Kratom for Chronic Pain?

By Drs. Jacob Teitelbaum and Ginevra Liptan

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Kratom

Kratom is not legally marketed in the U.S. as a drug or dietary supplement, according to the FDA. But people still use it. Fibromyalgia experts discuss Kratom as a pain relief option used under a healthcare provider’s guidance.

Lower Risk than Opiods

by Jacob Teitelbaum, M.D.

With one third of Americans suffering with chronic pain, approximately 50,000 preventable U.S. deaths each year from arthritis medications (e.g. NSAIDs like ibuprofen), and 5,000 yearly deaths from prescribed narcotics used as directed, we clearly have a major problem in how we treat chronic pain.

Having effectively treated thousands of people with fibromyalgia and other forms of severe chronic pain, and published a number of studies and textbook chapters on this, one simple fact has become very clear: Virtually all pain can be effectively treated, by using the entire healthcare toolkit. This includes both natural and prescription options, as well as socially controversial natural treatments such as marijuana, hemp oil, and kratom.

For example, numerous studies show that using natural options such as a special mix called Curamin, and even a mix of glucosamine plus chondroitin, is as or more effective than arthritis medications. And could save over 50,000 lives a year.

If not for a deadly quirk in our government’s regulatory system.

Basically, it costs anywhere from $100 million to $2.6 billion to put a single treatment through the FDA regulatory system. As nobody can pay this for non-patentable treatments, the enormous body of research using safe natural and low-cost generic medications cannot be effectively discussed or publicized.

Including Kratom.

Natural remedies, and Kratom is no exception, are not without risk. They simply carry much lower risks than medications. Although in my experience it has been uncommon if the dose is properly regulated, some people will develop cravings or even tolerance to this herbal. So I do not begin with this. Still, I have seen people who failed dozens of other herbals and medications, including narcotics, and had dramatic relief with Kratom.

As a physician, one learns to do a risk/benefit analysis. This includes looking at the validity of the data being used. As of 2017, the FDA reported 44 deaths worldwide associated with Kratom. But it is important to understand what the words “associated with” mean: simply that if they found any evidence of Kratom in the bloodstream when somebody died, even if they had a massive narcotic overdose and a gallon of tequila in them, this death is then “associated with” Kratom (1).
This faulty approach would claim that millions of deaths are associated with the use of milk, coffee or even toilet paper.

The bottom line? Kratom can be a very helpful tool in the healthcare toolkit when used with a health practitioner’s guidance; Kratom is far safer than ibuprofen and codeine; and Kratom should be reserved for when other natural treatment options have failed. To make it illegal will trigger far more suffering and deaths than it would prevent.

Still Too Risky

by Ginevra Liptan, M.D.

Kratom has significant medicinal potential for both pain management and easing opioid withdrawal, but most health care professionals do not recommend it due to safety concerns. Regardless of medical advice, consumers are using it—over 2 million Americans take kratom every year. While kratom is currently sold over the counter, its legal status is murky. Sales of kratom have been banned in six U.S. states, and in 2016 the DEA attempted to make it a Schedule I drug, but backed off after a public outcry.

I’ve found a surprising number of my patients are trying kratom without informing any of their doctors. Several of my patients report significant pain reduction with kratom, with some using it to successfully wean themselves off prescription opioids. Health care providers need to understand the pharmacology of this plant so they can discuss the risks and benefits with their patients.

Kratom has well documented medicinal actions, but its pharmacology is complex. The effects of kratom on the body are dosage dependent, lower doses give stimulant effects and larger doses provide analgesic and sedative effects. Kratom contains at least 40 different known phytochemicals with actions on multiple brain receptors. Its main active ingredients bind primarily to opioid receptors.

The biggest benefit of kratom is that while it has analgesic effects comparable to morphine, it causes less constipation, respiratory depression, and tolerance compared to opioids. However chronic use is not without risk and has been associated with drug dependency and development of opioid withdrawal symptoms. Rare side effects of kratom include psychosis, hypertension and liver failure. Although kratom has less respiratory suppression effects compared to opioids, it still can be deadly when mixed with other compounds. There are case reports of overdose deaths due to mixtures of kratom with over-the-counter cold medications, sleep medications, or benzodiazepines. However in total, kratom appears to be a much safer option than opioids.

Currently the biggest safety issue around kratom is the lack of supplement consistency and quality control as it is not being produced by any large or reputable supplement companies. There have been concerning reports of products adulterated with medications, or contaminated by bacteria, as occurred in a multistate Salmonella outbreak.

Kratom does have exciting therapeutic potential as a pain treatment, but for it to be really useful medically we need more information about safe dosing and interactions with other medications and access to high quality, standardized products.

