pronounced due to Post Acute Withdrawal Syndrome (PAWS).
Kratom vs.
Pharmaceuticals
Dependence does not mean addiction.
OTC medications are often not sufficient to treat
severe pain.
We are in the midst of an opioid epidemic crisis!
Opioid prescriptions are being restricted or even
denied. Many pain patients, out of desperation, have
turned to alternative forms of pain control (Kratom
and Cannabis). To restrict access to these
alternatives will result in suicides and black-market
purchases (which often contain deadly Fentanyl).
Many patients prefer to treat their symptoms with
plant supplements rather than pharmaceuticals.
Many physicians are not educated about kratom and
can stigmatize patients who opt to use alternative
medicine.
Organizations like the Veterans Administration (VA)
are unable to legally recommend kratom although
many veterans could benefit from the pain and PTSD
relief that kratom can provide.
Synthetic Products
are NOT Kratom
7 Hydroxymitragynine (7-OH) is
a metabolite of mitragynine. It
is less than 1% of the natural
plant.
7-OH products have a binding
affinity 14-22 times greater
than morphine.
Animal studies have
demonstrated respiratory
depression.
Extreme addiction concerns.
Many products have brand
names that allude to narcotics.
7-OH
Synthetics
These are
NOT Kratom!
Kratom Science
This Photo by Unknown Author is licensed under CC BY
Mayo Clinic
vs.
Johns Hopkins
&
University of
Florida
Mayo Clinic has never conducted research on Kratom.
The information cited on their website is not supported
by any scientific study or any real-world experience.
Johns Hopkins and University of Florida are
championing Kratom research. Each boast a team of
researchers committed to furthering the science around
Kratom. Many of the lead researchers have published
several papers helping consumers and the medical
community understand this plant supplement.
Reported Physical Effects of Kratom
Correlation Does Not Imply Causation
Reported Physical Effects of Kratom
Correlation Does Not Imply Causation
Many of the claims regarding kratom's effects come from individual case reports
or anecdotal accounts.
As a result, these reports are often prone to bias and do not establish causality.
Many cited case reports have confounding variables such as polypharmacy, pre-
existing health conditions and lifestyle factors (like diet, exercise, and substance
use).
Without isolating these variables, it becomes difficult to determine if kratom is
the sole cause of the reported outcomes.
Read Terms Carefully.
Beware of Jumping to Conclusions!
The terms often used in reports such as:
“linked to”
“related to”
“associated with”
“potential effects”
These terms reflect uncertainty and a lack of direct evidence.
The use of terms that imply causality without supporting evidence can lead to
misleading impressions, especially in public health communications or media
reports.
This can create unnecessary fear or stigma surrounding the use of kratom.
Comprehensive Review 2024
Liver Toxicity
Kratom Tylenol (Acetaminophen)
Tylenol liver toxicity: 30,000 people are hospitalized
each year for acetaminophen toxicity. (420,000 since
2011).
Acetaminophen toxicity is the number one cause of
liver transplantation in the United States.
300 people die annually from acetaminophen
toxicity.
Nine (9) single case studies cited for
evidence of liver toxicity since 2011.
All single case studies citing liver toxicity
have confounding variables such as co-
occurring substances, underlying
conditions, and lack of product
information.
None were fatal.
Comprehensive Review 2024
Other Single Case Studies
Seizures: 4 single
case reports
Cardiotoxicity: 2
single case reports,
1 experiment on
cardiac cells
The terms often used in reports such as "linked to," "related to,"
"associated with," and "potential effects“, reflect uncertainty and a lack
of direct proof. The use of terms that imply causality without supporting
evidence can lead to misleading impressions. This can create unnecessary
fear or stigma surrounding the use of kratom, despite the lack of
conclusive evidence linking it to harmful effects in many cases.
Randomized Controlled Trial
To determine the tolerability of kratom.
Subjects in both groups had nausea at 12 grams (24
capsules).
Baylor College of Medicine is currently conducting a human
abuse potential (HAP) study.
