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Kratom



BOTANICAL CLASSIFICATION
Family : Rubiaciae
Genus : Mitragyna
Species : speciosa
COMMON NAMES Kratom; Ketum; Kakuam; Ithang; Thom; Mambog
White Borneo

EFFECTS CLASSIFICATION
Stimulant; Depressant; Intoxicant

DESCRIPTION
Mitragyna speciosa is a leafy tree that grows from 3-20 meters tall. Its leaves contain 7-Hydroxymitragynine and mitragynine. The leaves are chewed as an opiate substitute and stimulant in Thailand and South-East Asia, primarily among the working class. It has a relatively long history of human use.
The Kratom User's Guide
Version date: October 12, 2016

( The most recent version can always be found at: http://sagewisdom.org/kratomguide.html )

Created by Daniel Siebert and "Sage Student"


The statements below have not been evaluated by the US Food & Drug Administration (FDA).
Information regarding the use of kratom in folk medicine is provided for education purposes only, it is not intended as medical advice.


Important News Update:
Kratom remains legal, for now!
On August 31, 2016, the Drug Enforcement Administration (DEA) published in the Federal Register a notice of intent to temporarily place mitragynine and 7-hydroxymitragynine, which are the main psychoactive constituents of the plant Mitragyna speciosa, also referred to as kratom, into schedule I pursuant to the temporary scheduling provisions of the Controlled Substances Act. Since publishing that notice, DEA has received numerous comments from members of the public challenging the scheduling action and requesting that the agency consider those comments and accompanying information before taking further action. In addition, DEA will receive from the Food and Drug Administration (FDA) a scientific and medical evaluation and scheduling recommendation for these substances, which DEA previously requested. The DEA is therefore taking the following actions: DEA is withdrawing the August 31, 2016 notice of intent; and soliciting comments from the public regarding the scheduling of mitragynine and 7-hydroxymitragynine under the Controlled Substances Act. DATES: The notice of intent that was published on August 31, 2016 (81 FR 59929) is withdrawn. The comment period will be open until December 1, 2016. Click here to read the DEA's withdrawl notice.

Introduction
This guide was created as an educational resource to provide accurate information about kratom. It is also intended to correct much of the misinformation circulating on the Internet and being perpetrated by the Media.

What is kratom?
Kratom is a tree native to Southeast Asia (Thailand, Malaysia, Indonesia, Borneo, etc.). Its botanical name is Mitragyna speciosa. Kratom is in the same family as the coffee tree (Rubiaceae). The leaves of kratom have been used as an herbal drug from time immemorial by peoples of Southeast Asia. It is used in folk medicine as a stimulant (at low doses), sedative (at high doses), recreational drug, pain killer, medicine for diarrhea, and treatment for opiate addiction. Many people report that kratom is an effective treatment for arthritis, restless legs syndrome (RLS), and fibromyalgia.

How is it taken?
In its native region, kratom leaves are often chewed fresh (usually after removing the stringy central vein). Dried leaves can also be chewed, but since they are a bit tough, most people prefer to crush them up or powder them so that they can be swallowed easily. Powdered kratom can be mixed with water and then drunk. This method is quick and easy. It can also be mixed with other liquids, such as fruit juice, milk, or kefir. Chocolate milk works especially well for masking the taste. Powdered kratom can also be made into a paste that can easily be swallowed with water. The powder can also be mixed with applesauce or yogurt. It can also be put into capsules. Dried kratom leaves are often made into a tea that is strained and then drunk. Kratom can be smoked, but doing so is impractical because the amount of leaf that constitutes a typical dose is too much to be smoked easily. A resin-like extract can be prepared by evaporating the water from kratom tea. This can be stored for later use. Small pellets of this extract can be swallowed, or it can be dissolved in hot water and consumed as a tea. Some people like to mix kratom tea with ordinary black tea, or other herbal teas, before it is consumed. This is done to make it more palatable. Sugar or honey can be added to sweeten it.