Jacob Teitelbaum, M.D., is one of the most frequently quoted integrative medical authorities in the world. He is the author of 10 books, including the best-selling From Fatigued to Fantastic!, Pain Free, 1,2,3!, The Fatigue and Fibromyalgia Solution, Diabetes Is Optional and the popular free smartphone app Cures A-Z. He is the lead author of 4 studies on effective treatment for fibromyalgia and chronic fatigue syndrome is. Dr. Teitelbaum often appears as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and FoxNewsHealth. Learn more at www.Vitality101.com.

 

Ginevra Liptan, M.D., is a graduate of Tufts University School of Medicine. She’s board-certified in internal medicine and trained in functional medicine, a holistic approach that blends both western and alternative medicine. After developing fibromyalgia as a medical student, Dr. Liptan spent years using herself as guinea pig to find successful treatments, and has fine-tuned her approach by treating thousands of patients. She is one of the few clinical specialists in the world to focus solely on fibromyalgia, and directs The Frida Center for Fibromyalgia in Portland, OR. She is the author of The FibroManual: A Complete Fibromyalgia Treatment Guide for You and Your Doctor and The Fibro Food Formula: A Real-Life Approach to Fibromyalgia Relief. Learn more on drliptan.com and follow her on Facebook for fibromyalgia-centric research, blogs, opinion pieces, and updates at facebook.com/drliptan.

19 COMMENTS

  1. I have 4 different strains of kratom. I use it in capsule form. And while it does take the edge off of my pain at the dosage of 50mg 4daily it is far more useful in helping me fall asleep in spite of the pain levels. It also has helped in controlling spastic muscle jerks, and migraine headaches. It’s a wonderfully mysterious supplement helping me to reduce the need for harmful medications for high blood pressure, restless legs and depression caused by the no taper approach my pain specialist decided on when taking away my pain meds.

  2. I enjoyed reading this and I wish more Drs were like you, honest and open minded. I am able to openly discuss kratom with my Drs and they both approve of kratom because they took the time to study up on kratom and they’ve seen how much better I’ve gotten because of kratom. Thank you for writing this

  3. I have bee using Kratom for over 5 years, 3 on a regular basis. I have thrown the prescriptions away and stop going to pain management. I recently had changed jobs and before my insurance had kicked in I was involved in a bad wreck and ended up with compound fractures of the Uina and Radius. To make a long story short, it was 2 weeks before I could raise the money for a surgery and I was able to tolerate the pain using Kratom . After surgery I did briefly take hydrocodone but to be honest I believe I got more relief from the Kratom. I did take almost three times my normal dose but it worked.

  4. I’m truly impressed with the honesty in this article. With so many pain management meds being taken away it’s nice to have some options for people struggling with chronic pain. The CDC is now reporting respiratory depression with gabapentin and Lyrica. So those meds are next on the chopping block. It’s absolutely awful that chronic pain patients are committing suicide in the greatest country on Earth. I really wish more Doctors would talk to their under treated patients about herbal remedies. No medication is without risk, herbal or otherwise. I feel Americans should be able to decide what they use rather than the FDA playing nanny in favor of the pharmaceutical companies profits over the health of citizens.

  5. Have been using kratom for years. My wife uses it for her fibromyalgia. We have been using it and CBD from only USA legit places like charlottesweb.com and soulfulherbals.com

  6. Best herbal treatment for pain insomnia depression anxiety narcolepsy. Social anxiety.
    Treat it with respect and it will be your go to for life

  7. I enjoyed the truthful coverage of these articles. I’ve been using Kratom for years and I am far more concerned about taking acetaminophen than Kratom. With regards to knowing appropriate dosages and reputable distributors we have a very active community that self polices for these things. I have never been more aware of big money pulling government strings to the extent that they are more than willing to put Americans at risk of pain and death in favor of profits than the campaign against Kratom. They made a mistake taking on this battle because their claims are so ridiculous that millions now question everything the FDA, DEA, & other government organizations say or do. I will never trust a word they say again.

  8. “….There are case reports of overdose deaths due to mixtures of kratom with over-the-counter cold medications, sleep medications, or benzodiazepines….”

    From what I know, and I am more informed than most, there is NO toxicology to back this up. ZERO!

  9. My doctors seem more concerned with contaminated Kratom sources, like fungicides. Although all my physicians are aware that I take Kratom

  10. I have taken kratom for over 14 years with no bad side effects. When I retired in 2011 my goal was to get control of my health. I slowly weened myself off all big pharma. I now only consume kratom and a few other herbs to control my pain. I have my quality of life back, thanks to kratom. Kratom saves lives!