FDA Single Ascending Dose Study 2024
Key Kratom Study Findings
Whole leaf kratom does not lead to respiratory depression.
It does not recruit the beta-arrestin pathway like classical opioids
A large John Hopkins survey indicates that <10% report symptoms of mild
Kratom Use Disorder.
Kratom has a wide safety range in dosing.
An FDA study demonstrated no adverse effects (other than nausea) for 12 grams (24
capsules) in a 5-minute period of time.
Despite millions of users, there are rare reports of physical harm from
kratom alone.
1.Dr. Marilyn Huestis, AB, MS, PhD (Toxicologist)
Dr. Huestis stresses the importance of a balanced, evidence-based approach to kratom regulation. She clarifies that most reported
“kratom overdose deaths” involved poly-substance use, adulterated products, or incomplete testing — not kratom alone.
Testimonies: Video 1, Video 2.
2.Dr. Christopher McCurdy PhD, FAAPS (Professor of Medicinal Chemistry, Pharmacologist)Dr. McCurdy has demonstrated that kratom’s primary alkaloids (mitragynine and 7-hydroxymitragynine) provide pain relief without the high risk of respiratory depression associated with opioids. His testimony also points to kratom’s promise as an aid in opioid withdrawal therapy. Video Testimony.
3.Dr. Kirsten Smith PhD (University of Florida Researcher)
Dr. Smith’s research shows kratom’s potential as a harm-reduction tool, particularly for reducing opioid cravings and withdrawal
symptoms. Video Testimony.
4.Dr. Ed Boyer MD/PhD (Renowned Toxicologist)
Dr. Boyer notes that adverse events tied to kratom are usually linked to contamination, misuse, or underlying conditions — not the
plant itself. He emphasizes the importance of continued research over prohibition. Video Testimony.
5.Dr. Jack Henningfield (Addiction Research Expert) - Adjunct professor of behavioral biology at the Johns Hopkins School of
Medicine
Dr. Henningfield highlights kratom’s role as a safer alternative for individuals with opioid dependence and urges against classifying
kratom as inherently dangerous without acknowledging its therapeutic potential. Video Testimony.
6.Dr. Nora D. Volkow MD (Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health)
Dr. Volkow has taken a measured approach to kratom, advocating for more research and appropriate regulation instead of a federal
ban. NIDA is actively funding research on kratom and its alkaloids, including mitragynine, with over $30 million in grants dedicated to
its study. This research aims to understand its potential benefits for treating pain and opioid withdrawal. Video Testimony
Kratom – A Harm Reduction
Perspective
Any transition away from “one pill kills” is a win!
Since Kratom is a partial opioid agonist and does not suppress breathing, it becomes a much safer option than opioids or illicit drugs.
Kratom can be an affordable option when drug rehabilitation stays or ongoing suboxone treatment is not possible.
Kratom effectively “pushes the pause button” on cravings making it possible for addicts to discontinue using dangerous substances. NOTE: Kratom is not to be taken in conjunction with alcohol.
Kratom has been shown to reduce alcohol cravings.
Those suffering from Substance Use Disorder can have physical pain conditions. Kratom can be a viable option to treat their pain and to transition them away from harmful opioids or illicit drugs.
Kratom’s
Addiction Profile
•Addictive 7-OH products are being
misrepresented as Kratom which causes
confusion.
•The vast majority of Kratom consumers
are not abusing these products.
•Caution should be taken if consuming
Kratom extracts since they contain more
concentrated mitragynine content and
can more quickly cause tolerance
issues.
•Kratom does have the potential to lead
to dependence in some individuals
(especially those with past drug abuse),
especially if misused.
“When kratom withdrawal occurs,
consumers usually characterize it as mild
to moderate and specify symptoms such
as kratom craving, low energy, fatigue,
irritability, fatigue, anxiety, depressed
mood, restless legs, difficulty sleeping
gastrointestinal upset, cold and hot
flashes, goosebumps, and muscle
twitches.” (17)
Withdrawals
Kratom * Government * Regulations * Safety
FDA & DEA
The FDA has had a long-standing concern regarding Kratom claiming safety concerns,
lack of regulation, potential for abuse and lack of scientific evidence.
