Last year, we published a 255 page document of first-person experiences that kratom consumers posted in the comments section of KratomScience.com articles. Other places like Reddit.com/r/kratom feature thousands of kratom testimonies.
So far the nuances of these experiences, though abundant and similar, have not been reflected in the science. Case reports, often woefully inadequate in information, have focused on rare kratom-related toxicities and negative experiences. Surveys of kratom consuming populations in both the US and Malaysia have been informative but by design lacking in nuance, context, and limiting in terms of telling a complex personal story.
Scientists from the National Institute on Drug Abuse (NIDA), Johns Hopkins University, and University of Florida College of Pharmacy have taken a step toward bridging the gap between the science of kratom and the real world experience of those who consume it. In an article published in Fronteirs in Pharmacology called “Examining the paradoxical effects of kratom: a narrative inquiry“scientists interview ten kratom consumers and, rather than just running a statistical analysis of answers to draw conclusions, extensive space is allowed for consumers to speak in their own words.
The researchers explain in the introduction:
Until there are controlled studies of the pharmacology and subjective effects of kratom alkaloids in humans, one of the best sources of insight on kratom-product use remains qualitative data with nuanced descriptions of kratom effects from those who use it regularly.
Excerpts from interviews with 10 kratom consumers appear in the paper, four female, six male, ranging in age from 26-60. The lowest average dose reported was 1 gram and the highest was 10 grams. Participants have been using kratom from 6 months to 8 years. Many of the participants used kratom for opioid withdrawals or alcohol use disorder, and also to deal with chronic pain. Kratom’s common effects were described, and all participants “experienced acute combination effects that were largely, even simultaneously, analgesic and stimulatory.” Many described eye wobbles as an effect of taking too much kratom, which the researchers relay as “a jittery feeling accompanied by what seemed to be nystagmus” and “a possible manifestation of serotonin syndrome”.
Researchers pointed out that about half of the participants qualified for “kratom use disorder” (KUD): 3 mild, 1 moderate, and 1 severe. KUD is not yet ensconced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) but researchers point out here that in prior studies, KUD was “determined largely on the basis of physical tolerance and withdrawal rather than psychosocial impairment or risky use”.
Open access for this article is available so you can read the participants in their own words.
We applaud the continued effort by scientists in their ongoing kratom research to consider the real world evidence of those who consume it, and analyze that evidence beyond what we can do here.
The researchers conclude:
Until sufficient scientific funding and manpower are harnessed to conduct human laboratory studies on kratom alkaloids, including clinical trials for some of the conditions for which people currently use kratom, we should invite people using kratom to share their expertise on kratom-induced effects via these in-depth qualitative discussions. At present, they remain the experts on this subject. This is both an indictment of the current science and a call for further investigation.
Smith, K. E., Feldman, J. D., Dunn, K. E., McCurdy, C. R., Weiss, S. T., Grundmann, O., Garcia-Romeu, A., Nichels, J., & Epstein, D. H. (2023). Examining the paradoxical effects of kratom: a narrative inquiry. Frontiers in pharmacology, 14, 1174139. https://doi.org/10.3389/fphar.2023.1174139