Richard states, “I have suffered immense pain from fibromyalgia for 25 years, to the point of disability & early medical retirement from my job in government healthcare as a licensed psychiatric clinician at a county facility. I tried many medications to relieve my pain to no avail. I have also been a practicing herbalist for 22 years. It was recommended I try Kratom from another herbalist friend. I cannot begin to tell you of the immense relief immediately felt from the first dose of this amazing plant. I have been using kratom for several months now. I have no adverse effects, no withdrawal if not used, nor noticeable side effects. I can now go through the day with absolutely no pain! Period! This is one of the most valuable herbal remedies I have ever used.”

When Jason was 18 years old he broke his wrist and knuckles. He was given Vicodin and became addicted. He graduated to methadone and heroin. He had never used anything before but pot and alcohol occasionally. For the next seven years he was in and out of detox. All his plans went downhill. He had wanted to be a pro baseball player. He had trouble getting and keeping a job. He got a D.U.I. He watched eight of his friends die from heroin overdoses and he still couldn’t stop using. Then one day a friend posted on Facebook about kratom. Jason ordered a sample pack of a red vein strain, the most calming strain of Kratom. Since he started using kratom, he has not had the urge to use opioids again. Jason’s life is now back on track. He’s been clean for over eight months and is going to school to get a machinist certificate. He uses kratom for pain management,  anxiety, and depression. He doses twice a day and reports that it costs him $30-$40 a month. He’s now confident about his future. 

Millions of Americans now use Kratom as an alternative to opioids. Many have similar stories.

Read other inspiring stories

What is Kratom?

Kratom is an herb that is native to tropical Southeast Asia and is part of the coffee family. Its scientific name is Mitragyna speciosa. The American Kratom Association says kratom is “more akin to tea and coffee than any other substances”. It has been used medicinally by the people of Southeast Asia for hundreds of years. More recently, millions of Americans have begun using kratom for pain management, anxiety, insomnia, as an energy booster, and to ease withdrawal from opioids. Many pain patients insist kratom has significantly improved their  quality of life and others, like Jason, say it has literally saved their lives. 

The Johns Hopkins Kratom Study

The study, published online in the journal Drug and Alcohol Dependence in 2020, was an anonymous, online survey of 2798 kratom users. 59% of users reported taking kratom daily and the most common dosages were 1-3 grams.

Kratom was used by 91% of respondents for pain management, 67% for anxiety and 65% for depression, “with high ratings of effectiveness”. 41% reported using kratom as an opioid alternative. About a third of those using kratom for opioid withdrawal reported they were abstinent from opioids for over a year due to their kratom use.

About one third of respondents said they had adverse effects from kratom such as constipation, upset stomach or lethargy. They rated their adverse effects as mostly mild in severity and lasting less than 24 hours. A very small minority, .6%, sought treatment for adverse effects.

According to researchers, 2% of respondents met the diagnostic criteria for kratom-related substance abuse disorder. When asked how troubled they felt about their kratom use, the mean rating was 3.2 on a scale of 0 to 100.

A previous kratom study showed similar results

The results of this survey are similar to the 2016 online survey of 6150 kratom users by Pain News Network and the American Kratom Association. Nine out of ten respondents said kratom was “very effective” for pain management, depression, anxiety, insomnia, opioid addiction and alcoholism. Less than one percent said it didn’t help. The percentage of patients who rated kratom “very effective” for their pain condition:

• Irritable bowel syndrome 94%
• Migraine 93%
• Fibromyalgia 93%
• Rheumatoid arthritis 92%
• Back pain 92%
• Acute pain 92%
• Lupus and other autoimmune diseases 91%
• Osteoarthritis 90%
• Neuropathy 90%
• Trigeminal neuralgia 88%
• CRPS 79%
• Ehlers Danlos syndrome 76%

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Is there any evidence that kratom has a high potential for abuse so that it would not be a good opioid alternative?

According to Dr. Jack Henningfield, a highly respected addiction specialist at Johns Hopkins, kratom is no more addictive than caffeine and “the factors that appear important in sustaining kratom consumption appear more similar to those that sustain dietary caffeine consumption, namely to better manage fatigue and daily life demands and provide mild effects considered enhancing to quality of life” including pain relief and enhanced work performance. 

According to the National Institute on Drug Abuse, “Compared to deaths from other drugs, a very small number of deaths have been linked to kratom products and nearly all cases involved other drugs or contaminants.”

The federal government’s efforts to ban kratom

In 2016, the Drug Enforcement Administration proposed temporarily classifying kratom  as a Schedule I drug under the Controlled Substances Act, a drug with no known medical uses and a high potential for abuse. This would have made the use of kratom illegal. But the agency backtracked after a public outcry and pressure from some members of Congress. The DEA then asked the FDA to expedite scientific and medical evaluation instead.

In November 2017 the FDA issued a warning to consumers against using kratom, saying that there had been 36 deaths related to the herb. Scott Gottlieb, FDA Commissioner at the time, stated that kratom has similar risks of abuse, addiction, and death as opioids. This statement was ludicrous because the purported deaths from kratom occurred over a period of several years and were fewer than occurs in one day as a result of opioid overdoses. The National Institutes on Drug Abuse (NIDA) tested the FDA claims that kratom is associated with deaths, and they concluded those claimed deaths were actually caused by poly-drug users who abuse dangerous drugs or were caused by people who used an adulterated kratom product.

In 2018, the FDA published a report claiming that FDA scientists had “analyzed the chemical structures of the 25 most common compounds in kratom and concluded that all of the compounds share structural characteristics with controlled opioid analgesics, such as morphine derivatives. They also found that compounds in kratom that “bind strongly to mu-opioid receptors, comparable to opioid drugs”. This study and its conclusions have been widely criticized as misleading and unscientific. Other substances, such as Imodium, an over-the-counter remedy for diarrhea, also bind to opioid receptors but are not classified as opioids.

About 95% of kratom comes from Indonesia. The FDA reportedly played a role in the Indonesian government’s 2019 decision to ban the export of kratom as of 2022. Kratom advocates in Indonesia and the U.S. have convinced the Indonesian government to delay the export ban at least until 2024. There have been some restrictions placed on export by the Indonesian government that are negatively affecting supply and cost and hurting Indonesian farmers who were earning their living growing kratom.

In 2021, the FDA went to the World Health Organization and asked them for an international ban on kratom. In response, the WHO’s Executive Committee on Drug Dependency (ECDD) voted 11-1 to simply continue to monitor data on health impacts of kratom over the next two to three years, rather than institute strict controls. Members found “insufficient evidence” to warrant any action at the time. The committee based its decision on a scientific review of the benefits and risks of kratom. 80,000 people also submitted comments to the committee about their experiences with the herbal remedy.

The FDA continues to seize shipments of kratom to the United States  with no rationale other than that it is kratom.  The FDA’s continuous attempts to demonize kratom have also caused six states to criminalize kratom: Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin.

These actions by the federal government and states have caused many consumers to be fearful of trying kratom. In my humble opinion, the FDA and DEA are more concerned about protecting pharmaceutical profits than protecting public health.

Conclusion: Kratom is a safe and effective alternative to opioids

Although extensive research is lacking on kratom, all indicators are that kratom is much safer than opioids and provides better pain relief, making it an excellent opioid alternative.

The author, Cindy Perlin, is a Licensed Clinical Social Worker, certified biofeedback practitioner and chronic pain survivor. She is the founder and CEO of the Alternative Pain Treatment Directory and the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She's located in the Albany, NY area, where she has been helping people improve their health and emotional well-being for over 30 years. See her provider profile HERE. She is available for both in-office and virtual consultations.

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