See Part 1 of my series on kratom here.

I work at a local free clinic alongside other students and colleagues dispensing healing advice, free herbs and acupuncture. One of our regular clients is a woman who had been famous for her constant irritability and violent outbursts of anger. One day, unkempt, dirty, toothless, friendless, homeless, “crabby Judy” as I lovingly dubbed her, appeared in her customary angry and fitful self (though less so than as in previous months, thanks to our steady work with her). This time, she complained of chronic migraine headache and pain throughout her body. I decided to try giving her a teaspoon of the more uplifting white-veined kratom and administered some acupuncture on a bench outside of our clinic area. When I came back to her a half hour or so later, she specifically commented how her headache was nearly gone, her pains were greatly relieved, and in her own words she described how she felt “somewhat more uplifted.” Having treated her several times before, I could easily differentiate the beneficial difference kratom had on her psyche.

A wise man once told me that the most important aim of a healer is to instill hope in their patients. It is difficult to do this if a patient experiences the same complaints and pain as when they first came. My experience treating Judy that morning inspired hope in both of us; not that all of her life problems could be resolved but that with the help of a near-miraculous herb, kratom, we could each part with a sense of hope because she felt better.

I’m sure if you cut through the confusion and hype, you will see that kratom is not a cure-all, but many suffering people would find it useful.

Clinical Classification and Uses of Kratom

Mitragyna speciosa (Kratom)

Family: Rubiaceae (same family as coffee)

Energy and flavors: Warm and stimulating in small amounts; cool and sedating in large doses. Bitter.

Organs and channels affected: Liver, Lung, Heart, Large intestine

Chemical constituents: Over 40 alkaloids, especially mitragynine and 7-hydroxymitragynine. These are both opioid receptor cell agonists, occupying all but one of the opium receptor sites in the body. This is considered the reason that it can be used as an alternative to opioid drugs with none or few adverse side effects.

Properties and actions: TCM: Relieves pain, Calms Shen, astringes Lung Qi, astringes the Large Intestine. Western: Analgesic, sedative, anti-anxiety, mild anti-depressive, anti-inflammatory, anti-diarrheal. Ayurvedic: pro-vata dominant because of its cooling and drying properties; anti-pitta because it is cooling; anti-kapha mainly because of its bitter flavor.

Uses and Indications:

1. Pain
2. Opiate withdrawal
3. Alcohol withdrawal
4. Speed-type drug withdrawal
5. PTSD
6. Anxiety
7. Depression
8. Insomnia
9. Inflammation
10. Diarrhea
11. Cough

Note: Of the many indications described above, I have had particularly good results from individuals who suffer from PTSD with related severe bouts of anxiety and depression.

Dosage: Of the powder, 3 to 9 grams once to three times daily. Dosing is highly variable depending on the individual, the severity of the condition to be treated, the strain and strength of the kratom powder.

A widely published dosage recommendation is as follows:

• 2 – 4 grams= mild stimulating effects (a teaspoon of powder is three grams)
• 4 – 6 grams= medium effects (Stimulant or Sedative effects / Analgesic Effects)
• 6 – 8 grams= strong effects (Sedative / Analgesic Effects; Too strong for most people)
• 8 grams or Higher= very strong effects (Sedative / Analgesic Effects; NOT RECOMMENDED)

Note: The dosages above are not per-day doses but a dose taken at one time, once, twice or three times a day.

Always begin with the low to medium dose, usually about a teaspoonful. Its pain-relieving effects last anywhere from 4 to 6 hours. The dose can be repeated, increased or decreased as needed with the general rule that one should take as low of a dose necessary. The dose can be increased gradually based on and as needed basis according to the above dosage guidelines.

To reiterate: only take the minimum dose necessary. (I don’t recommend using it recreationally – it is actually just not that much fun!)

The Three Predominant Strains of Kratom Are Classified as Follows:

Red-veined	Green-veined “maeng da”	White-veined
Considered the most sedative and pain relieving	Medium potency, most useful clinically	More stimulating, rather than sedating and pain relieving

All three strains share the same basic properties with various strengths and potencies as described above.

Since the powder is the form most commonly used, I usually recommend ingesting a teaspoon of the powder and quickly washing it down with water. Because the properties of kratom are based on its alkaloids, it is most powerfully absorbed when it is taken with a little apple cider vinegar mixed in water or lemon juice. Some people have trouble tolerating its bitter flavor; to offset this, some take kratom mixed with chocolate milk or chocolate.

Can You Build up a Tolerance to Kratom?

Though I have not witnessed this personally, some who need to use concentrated high doses for severe problems may find themselves building up a tolerance. This can lead to increased dependency. If possible, use it on an as-needed basis and to refrain from taking it every third day or so. If after using kratom for a while, you find yourself craving it, stop using it altogether for several days.

Much like caffeine withdrawal experienced by coffee quitters, after stopping kratom, some people may experience a few days of mild discomfort, which range from headaches, jittery feelings, nausea, etc. These symptoms are relieved as kratom is cleared from the system.  (see https://www.kratomscience.com/dosage-conversion-chart/

Contraindications, Possible Adverse Reactions and Adulteration Issues

Kratom is generally safe and its effects are similar to the effects of Kava (Piper methysticum) in its anti-anxiety and calming effects. It is much stronger than kava for pain. Use with caution for symptoms associated with Yin Deficiency such as night sweats, dryness, constipation, unusual thirst, and itchiness. However, if it is still needed for its pain-relieving, anxiety-dispelling, and opiate-withdrawal properties, it would be best to take it with a Yin tonic. These are herbs with tonic, demulcent properties that help balance the drying effects of kratom, such as mai men dong (Ophiopogon japonica tuber) and/or marshmallow root.

