Once, our ancestors utilized botanicals to treat medical conditions. Ancient Egyptians and Asians used cannabis, amongst many other examples of flora, as did Native Americans and the Aztecs and Mayans. Our earthly interest in botanical plants has seemingly come full circle, like the ouroboros, as common herbs and spices like thyme, lavender, turmeric, and black pepper consistently turn up in the scientific literature, yet again of medicinal interest. All those wonderful, fragrant terpenes never cease to amaze with their dominion, helping protect plants and humankind in very different ways. 
Species like Cannabis sativa, Psilocybe sp., or ayahuasca  are under expanding scrutiny, not for backwards-minded taboo mumbo-jumbo, but for their significant medicinal merit. I first learned about kratom from a colleague and then took a deeper dive on Hamilton’s Pharmacopeia, a wonderful show on Hulu that delves into different plants steeped in stigmatic drivel. The show rekindled my interest in ethnobotany.
You may find head shops or strip mall tobacco/lottery outlets that carry kratom. It may be that the staff knows nothing about it to advise you on anything tangible. Is it legit? Medicinal? Safe? I spoke with Justin Kats, of Kats Botanicals, a New Jersey-based company that vends natural products from kratom, turmeric, hemp, and an interesting substance called shilajit, a black resin found in the Himalayas (amongst other places) that exudes out of rocks (more on that some other time).
In 2016, Kats was in the national tennis coaching business. He was consuming kratom. During this period, the US Food & Drug Administration was trying to convince the Drug Enforcement Agency (DEA) to schedule kratom on an emergency ban that would place it in the same league as heroin. Kats decided to stock up on as much as he could.
“I imported a couple hundred kilos,” he began, “but I was scammed out of half the money I sent to Indonesia, where I bought the products from. Thirty days after the ruling, Congress and the people convinced the DEA that they are overstepping their authority and the ban never went through.”
Kats, therefore, had abundant kratom, so he solicited people on Facebook to provide some free samples. This evolved into a Facebook group and Kats Botanicals was formed. Eventually, he expanded into cannabidiol (CBD) products, as well.
Kratom is a member of the Rubiaceae family which also includes coffee and gardenias. One of the most common species, Mitragyna speciosa, grows in Southeast Asia in Thailand, Malaysia, and Indonesia. Kratom has been used in these places for centuries, but its use in Western society has been rather limited, recently becoming more widely available. But just because it’s grown and used in SE Asia doesn’t mean it’s legal.
“It’s illegal in Malaysia and until recently, in Thailand, where it’s now medically legal,” Kats added. “Most kratom comes from Indonesia.”
Low to mid-level doses (1-5 g) of the ground plant leaves or teas/extracts brewed from the leaves can produce stimulating effects.  Larger doses (5-15 g) can have opioid-like effects like sedation and stupor. Therefore, kratom is often evaluated for its use in opioid addiction applications. [4,5]
It’s not just recovery opioid addicts that use kratom, however. Studies have also demonstrated that kratom has analgesic properties, helping reduce inflammation or pain , but the science is limited resulting in a potentially promising, but poorly understood plant.
The Basic Phytochemistry
The opioid-like effects of kratom are thought to stem from the alkaloids mitragynine and 7-hydroxymitragynine. Because mitragynine has activity on opioid receptors, physical dependence can develop. Interestingly, whereas psychedelics like mescaline, psilocin, or lysergic acid diethylamide activate 5-HT2A receptors resulting in their trademark effects, mitragynine blocks activity at this receptor.  Higher levels of 7-hydroxymitragynine will make a product stronger, as it exhibits a higher potency than morphine or mitragynine, (13x and 46x, respectively). [3,7]
Red, White, and Green?
Just as in cannabis, companies jockey to market kratom with verbiage that may not mean much. Kats recommends that new consumers purchase white, green, and red veined products. “You need to understand how your body reacts to all three,” he explained.
The red, white, and green nomenclature refers to how the leaves were dried. All varieties come from the same leaves. The chosen drying process changes the leaves’ color with concomitant changes in chemistry.
“If you dry leaves in burlap, the color will turn dark red, hence the red vein,” Kats expounded. “If you dry leaves first indoors and then outdoors, you’ll get green leaves, and if you do all of your drying outdoors, the leaves turn white.”
Different terms on a product label could relate the region where the plants were harvested, but Kats says that terms like Maeng Da or Bali are strictly for marketing.
The red vein products are used to promote tranquility, a sense of calmness. White vein kratom is said to provide the most “kick” or stimulation. Green vein kratom is considered a Goldilocks hybrid of red and white veins.
What to Look For
There’s not abundant scientific literature out there on kratom. A Google search may overwhelm you with doom-laden discussions on kratom’s ineffectiveness or chemical dependencies. Anyone interested in kratom should consider all sides, but again, like many ethnobotanical plants, there’s bound to be more negativity than positivity at this point in time. We need the scientific and medical communities to undertake unbiased studies to determine medical efficacy.
But a substance’s effectiveness is really in the eye of the beholder. If you’re chronically in pain and you take kratom and it works, of course you’ll want to turn to it again. And if the plant can help ween people off addictive medications, it’s worth the scientific R&D investment. But, in our opioid overrun society, it’s understandable why there’s concern over whether kratom may have side-effects and how deleterious these may be.
Kats stressed the importance for the kratom industry to be recognized as legitimate. Kratom is currently regulated in Utah, Georgia, and Arizona (pending in Oregon). Soon, product manufacturers will have to be qualified under Good Manufacturing Products (GMP).
What’s more, Kats understands the need for accurate analytics. “A lot of companies are not testing their kratom batches,” he conveyed. “If a customer asks for a certificate of analysis, we’ll provide it. Everything is tracked on the back end so we have batch traceability. Unfortunately, not all vendors do this due to cost and logistics. A lot of top brands batch test, but some companies refuse.”
Kats Botanicals will also be updating their packaging to include a breakdown of the alkaloid content.
How to Consume Kratom
Kratom can be bitter and some people are sensitive to the taste. Kats recommends a “toss and wash method” where you place some of the powder on your tongue and swig a drink of your choice to wash it down. “70% of our clients use the toss and wash,” Kats commented. “Some people do brew teas, but not the majority. Other customers make their own capsules.”
There’s also a new method that utilizes edible, oblate discs. The powdered is wrapped in the disc, which is swallowed, thereby reducing any messiness.
There are also kratom extracts. “These are illegal in Indonesia, however, so you can only export powder,” Kats advised. “We’re working with reputable CBD oil vendor in Utah to make kratom extracts. These extracts do raise your tolerance very quickly because they’re obviously much more concentrated.”
The Kats Future
The Kats crystal ball shows a plethora of interesting botanical options, in addition to their current product portfolio. “We’re primarily a kratom company, but we’ll be branching out,” Kats foretold. One product they are looking to vend is medicinal mushroom extracts. They are also striving to obtain their GMP qualification.
There’s reported to be somewhere between 10 and 15 million kratom users just in the United States. Where the kratom landscape will evolve to is anyone’s guess. But like many ethnobotanical plants, the science behind the plant can bolster the efficacy of kratom leaves. As more people look towards the older ways of treating medical conditions, kratom holds early promises that need more thorough investigation.
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- Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction. 2008;103(6):1048-1050. [journal impact factor = 6.851; times cited = 183 (SemanticScholar)]
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- Adkins JE, Boyer EW, McCurdy CR. Mitragyna speciosa, a psychoactive tree from Southeast Asia with opioid activity. Curr Top Med Chem. 2011;11(9):1165-1175. [journal impact factor = 3.218; times cited = 110 (SemanticScholar)]