Kratom is not an opioid. Period.
This is a scientific fact that is often misunderstood. They do get regularly conflated, but there are key differences between kratom’s alkaloids and opioids. While it may just seem like semantics, this distinction is crucial. Facts matter.
After all, consumers, researchers, and policymakers need to rely on facts to guide their decisions regarding kratom. Everyone must be clear on what kratom actually is—and what it is NOT.
First of all, is it opioid or opiate? People use these terms interchangeably, although it isn’t quite accurate to do so. All opiates are opioids, but not all opioids are opiates.
Opioids include all natural, synthetic, or semi-synthetic chemicals that derive from—or are created to replicate—the opium poppy plant (Papaver somniferum). Opiates are a sub-category of opioids that only include the natural chemicals, not synthetic or semi-synthetic.
In other words, opiates come directly from nature, and all other opioids come from a lab. Opiates are extracted from the seed pod of the poppy plant. Synthetic opioids are completely man-made, without any natural ingredients. And semi-synthetic opioids are somewhere in between, created in labs from a natural opiate.
For instance, many consider heroin to be an opiate because it is derived from the poppy. However, it should technically be classified as a semi-synthetic opioid, as it is made from morphine, a natural opiate that has been chemically processed.
Below are some examples of different types of opioids. (You’ll notice that kratom isn’t on any of these lists).
Opioids bind to opioid receptors in the central nervous system, resulting in strong euphoria and pain relief. By activating these receptors, opioids block pain signals from the brain to the body. They also release large amounts of dopamine, which is a neurotransmitter that helps create feelings of pleasure.
Because opioids stimulate the brain’s reward system, people seek to repeat the pleasurable experience, just like a lab rat would do. This repeated use eventually builds up a tolerance, as the opioid receptors start becoming less responsive. Greater amounts of opioids are then needed to produce the same level of effects.
With prolonged opioid use, changes occur in the brain that cause dependence. To avoid painful and unpleasant withdrawal symptoms, the person must continue using. They are now fully addicted.
There has been a great deal of disinformation spread by those with an anti-kratom agenda, including promoting this false equivalency to opioids. Aside from that aspect, however, there are a couple of other factors that contribute to the confusion.
Kratom’s effects are commonly described as “opioid-like.” But this is not a complete description. Unlike opioids, kratom has a wide range of effects that can vary considerably depending on the dosage or even the individual. Normal doses typically result in energizing effects rather than sedative. Which makes sense, considering the Mitragyna speciosa tree (kratom) is a relative of the coffee family. It is a completely different plant with a different chemical structure than opioids. So when it comes to its stimulating effects, kratom more resembles coffee than opioids.
Along with pain relief and self-treatment of emotional or mental conditions such as anxiety, depression, and PTSD, one of the top benefits users have reported about kratom is relief of opioid withdrawal symptoms. Some may misinterpret this as evidence that kratom must be an opioid itself. However, there are other nonopioids that have been prescribed for treating opioid withdrawal, such as blood pressure drugs clonidine and lofexidine. In fact, lofexidine was even approved by the FDA for management of opioid withdrawal symptoms. So this use certainly does not necessarily classify a substance as an opioid.
Perhaps the biggest and most understandable reason for the misconception, though, is the fact that kratom’s main alkaloids do act on opioid receptors. This leads some to conclude that kratom must therefore be an opioid, as the Food and Drug Administration (FDA) tried to argue in 2018. But the American Kratom Association (AKA) calls this analysis “simplistic,” stating:
“Although kratom’s compounds do in fact bind to mu-opioid receptors, real experimental data show that these compounds have unique signaling properties at mu-opioid receptors and do not induce the same degree of respiratory depression or present the same risk of abuse as classical opioids.”
Safety is truly a major difference between the two. We all know how dangerous and deadly opioids are. But one study actually quantified this in comparison to kratom, finding that opioids have at least a 1,000 times greater risk of overdose deaths than kratom. This shows that not only are kratom and opioids on different teams, but they are in a completely different ballpark.
According to a 2021 comprehensive review by Dr. Jack Henningfield and PinneyAssociates:
“Studies of kratom’s alkaloids support the conclusion that mitragynine and other alkaloids are not appropriately categorized as opioids, as they are diverse in their activity, effects, and mechanisms of action. Moreover, the primary active constituent of kratom, mitragynine, does not produce the signature powerfully rewarding and lethal respiratory depressant effects that characterize morphine-like opioids.”
And Drs. Jack Henningfield, Marilyn Huestis, Oliver Grundmann, and Albert Garcia-Romeu concluded:
“While some naturally occurring substances in kratom act on opioid receptors, kratom is not a prototypical opioid based on its chemical structure, botanical origins, or law – nationally or internationally. Like many natural products, it has diverse effects and mechanisms of action that contribute to these effects and the reasons people use kratom. Some kratom constituents bind to opioid receptors and relieve pain whereas others do not. Unlike opioids which sedate and can impair mental functioning, kratom is used by many people in place of coffee for its alerting, mental focusing, and occupational performance enhancing effects. Animal and human studies, as well as neuropharmacology mechanisms of action studies, show that kratom does not carry the substantial opioid-like risks of deadly respiratory depression or powerfully addictive euphoria.”
So there you have it. The experts have spoken. Therefore, let me now confidently repeat:
Kratom is not an opioid.
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