Dear reader: Before we begin, let’s think for a moment about America’s opioid epidemic. The origin of this epidemic stems from the desire of the medical community to control pain: pain was the enemy and opiates were the cure. But over the years, the addictive potential of these drugs has destroyed many lives. As a society, we are now using other drugs to control pain, while actively researching other drugs.

Some believe that kratom (Mitragyna speciosa), a tree native to Southeast Asia, has potential in this regard. Kratom has been used in traditional medicine since the 1800s, with the leaves of the tree being chewed or made into tea. These leaves contain many compounds, but two in particular, mitragynine and 7-hydroxymitragynine, appear to have the main analgesic effects. These compounds bind to and stimulate the mu-opioid receptor in the brain, creating a positive reinforcement, while blocking the analgesic effect on two other opioid receptors. Kratom also contains chemicals that attach to other receptors in the brain, possibly promoting calm. Additionally, since kratom is a member of the caffeine family, the leaves of the tree also appear to have stimulating effects.

People who have used kratom have reported pain relief, relaxation, improved mood, and decreased anxiety. Due to its pain-relieving mechanism and its action via opioid receptors, kratom has been seen as a potential alternative to traditional opiates, with perhaps even the ability to help people wean off opiates.

We already have a history with the substance, as kratom has been available in the United States since 2010. A 2017 study asked 500 men and women in recovery centers about their use of kratom. About 21 percent had used kratom once and 10 percent had used it in the past year. Kratom users were more likely to be university educated and younger than addicts who had never used kratom. In fact, many had used kratom to treat their opioid addiction.

While these results may suggest that kratom may hold promise for pain relief and opioid addiction, we just don’t have good studies on its effectiveness.

And it can have serious side effects. The substance is eliminated from the body by the liver, so if a person has liver problems or takes drugs that are metabolized by the liver, it can remain in the bloodstream. From 2010 to 2015, 660 kratom poison control calls were made; 65% of these appellants had used kratom alone, with no additional substances. Appellants complained of rapid heartbeat, restlessness, drowsiness, nausea and high blood pressure.

Symptoms can be amplified to life-threatening levels when kratom is mixed with alcohol and prescription or illicit drugs, sometimes resulting in liver toxicity, seizures and death. Kratom was linked to 15 deaths between the years 2014 and 2016; It should be noted that these deaths do not appear to be related to the use of kratom with other drugs – just kratom alone. That said, the number of deaths from prescribed opioid drugs far exceeds the number of deaths from kratom.

In summary, while the abuse potential of kratom appears to be less than that of more traditional opioids, the fact remains that kratom acts on the mu-opioid receptor, which means it can be abused. This potential prompted the FDA to warn recently about the opioid-like properties of kratom and its potential for risk.

In short, we need more studies on kratom – and better opioid substitutes. From now on, I would look for other ways to manage the pain.