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Kratom Symptoms and Signs

High doses of kratom have been associated with multiple side effects, including nausea and vomiting. Other studies have shown some people who use kratom for its mind-altering effects may become addicted or dependent if it is used regularly on a long-term basis. The same studies state kratom withdrawal symptoms resemble those of opiates. Some users have reported they do not feel high when using kratom and associated withdrawal symptoms are milder than those associated with opiates.1

Kratom Side Effects

Kratom effects are tied to the duration of use and other factors such as co-occurring drug use and the overall health of the user. In general terms, low doses result in increased energy, sociability and alertness, while high doses result in sedation, euphoria and decreased pain. Toxicity levels of kratom have yet to be determined.2 Short-term use is associated with the following:

  • Sun sensitivity (sunburn)
  • Nausea
  • Vomiting
  • Chills
  • Itching
  • Sweating
  • Myalgia (muscle pain)
  • Dry mouth
  • Constipation
  • Increased urination
  • Loss of appetite2,3

Long-Term Use

  • Anorexia
  • Weight loss
  • Insomnia
  • Loss of libido
  • Hyperpigmentation (skin darkening)
  • Dry mouth
  • Frequent urination
  • Constipation
  • Respiratory depression
  • Hepatotoxicity (liver damage)
  • Seizures
  • Hallucinations and paranoia (at high doses)2,3

Sign of Overdose

  • Seizures
  • Psychosis
  • Hallucinations
  • Paranoia
  • Severe vomiting
  • Respiratory depression
  • Coma
  • Death3

Poison Control Center Data (2010 to 2015)

A few insightful statistics on medical outcomes associated with kratom exposure can be found in a special report published by the Centers for Disease Control and Prevention (CDC) in July 2016. Co-ingestion with opiates, benzodiazepines, antidepressants or mood-stabilizing medications (Depakote or Lamictal) can result in serious cardiac complications, seizures and loss of airway protection, leading to coma or death, as evidenced by the CDC case series. The following is the breakdown of cases by severity, from no apparent effects to one fatality:4,5

  • None – No apparent effects were reported or found: 26.2%
  • Minor – Minimal signs or symptoms resolved rapidly with no residual disability: 24.5%
  • Moderate – Not life-threatening, with no residual disability; required some form of treatment: 41.7%
  • Major – Life-threatening signs or symptoms with some residual disability: 7.4%
  • Fatality – One death was reported in a person who was exposed to the medications paroxetine (an antidepressant) and lamotrigine (an anticonvulsant and mood stabilizer) in addition to kratom4

CDC-Reported Signs and Symptoms

  • Tachycardia: 25.0%
  • Agitation or irritability: 23.8%
  • Drowsiness: 19.4%
  • Nausea: 14.7%
  • Hypertension: 11.7%4
  1. Kratom: What We Know. Medscape website. http://www.medscape.com/viewarticle/874301 Published January 23, 2017. Accessed February 13, 2017.
  2. Commonly Abused Drugs Charts. National Institute on Drug Abuse. https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts Updated January 2016. Accessed February 13, 2017.
  3. Chang-Chien GC, Odonkor CA, Amorapanth P. Is Kratom the New ‘Legal High’ on the Block?: The Case of an Emerging Opioid Receptor Agonist with Substance Abuse Potential. Pain Physician. 2017 Jan-Feb;20(1):E195-E198.
  4. Anwar M, Law R, Schier J. Notes from the Field. Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers – United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65:748–749. DOI: http://dx.doi.org/10.15585/mmwr.mm6529a4.
  5. Robert Glatter. Kratom: New ‘Emerging Public Health Threat’, Says CDC. Forbes. July 30, 2016. http://www.forbes.com/sites/robertglatter/2016/07/30/kratom-new-emerging-public-health-threat-says-cdc/#5192414b5ae0 Accessed February 13, 2017.
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