Kratom is a tropical tree native to Thailand, Malaysia, Myanmar, and other areas of Southeast Asia. Consumption of its leaves produces both stimulant effects (in low doses) and sedative effects (in high doses) and can lead to addiction. The leaves from Kratom trees are widely available on the internet and sold as crushed leaves that can be smoked or steeped for tea and as gel capsules. Street names include Thang, Kakuam, Thom, Ketum, and Biak. The kratom tree can reach heights of 50 feet with a spread of more than 15 feet.

Forms available through the internet include leaves (whole or crushed), powder, extract, encapsulated powder, and resin “pies” (pellets made from reduced extract). Kratom is mainly abused orally as a tea. Chewing kratom leaves is another method of abuse. At low doses, kratom produces stimulant effects with users reporting increased alertness, physical energy, talkativeness, and sociable behavior. At high doses, users experience sedative effects. Effects occur within 5 to 10 minutes of ingestion and last for 2 to 5 hours.

Kratom consumption can lead to addiction. Several cases of psychosis resulting from use of kratom have been reported, where individuals addicted to kratom exhibited psychotic symptoms, including hallucinations, delusion, and confusion. Withdrawal effects include symptoms of hostility, aggression, mood swings, runny nose, achy muscles and bones, and jerky movement of the limbs. Kratom’s effects on the body include nausea, itching, sweating, dry mouth, constipation, increased urination, and loss of appetite. Long-term users of kratom have experienced anorexia, weight loss, insomnia, skin darkening, dry mouth, frequent urination, and constipation.

The dominant effects of kratom are similar to those of psychostimulant drugs. Kratom has been abused as a recreational drug around the world. In low doses (10 grams) kratom induces mild euphoria and reduces fatigue, and generally does not interfere with ordinary activities. With strong doses (20-50 grams) the effects are said to be profoundly euphoric and immensely pleasurable.

Kratom is not controlled under the Controlled Substances Act. There is no legitimate medical use for Kratom in the United States. However, it is marketed on the Internet as “alternative medicine” for use as a pain killer, medicine for diarrhea, and other ailments and for the treatment of opiate addiction. Kratom is legal in the United States but is on the DEA list of Drugs and Chemicals of Concern. The kratom tree grows in areas of Southeast Asia, but various forms of kratom are widely available on the Internet.