July 28, 2023 • 26min
AMA #9: Kratom Risks, Does Infrared Sauna Work & Journaling Benefits
Huberman Lab
Key Takeaways
- Kratom is an opioid that acts on the mu opioid receptor, similar to morphine and hydrocodone, but with lower potency
- At low doses, kratom has a mild stimulant effect. At higher doses, it acts as a painkiller and sedative
- Kratom can be habit-forming and addictive, especially at higher doses
- Some people have used kratom to wean off more potent opioids, but it carries its own risks of addiction
- There is a lack of regulation over kratom supplements, leading to inconsistent potency and potential risks
- Death from kratom alone is rare but possible, especially when combined with other substances
- If you haven't tried kratom, it's best to avoid it entirely due to addiction potential
- Those already using kratom should be very mindful of dosage and potential for dependence
Introduction
In this Ask Me Anything (AMA) episode, Dr. Andrew Huberman addresses a question about the short and long-term effects of taking kratom. Kratom is a substance derived from the leaves of a tree native to Indonesia that has both stimulant and opioid-like effects. Dr. Huberman provides a balanced overview of kratom's pharmacology, potential benefits, and significant risks, drawing on scientific research and expert opinions.
Topics Discussed
What is Kratom? (2:00)
Kratom comes from the leaves of the Mitragyna speciosa tree native to Indonesia. It has been used for hundreds of years, traditionally by chewing the leaves for a mild stimulant effect. Today, kratom is often sold as a supplement in capsule or powder form.
Key points about kratom:
- At low doses, it has a mild stimulant effect
- At higher doses, it acts as a painkiller (analgesic) and sedative
- Kratom acts as an opioid in the body, making it controversial due to addiction potential
Kratom and the Opioid Crisis (4:00)
Dr. Huberman discusses kratom in the context of the broader opioid crisis:
- The opioid crisis refers to widespread addiction to opioids like morphine and oxycodone
- Kratom is also an opioid, but with some differences from prescription opioids
- Some people have used kratom to wean off more potent opioids
- However, kratom itself can be habit-forming and addictive, especially at higher doses
"Kratom itself has also proved to be not only habit forming, but addictive, especially when taken at dosages that exceed that lower dose that just generally creates a bit of stimulant, a little bit of euphoric effect."
Varied Responses to Kratom (6:00)
Dr. Huberman notes the polarized responses he received when asking about kratom on social media:
- One group reported extremely negative experiences, including addiction and difficulty quitting
- Another group claimed kratom was useful for getting off other opioids when used responsibly
- Some medical professionals acknowledged kratom's potential role in opioid tapering, but only if users commit to eventually quitting kratom as well
Key takeaway: If you haven't tried kratom, it's safest to avoid it entirely due to addiction potential.
Individual Differences in Opioid Response (10:00)
Dr. Huberman emphasizes that people vary greatly in their response to opioids:
- An estimated 10-40% of people have a particularly strong positive response to opioids
- This subgroup is at much higher risk for developing opioid addiction
- Others may dislike the effects of opioids and be less prone to addiction
"When those people take an opioid, wow. Oh, wow. Do they like it? And those people in particular are very much at risk for developing an addiction to opioids. And so those people especially should never, ever go near kratom."
Pharmacology of Kratom (14:01)
Dr. Huberman explains how kratom works in the body:
- Kratom activates the endogenous opioid system, similar to other opioids
- It binds primarily to the mu opioid receptor, like morphine and hydrocodone
- This activation leads to pain relief, euphoria, and sedation at higher doses
- Kratom indirectly activates dopamine and serotonin systems, contributing to its reinforcing effects
Important note: Blocking the mu opioid receptor prevents all of kratom's effects, confirming its mechanism of action.
Kratom Compared to Other Opioids (18:02)
Dr. Huberman addresses comparisons between kratom and other substances:
- Kratom is less potent than prescription opioids, but still carries addiction risk
- The argument that kratom is "safer" than other opioids is weak and potentially dangerous
- Lack of regulation over kratom supplements is concerning due to inconsistent potency and quality
"What we should be saying is whether or not it's cannabis or alcohol or kratom or any substance for that matter, what are the potential benefits? What are the potential risks?"
Risks of Kratom Use (20:02)
Dr. Huberman outlines potential dangers associated with kratom:
- Death directly from kratom is rare but has occurred
- Kratom may suppress respiration, especially when combined with other substances
- Risk of respiratory failure increases with higher doses
- Kratom can be a "trap" for those trying to quit other opioids, leading to continued dependence
Warning: Combining kratom with other opioids or alcohol significantly increases risks.
Advice on Kratom Use (24:02)
Dr. Huberman provides clear recommendations regarding kratom:
- If you haven't tried kratom, don't start
- Those already using kratom should be very mindful of dosage and potential for dependence
- Seek professional help if trying to quit opioids rather than self-medicating with kratom
"My advice would be, if you haven't touched kratom, don't touch it at all, ever. If you are taking kratom, you need to take note of what we just discussed."
Conclusion
Dr. Huberman provides a balanced and scientifically-grounded overview of kratom, its effects, and associated risks. While acknowledging that some people have used kratom to wean off more potent opioids, he emphasizes the significant potential for addiction and other health risks. The lack of regulation in the kratom supplement industry adds another layer of concern.
Ultimately, Dr. Huberman advises against trying kratom if you haven't already used it, due to its addictive potential. For those already using kratom, he stresses the importance of being aware of the risks and carefully monitoring dosage. The safest approach is to avoid kratom entirely and seek professional medical help if dealing with opioid dependence.
This AMA episode highlights the complexity surrounding substances like kratom and the importance of considering both potential benefits and risks when evaluating any drug or supplement. It also underscores the need for more research and regulation in this area to better understand the long-term effects of kratom use.