Because it is sold as a recreational drug, some distributors have taken to spiking their kratom powder with substances to intensify its effects. Some kratom products (see Krypton Kratom) were found to be spiked with the opioid tramadol that is addictive. Deaths and severe reactions were associated with these adulterated products. Avoid this at all costs; find a reliable source of pure, unadulterated kratom. In general, avoid buying kratom from outlets specializing in dispensing cannabis and other intoxicating substances for private use. The exception to this may be the various “kava bars” which have sprung up around the country.  These bars sell mild psychoactive herbal drinks which are consumed in a public setting.

Is Kratom Addictive?

I’m sure that any herb that is a potent pain reliever, antidepressant, anti-anxiety agent and has a long-time reputation responsible for helping thousands of people throughout the world overcome addiction to far more dangerous drugs and alcohol, has itself the potential to be addictive to some. This is especially true since kratom is also widely used and abused recreationally. Kratom is controversial because some choose to abuse it by taking high doses (over 10 to 15 grams or more of the powder one or more times daily); these people are bound to develop a dependency or addiction to it. I once knew a man who regularly drank 15 cups of coffee each day. He, like many others who use coffee on a regular basis, or the highly caffeinated so-called “power drinks” widely sold throughout the country would have difficulty withdrawing from these substances.

While caution from overuse of any substance should be implemented, in the words of one of the many thousands who have found benefit from kratom said in a letter on drugabuse.com: “Making a substance illegal because there’s potential for a fraction of the population to have trouble with it does not seem to me to be a logical approach.”

I’m mainly an advocate for the responsible clinical use of kratom as an effective non-addictive alternative to other psychoactive drugs with well-known adverse health effects. Even those who claim that it is addictive will say that it is mild compared to highly addictive drugs such as opiates, alcohol, speed, etc.

The opiate drug oxycontin was created because its pain-relieving effects are longer-lasting that morphine and other opiates. The company who first brought it to market in the 1990s, Purdue Pharmaceuticals, convinced and enticed hospitals and doctors to use it even for mild or moderate pain conditions. As a result, it was widely prescribed even to children and that was the beginning of the present opioid epidemic.

With kratom, we have an herb that has offered hope for thousands to help wean themselves off of these deadly drugs, but even so, some government agencies want to suppress it. Even if one were to concede that there can be some problems with people abusing kratom, those problems have no comparison to the already existing problem of opioid addiction.

Making Kratom Tincture

Kratom is widely sold as leaf powder. Powders have a limited shelf life (about 3-4 months for full potency), and ingestion can be challenging because of its flavor. Making a tincture assures potency for many years, and are convenient to take because the drops can be diluted in water or another liquid to mask the flavor.

The downside of kratom tincture is that it is alcohol-based and therefore not suitable for individuals who have a history of alcohol addiction. Also, it is too easy to consume more than is needed when it is a liquid as opposed to the limitation of taking it as leaf powder. With both of these considerations in mind, the following tincture recipe is given from KratomGuides.com.

Ingredients:

• 1 quart vodka or diluted ethanol measuring 40 to 50% alcohol
• 8 oz. (about 227 grams) of pure high quality Kratom leaf powder
• About ½ ounce apple cider or white wine vinegar (which aids in the assimilation of the important kratom alkaloids)

Combine these ingredients in a wide-mouthed jar. Shake or stir daily for at least two weeks (although an extract made in this way could be used after a day or two).

When completed, carefully strain through fine mesh cloth. Bottle in 2- or 4-oz. amber dropper bottles at this point or allow to stand in a clear glass container for a day or so to allow any powder particulates remaining to settle to the bottom. Carefully decant the pure extract and bottle for use.

This is approximately a one to four ounce tincture, meaning that 1 part of the tincture is equal to 4 parts of the powder. One may have to experiment with the tincture dose but on average one might start with a dose of 30 to 60 drops which is approximately a half to one teaspoon.

Feel free to experiment with flavoring agents to make it more palatable. The most common is pure anise or fennel seed oil. One may only need a few drops to flavor. (Use caution when using pure essential oils for flavoring; consult a qualified practitioner and use food-grade oils from a reputable company. –M.T.)

2017 Reputable Sources for Kratom Leaf Powder

1.      BuyKratom.us – www.buykratom.us
This is the company I’ve been purchasing my Kratom from. I find them to be reliable, good quality and reasonably priced

2.      http://kratomguides.com/recommends/kratom-spot/

3.      http://kratomguides.com/recommends/pure-kratom/

4.      http://www.phytoextractum.com/?referrer=REF327161478868859

Read more about these companies at KratomGuides.com

Conclusion

Matt Wright, the general manager at Low Tide Kava Bar in Gulfport, Florida, described some of the signs held by demonstrators at a pro-Kratom rally held in Washington D.C. last year: “In support of keeping kratom legal there was a sign that read, ‘Death statistics of other illegal drugs from 2014: Heroin: 11,000; Cocaine: 5,000; Alcohol: 88,000; Opioid Pain Relievers: 20,000; Kratom: 0.’ There were also numerous other signs saying ‘Kratom Saves Lives,’ ‘Plants Not Pills,’ ‘Farm Not Pharma,’ and one heart-wrenching sign held by a young boy who appeared to be between 6 and 9 reading ‘Kratom Saved My Mom.’

This says it all.

Please at least go to https://www.americankratom.org/petition and sign the petition to the DEA to keep kratom legal.