  11. I have a rare abdominal disease and chronic pancreatitis. The mesenteric panniculitis is actually more painful than the pancreatitis when flaring. I did not have access to pain medication nor pain management. The pain was literally killing me. I had heard about kratom and was scared to try it at first because of all the negative things that are posted about it. I finally reached the point that I had nothing to loose. Now I’m thankful for it!
    I started researching and found a reputable vendor online. I started using very small amounts and keeping a journal. When I found the right dosage for my pain I realized I no longer needed any medication for depression nor anxiety. My husband started using it for pain and completely quit drinking alcohol.
    I have used responsibly for several years. On the rare days that I don’t need it, I have no problem in not taking it. Caffeine, I will notice the day of, but never the kratom. I have never experienced any kind of high from it. I only take the amount that works for me. Just like medication, people need to be responsible with any supplements.
    A kratom protection act would bless all that use it. Keeping us safe and keeping regulations for vendors. Kratom works for me and my family. It should be my choice to not take narcotics to control my health issues.
    Again, regulations would protect everyone, but a ban would destroy many lives.

  12. I am a health care Professional who’s been responsibly using Kratom for over 3 years when all other means of pain management. & surgery have utterly failed me, after breaking a patient’s fall, and herniating 4 disks, creating a Lumbar Root Entrapment , & triggering what was asymptomatic severe Degenerative Disk Disease. It’s that left me with severe pain, Sciatica & Radiculopathy. I’ve run the Pain Management course.. I’ve done everything asked of me BUT nothing has been very effective.
    So a nurse friend suggested Kratom.
    I have NEVER had a bad side effect. Kratom effectively treats my pain, without the fogginess that traditional pain meds bring on. It gave me my life back. No Doctor is willing to treat me with opiates long term.. Yet my pain is chronic and always will be.
    Thank you Kratom! And Thank You for your honest and fair reporting !

  13. Very educational non obtrusive article which I agree with the findings. I have been a Kratom consumer for 18 months now. I suffer from sciatica, arthritis, CFS, Bi-Polar. Different strains of Kratom has eased all my symptoms and enables me to live a productive healthy life. As a responsible consumer I use vendors that test their products, and make available the lab tests. I grow weary of Government interference of any kind and history has shown that it has never benefited the consumer. I believe if you take a look at the actual number of instances where Kratom has had a negative impact I think you will find the number less than with Advil, Tylenol or any alcohol beverage. I have spoken to my Dr regarding my Kratom use and she is very open minded and trusts my judgement as her adult patient I think education on the benefits and the possible side effect are important as with any other substance. I appreciate your honesty in writing this article, and encourage more education and awareness regarding this fantastic tea!

  14. Kratom got me back to work after having been bed-bound for more than a year. I would strongly urge doing a great deal of research and understand how valuable it is for the millions of chronic pain patients across the world.

  15. i live in Missouri where right now they are trying to kratom.that would be catastrophic. so msny if us like myself use it for chronic pain major depression anxiety I could go on and on.It is a blessing.big pharma is an evil corrupt entity that destroy lives.Kratom saves them

  16. Thank you for this honest and fair report. I m a distributor of the supplement and 100% agree that in order to be taken seriously, has to undergo regulations such as any other alternative remedy/supplement/natural compound. However to do so, the FDA has to recognize these findings that were mentioned in this here report. Unfortunately we find ourselves in the cross heirs of not just the FDA but a number of other agencies that want to discredit these and other experiences of the consumer who have taken this supplement for many years with little to no side effects. Side effects, such as mild withdrawals can happen with any other substance such as coffee and even more so , sugar. However we are up against very powerful lobbies, who would loose a great deal of profit, if Kratom would gain the recognition it deserves. In my personal case i was able to get not only my chronic pain to a manageable level. it also helped me to quit a far more dangerous, yet legal substance Alcohol. Not only that but i have been given a fresh take on life after suffering from severe depression and Kratom alleviates these to the point of no existence. Yes the industry needs to regulated, however this is only possible if recognized as a powerful tool to help with many ailments (some not mentioned here) and not vilified by skewed reports and findings that are basically “junk science”, such as the FDA’s attempt to classify the compound as a opiate, which can’t be further from the truth. Just because a substance attaches itself to a body’s opiate receptors, doesn’t make it a opiate. Chocolate would be a opiate, if this be the case. Once again, thank you for fair and balanced reporting, it’s like a breath of fresh air.

  17. While I appreciate that Dr Liptan’s comments were fairly balanced, don’t think her statement that “rare side effects of kratom include psychosis, hypertension and liver failure ” can actually be substantiated. I don’t believe there is any credible evidence that traditional whole leaf kratom (iow, not extracted, concentrated, or adulterated…and definitely not GMP…mostly likely in an old tub somewhere ) causes such problems, even rarely. One has to realize that dubious extracts and adulterated products are not simply kratom, even if they are sold as such. A doctor should certainly realize that, and be more careful with her words. If she would like to back up her assertion, let’s see it. Also, ditto on this comment:

    Charles December 22, 2019 at 9:03 am
    “….There are case reports of overdose deaths due to mixtures of kratom with over-the-counter cold medications, sleep medications, or benzodiazepines….”

    From what I know, and I am more informed than most, there is NO toxicology to back this up. ZERO!

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