A Chronic Pain Patient’s Guide to Kratom

Mitragyna speciosa is the fancy taxonomical name for kratom, a deciduous evergreen* tree native to Southeast Asia that’s in the Rubiaceae family alongside coffee and tea. Unlike these two oh-so-common commodities, kratom doesn’t contain any caffeine. Rather, kratom contains about two dozen alkaloids that are collectively responsible for its pain-relieving, uplifting, and opioid-dependency-satisfying effects.

“Kratom” refers to both the Mitragyna speciosa tree and its leaves, the part of the plant that’s actually consumed. Don’t worry, though — in the United States, kratom trees don’t grow wildly, so “kratom” always refers to the leaves here.

*If kratom were grown in much of the U.S., its leaves would fall off in the winter; it’s native to tropical Southeast Asia, where the temperature never gets low enough for Mitragyna speciosa to go dormant (lose their leaves), making it a “deciduous evergreen” tree.

The Origin of Kratom

Although Mitragyna speciosa grows across tropical SE Asia, it’s only legal in Indonesia. While some kratom might come from illegal sources, it’s safe to say 99% of kratom available to American consumers is from Indonesia.

Indonesia is the fourth-most populated country on the planet with some 270 million residents but has just one-fifth the land mass. The country takes the form of an archipelago, or a bunch of islands; the second-largest of its 17,000 islands, Borneo, happens to be one of the most sparsely-populated spots in the Republic of Indonesia. Indonesia owns about three-quarters of Borneo — its share is split into five provinces: Central, East, North, South, and West Kalimantan.

West Kalimantan is where most kratom comes from. I don’t know how much, but I feel comfortable saying at least 95% of all kratom on the current market comes from Indonesia’s part of Borneo.

The city of Pontianak, (in the province of) West Kalimantan, (in the country of) Indonesia is the largest kratom hub in the country — and, by extension, the world.

Some kratom is grown in the U.S., but almost entirely for personal consumption. I feel confident the U.S. will ramp up its production of kratom in the future, but I don’t know how long that’ll take.

How Traditional Kratom Use and Modern American Consumption Differs

Traditionally, laborers of SE Asia have chewed fresh kratom leaves — in much lower doses than what modern American kratom consumers take — to power through the workday and alleviate aches and pains. They’ve been doing this for at least a few hundred years, if not way longer (I’d think it’d be thousands of years, but I’m not sure if the already-super-lacking body of kratom research supports this). Brewing tea — technically, it’s a tisane, not a tea — has also been common throughout SE Asia.

In the United States, we practically only consume kratom in dried, powdered form. Kratom leaves are milled like flour. Most often, we either swallow the powdered kratom, often done with a liquid, or make tea out of it, though tea-making is much less common. Modern American kratom consumers’ doses vary wildly, though most range between 3 and 12 grams.

The first noticeable wave of kratom came into the States after American soldiers returned home from the Vietnam War. This didn’t cause a permanent surge in kratom demand, though. The modern wave of popularity began within just the last 20 years. No doubt, the ongoing “opioid epidemic” — I don’t like that name, and you probably don’t, either — influenced the botanical’s popularity. The rise of e-commerce played a big role in boosting kratom’s accessibility, as did globalization.

Usually, you’ll find kratom in loose, powdered form. It also comes in capsules for ease of dosing, though capping them yourself is much cheaper. The only way to get fresh kratom leaves is to grow them yourself, have a friend or acquaintance who grows them, or live in SE Asia.

The Unfortunate State of Chronic Pain Treatment

I won’t elaborate on how tough opioid prescriptions are to come by for chronic pain here in modern America, but, just as you guys know, it’s fuckin’ tough. Even if you can get one — good luck finding prescribers willing to give you as much as you need — a constant worry of getting cut off lingers in the back of chronic pain patients’ minds.

The very real potential of having your legal opioid painkiller supply cut off out of nowhere is a big issue on its own. That risk comes in the form of opioid dependency. Wouldn’t you want a magic bullet to make opioid withdrawal syndrome go away once it rears its ugly head? It’s bound to happen in every CPP’s doctor-visiting career.

Kratom does just that. Yup, no bullshit, it satisfies our brains’ opioid receptors enough to stop withdrawal dead in its tracks. And it’s not that kratom has some limitless recreational potential or something — that couldn’t be further from the truth. There’s debate on whether kratom is an opioid or not, but, come on, it sure as hell acts like one!

But not when it comes to euphoria.

It acts like an opioid in terms of analgesia, say countless thousands of anecdotes online, but not when it comes to causing dependencies of its own.

We haven’t even got to the legality aspect yet. Mitragyna speciosa, at least in its raw form, is legal in almost every jurisdiction across the U.S.

And did I mention how cheap it is? Fair market value (FMV) of a kilogram of kratom is currently between $80 and $130; with doses ranging from 3 to 12 grams, a fair-market-value dose’ll run you ~$0.25 to ~$1.50. When I took kratom regularly, I dosed anywhere from 3 to 6 times daily.

Kratom holds its ground as a stand-alone pain reliever. Pharmaceutical companies hold several patents on alkaloids that are in kratom; patents don’t always indicate worthwhile or commercially-viable ideas, but early research indicates these alkaloids are worth their salt in healthcare contexts.

