As of 2013, no clinical trials had been done to understand kratom’s health effects and it had no approved medical uses.[3][4][7]Some people take it for managing chronic pain, for treating opioid withdrawal symptoms, or – more recently – for recreational purposes.[3][7] Onset of effects typically begins within 5 to 10 minutes and lasts 2 to 5 hours.[3]
Common minor side effects may include nausea, vomiting, and constipation.[3] More severe side effects may include seizure, addiction, and psychosis.[3][8][9][10] Other side effects may include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity.[3][10][11] When use is stopped, withdrawal may occur.[6][7] Respiratory depression (decreased breathing) is a major risk with all opioids;[12]:196 the medical literature is divided on whether it is a significant side effect of kratom, with some authorities not mentioning it[8][11] and others emphasizing it.[9][13] Deaths have occurred when kratom was present, mixed with other substances.[6][7] In the United States, there were fifteen kratom-related deaths between 2014 and 2016,[14] although, in none was kratom thought to be the sole factor.[7]
As of 2015, there was a growing international concern about a possible threat to public health from kratom use.[7][15] In some jurisdictions, its sale and importation have been restricted, and a number of public health authorities have raised alerts.[7][14][15]Sometimes the finished product is mixed into cocktails with other psychoactive drugs such as caffeine and codeine.[6][16]