Timeline & Facts
The DEA announced intent to reclassify Kratom as a schedule one substance.
Due to public outcry, the rescheduling is postponed.
In August, HHS Assistant Secretary for Health Brett Giroir MD formally withdrew the FDA's
scheduling recommendation for kratom, citing "disappointingly poor evidence & data and
a failure to consider the overall public health.“ This is the first time in history that the DEA
has withdrawn a scheduling request.
FDA announces their intent to conduct a Human Abuse Potential (HAP) Study for Kratom.
FDA conducts Single Ascending Dose (SAD) Study and finds that Kratom is safe so HAP
study can occur at a future date.
FDA refuses to testify in a court case. "They [FDA] have refused to provide us with
witnesses or documents to support our position . . . The reason they gave was that they
have not yet made a determination regarding whether kratom is dangerous.”
FDA publishes safety notice regarding 7-OH products. On July 29, 2025, the FDA
admonishes the DEA to begin scheduling process for 7-OH products.
2016
2016
2018
2024
2024
2024
2025
Blue – Legal & KCPA passed
Green – Legal states
Yellow – States with some local bans
Red – States with kratom bans in place
Why Should Your City Pass The Kratom
Consumer Protection Ordinance?
Age restricted
Good Manufacturing Practices (GMP)
Proper labeling
Lab testing
Limitations on concentrating or synthesizing
Sec. 3. Kratom product limitations.
It shall be unlawful for any processor to prepare, distribute, sell, or expose for sale any of the following:
a)A kratom product that is adulterated with a dangerous non-kratom substance further defined as a
kratom product that is mixed or packed with a non-kratom substanceA kratom product containing a
level of 7-hydroxymitragynine (7-OH) in an alkaloid fraction that is greater than 2% of the overall
alkaloid composition of the product. A product serving size cannot exceed 1 mg. per serving of 7-OH.
b)A kratom product containing any synthetic alkaloids including synthetic mitragynine, synthetic 7-
hydroxymitragynine, or any other synthetically derived compounds of the kratom plant.
c)A kratom product that does not provide labeling directions necessary for safe use by consumers,
including a recommended serving size.
d)A kratom product that bears a label that makes claims the product is intended to diagnose, treat,
cure, or prevent a medical condition or disease.
e)A kratom product that the retailer at the point of sale does not have on file and available a COA
showing the kratom product is compliant with the provisions of this ordinance.
Key Elements from KCPO
(see KCPO for full language)
Sec. 4. Age limits and Selling Conditions
a)A processor shall not distribute, sell, sample or expose for sale a kratom product to
an individual under (18 or 21) years of age.
b)Kratom products offered for sale must be placed behind the retailer’s counter.
Sec. 5. Violations. (customize this on a city-by-city basis)
a)A processor that violates section 3 is subject to an administrative fine of not more
than ($xxxx) for the first offense and not more than ($xxxx) for the second offense.
b)A retailer does not violate section 3 if it is shown by a preponderance of the
evidence that the retailer relied in good faith upon the representations of a
manufacturer, processor, packer, or distributor of food represented to be a kratom
product.
c)Administrative enforcement. Any third violation of this ordinance is hereby
declared to be grounds for revoking or suspending any business license necessary
to sell consumer goods in (list city, county, etc.)
Key Elements from KCPO
(see KCPO for full language)
Properly Labeled GMP Kratom Product
KCPA State and Local
Legislation
Enact
Educate
Enforce
It’s the way forward!
Protect consumers while
preserving safe access.
For More Information About Kratom:
www.kratomanswers.org
www.americankratom.org
www.protectkratom.org
Understanding Kratom Use: A Guide for
Healthcare Providers
Marc T Swogger 1,*,Kirsten E Smith 2,Albert Garcia-
Romeu 3,Oliver Grundmann 4,5,Charles A Veltri 4,Jack E
Henningfield 3,6,Lorna Y Busch 1
Link:
Understanding Kratom Use: A Guide for Healthcare
Providers - PMC