Mass Mis-Marketing in the Modern Mitragyna Market

We know almost all kratom comes from Borneo. Then why are there so many “strains” that come from other islands? I’ll tell ya why — ‘cuz it’s a marketing ploy.

Don’t pay much attention to “strain” names. Just find what works for you. I already wrote about this issue in full here, if you want to learn about mass mis-marketing in the modern Mitragyna market.

Problems With Kratom’s Mainstream Marketing

One thing that hurts kratom’s stock is how it’s marketed like the rash of legal highs that exploded in head shops, gas stations, and even “legal high” specialty stores in the early 2010s across the United States. It’s often sold in eye-grabbing packaging and, while I can’t be mad at store owners trying to put roofs over their heads, I most definitely am upset with the way kratom is sold at gas stations, head shops, etc.

I wrote about why buying kratom at stores like this is a bad idea here, if you’re interested.

Where to Find Kratom

Local in-person, non-ecommerce kratom markets are not very competitive. Where I live, a town of 10,000 and a county of 30,000 in the South, kratom never costs ≤ $0.50 and usually doesn’t go for ≤ $0.75. Shopping online is how you get kratom for the FMV of ~$80 to ~$130 — don’t expect to find kratom for this cheap at a gas station!

I don’t want to promote any vendors. Seemingly EVERY kratom resource online either’s hosted on a vendor’s page or has affiliate links to one or more vendors’ websites. Who am I if I fall guilty to the same lack of objectivity? I’m trying to teach you to fish here rather than just give you the fish, too, as that old-as-dirt proverb goes; here’s the steps I would follow:

Look for American Kratom Association Good Manufacturing Processes (AKA GMP) certified kratom-selling outfits in the United States — this is, of course, assuming you’re in the U S of A like me. You can find a list on the AKA’s website. Only the largest kratom businesses can afford getting this seal of approval. Buying from nobody but AKA GMP-certified vendors would leave countless more-than-suitable, way-cheaper alternatives.

AKA GMP This stamp of approval is the safest way to find a legit source of kratom, but I’ve never done it myself. I’ve always received kratom from non-certified sources. Here’s the thing — every single bit of kratom that any AKA GMP-certified company imports comes from non-AKA GMP-certified entities. Buying directly from Indonesia is ideal for getting the most value (lowest price); it’s also likely to be fresher coming straight from the source.

I got into kratom because of my problematic non-medical opioid use. What I mean is, even though I wasn’t opioid-dependent, kratom improved my ability to abstain from the use of “real” opioids, in turn boosting my quality of life. I’m not a chronic pain patient (though I am a CPP advocate) and want to be clear about how I got involved with kratom. This is relevant because I was always used to buying unregulated drugs (yes, kratom is a drug). CPPs are used to buying regulated goods and services; veering away from AKA GMP-regulated kratom sources could ultimately delegitimize our shared interest of giving CPPs more tools to handle chronic pain.

If I had to leave you with three ways to find good kratom sellers online, it’d be these:

  • The more legitimate the social media presence, the better.
  • The longer they’ve been around, the better.
  • The more (legitimate) reviews, the better.

How to Use Kratom

You can toss-n-wash — that’s short for “toss and wash” — powdered kratom with a liquid fairly easily. Put the kratom in your mouth and take a few swigs of chocolate milk (my favorite), orange juice, or, hell, just water. Trust me, though, this shit tastes rank.

You can also mix kratom into a drink, like a chocolate milk, for example. That’s what I always did.

Of course, you’ve got the capsule option. I don’t think capsules are good for dosing upwards of three or four grams; for me, personally, it always felt like the capsules rose to the top of my stomach — I could feel them inside of me for, I dunno, 30 minutes or so after dosing. And I didn’t like that feeling. But you might not have the same experience — that’s the big thing here, you won’t know which mode of administration is best until you try them out for yourself.

And then there’s tea — or tisane, is the right name, so I understand. Boil kratom powder or crushed leaf — I think crushed leaf is better for tea, personally — for a few minutes or even 30, 45 minutes. Add some lemon juice to extract some more alkaloids into the final product. I don’t know how it works, but it do.

Don’t worry about the specifics of how you toss-n-wash or make tea out of kratom. Just experiment and find out what works best for you. Don’t buy into any bullshit guides online — all of them come from places of personal experience. What works for Billy Joe might not work for Bobbi Sue.

To Tell, or Not to Tell… Your Doctor?

No… just, no. Let’s think — what’s the upside? Your doctor is cool with it and points out potential drug interactions.

What about the potential downside? Your doctor tells you kratom was responsible for X deaths in a recent year and that it’s bad. He identifies drug interactions that aren’t there and uses this excuse to cut back on your other meds or even not prescribe them at all.

Although there’s a blatant lack of empirical, academic-type research about kratom, there’s tons of anecdotal reports from fellow kratom users that can easily be found online. This includes other kratom consumers’ experiences with telling their doctors or other healthcare professionals about their kratom use. Just don’t do it — it’s sad I have to say that, but keeping your trap shut about kratom use is a very real concern in the modern American healthcare space.

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