Kratom

Kratom is an opioid and stimulant from Southeastern Asia commonly exported to other countries for it's effects in: relieving opioid withdrawals, relieving pain, boosting mood, and even providing euphoria at higher doses.

Harm reduction

Kratom is a relatively safe drug, however it's been known to cause an extremely rare liver condition consisting of signs of relatively severe hepatotoxicity, such as jaundice (yellowing of the skin, eyes, and gums), intense itching, dark urine, and fatigue. The symptoms are generally experienced extremely soon after starting kratom, with toxicity arising in most, if not all, cases within 1 - 8 weeks. If these symptoms are experienced, immediately cease usage of kratom, and see a doctor as soon as possible. If jaundice is severe or there's pain in the upper abdominal area it's advised to seek immediate medical attention.

Kratom alone has a somehwat negligible risk for respiratory depression, however caution should be exercised in regards to combinations with other depressants, especially other opioids. Under twenty deaths have been reported to have kratom alone in the toxicology report, and the results are somewhat controversial. Over a hundred deaths, however, have been reported with kratom constituents in addition to other opioids or depressants. It's highly advised to not combine these categories of drugs with kratom, but if done, using low to common doses of each substance is recommended.

Kratom is moderately to extremely dehydrating due to unknown properties (possibly a diuretic), so it's important to remember to stay hydrated. Consumption of slightly more water than average is helpful, but don't overdo it, as excess water intake can be life threatening if enough is ingested.

Addiction potential

Kratom is an opioid, and accordingly can produce withdrawals similar to those seen with "harder" drugs such as heroin, oxycodone, etc. However, it's less likely to produce dependency in comparison, with even some multi-year users reporting almost zero or incredibly mild symptoms upon discontinuation. Regardless, the exact frequency of dependency is unknown, and is absolutely possible. It's advised to treat kratom as you would any other opioid, and never use it for extended periods of time, nor sohuld you allow your tolerance to rise to a significantly higher level. No reports of dependency have been seen with usage two to three times per week as of yet, so this can be assumed as a starting point for mitigating dependency risk. Taking multiple day to two week beaks roughly every four to six weeks of usage is advised.

Effects

Kratom is quirky in that it has more of a stimulating effect at lower doses, and more of an opioid effect at higher doses. Generally speaking, however, kratom is mainly a weak opioid and has the effects of one. At lower doses it produces a smooth stimulation not unlike that of caffeine without the "dirtiness" commonly experiened. At higher doses, it produces effects reminiscient of hydrocodone, albeit weaker; this means it'll cause a powerful yet subtle sense of greater physical comfortability than normal, a warmness, and an overall more relaxed state. Headspace-wise, most users experience a reduction in anxities and stresses (although an increase has been noted in some susceptible individuals), and moderate to overpowering contentedness and mental relaxation. Despite the state of relaxation, a somewhat significant portion of users report extreme irritability, particularly in regard to sound.

Side effects can include itchiness (although some users enjoy this), the aforementioned irritability, pinned pupils, increased incidence of "tip of the tongue" moments, dehydration, headache, the "wobbles" (inability to focus your eyes, double vision, and motion sickness), and last but not least, extreme nausea and subsequent vomiting. The last side effect generally only happens when a high dose is used without tolerance, although some people vomit at doses as low as two grams.

Strains

It's been determined that the strain names are nothing more than a marketing tactic, however the color is indeed meaningful. The different colors are the result of different drying tactics, with exposure sunlight having a demonstrated effect in enhancing the quantity of 7-hydroxy-mitragynine via oxidation of mitragynine. Red strains are generally going to be more sedating, white are going to be more stimulating, and greens in between. Aside from enhanced 7-hydroxy-mitragynine content of reds via drying, the mechanism by which the drying has a legitimate influence on the batche's effect is unknown.

Basic Pharmacology

There's over thirty alkaloids in kratom, however the majority of the effects are thought to be from only two. These two are mitragynine, and 7-hydroxy-mitragynine. Both act as activators/agonists of the mu-opioid receptor, responsible for the effects of nearly all clinically used opioids, with 7-hydroxy-mitragynine being significantly more potent (ten to thirty times more). However, they activate it in a somewhat unique way, in that these alkaloids only elicit under fifity percent of the normal response associated with activation. In addition, there's two pathways for the mu-opioid receptor to follow. One of them, the g-protein pathway, is associated with the majority, if not all, of the positive effects. The other, the beta-arrestin 2 pathway, is responsible for development tolerance and respiratory depression (main cause of death with opioid overdose). Kratom preferentially activates the g protein pathway, with the beta-arrestin 2 pathway being activated only one tenth as much as would be expected. This is a major factor, if not the sole reason, in why kratom has such a better safety profile in comparison to traditional opioids. In addition to this, mitragynine is actually converted to 7-hydroxy-mitragynine in your body, via the CYP3A4 enzyme. This is the reason as to why grapefruit juice, tagamet, etc. actually reduce the effect.

The mechanism of kratom's stimulatory effects hasn't been fully elucidated, however it's thought to be the result of activation/agonism of adrenergic receptors (target of adrenaline & noradrenaline, specifically the postsynaptic adrenergic a2 receptor) and activation of serotonergic and additional (nor)adrenergic pathways via an unknown mechanism.

Overdose

Kratom is extremely difficult to fatally overdose on alone, with only <20 deaths attributed to kratom itself; and, it's theorized these arethe result of adulterated extracts. Overdosing as in having an extremely uncomfortable and dysphoric experience, however, isn't too difficult. Symptoms associated with taking too high of a dose of kratom includes intense nystagmus/eye wiggles (aka the wobbles), uncomfortable sensation of warmth, excessive itchiness, severe nausea, and vomiting. In extremely rare cases, it can even result in seizure, psychosis, hepatotoxicity/liver toxicity, dangerously high blood pressure, asphyxiation of vomit while asleep, and even death. If you notice any signs of legitimate toxicity, it's advised to immediately seek medical help.

Legality

The legality of kratom is a constantly evolving and highly complex situation. It's illegal in most of the european union, but legal in the majority of U.S. states. It's highly advised to look up whether or not kratom is scheduled in your state or country before attempting to acquire any.