How does one prepare a chocolate kratom milkshake?
This is the nicest way to ingest kratom that we know of. It actually tastes quite good. Chocolate milk masks the bitter taste of kratom remarkably well and its viscosity helps to keep the kratom from settling to the bottom. If you just add powdered kratom to a glass of chocolate milk, the kratom tends to float on top and resists absorbing liquid. Even with stirring, it tends to stay floating on the top and forms lumps. Ideally you want to make a smooth milkshake without lumps and without dry kratom powder floating on the top. To do that, follow these simple instructions:

AMAZING CHOCOLATE KRATOM MILKSHAKE
Use about 1 cup (8 fl. oz.) of chocolate milk per dose of kratom. Chocolate-flavored almond milk also works very well for this, and is non-dairy (we especially like the "dark chocolate" flavored almond milk produced under the brand name Silk®, because of it's especially thick viscocity and rich flavor).

1.) Put one dose of powdered kratom into an empty glass.
2.) Add an equal volume of chocolate milk (typically, just 1-2 tablespoons).
3.) Stir until the kratom absorbs the liquid completely and forms a homogeneous paste.
4.) Add a few more tablespoons of chocolate milk and stir again until smooth and free of lumps.
5.) Add the remaining chocolate milk and stir again until well mixed.
6.) Drink until the glass is empty.
7.) Add a little more chocolate milk to the glass, stir, and drink. (This caches any kratom particles left clinging to the sides of the glass. And since it is mainly just chocolate milk, it tastes even better than the kratom milkshake.)

How does one prepare a powdered kratom PASTE for drinking?
1.) Place a single dose of powdered kratom in a small empty cup.
2.) Add just enough water to make a soft paste (roughly equal parts kratom powder to water, by volume). You will need to stir the mixture for a few minutes until the powder completely absorbs the water and you have a nicely homogenized paste.
3.) Fill a separate glass with water and set it aside. Using a spoon, scoop an easy-to-swallow spoonful of paste into your mouth, then take a big sip of water from the other glass and gulp it down. Repeat spooning, sipping, and swallowing until you have consumed the entire dose. Be careful not to gulp down too much at once, so you don't accidentally choke on the mixture.

How does one prepare a powdered kratom SLURRY for drinking?
1.) Add powdered kratom to a glass of water (or other beverage). For a typical dose of kratom (about 7 grams), use about 1 cup (8 ounces) of water.
2.) Stir throughly (until the powder is completely suspended), then gulp it down quickly before it has a chance to settle (it is like drinking a bitter-tasting, slightly fibrous smoothy).
3.) Add more water to the glass to recover any material that stuck to the sides. About 1/2 cup of water should be sufficient, but it doesn't hurt to use more.
4.) Stir again and drink.
5.) When you have got it all down, you can drink a little fruit juice to chase away the bitter taste. Mint-flavored chewing gum also work great for this.

How does one make kratom tea?
Following is a basic recipe for making kratom tea. This recipe makes enough tea for several doses--about 8 moderately strong doses, if using "premium quality" kratom (see "dosage guidelines" below):
1.) Take 2 ounces (56 grams) of dried, coarsley ground or crushed kratom leaves and put into a pot. To this add 1 quart (about 1 liter) of water.
2.) Boil gently for 15 minutes.
3.) Pour the tea through a strainer into a bowl and reserve the liquid.
(squeeze the leaves in the strainer to get most of the liquid out).
4.) Put the leaves back in the pot and add another liter of fresh water. Repeat steps 2 and 3.
(after the leaves have been strained a second time, they can be discarded.)
5.) Put the combined liquid from both boilings back into the pot and boil until the volume is reduced to about 1 cup (250 ml).
(The idea is to boil the tea down to a small volume so that each individual dose can be quickly swallowed.
You can boil it down to whatever concentration you are comfortable with. Be careful near the end of the process.
If it starts to become syrupy, it may spatter and/or burn.)

The tea is bitter tasting. To minimize the unpleasant taste, gulp it down quickly and then immediately chase it with a pleasant-tasting bevearge, such as fruit juice.

The same general preparation method can of course be used with larger or smaller amounts of herb by simply adjusting the volume of water used. Kratom tea can be safely stored in the refrigerator for about five days. It is probably okay to keep it a bit longer, but it's better to play it safe and not drink it after five days. It can be stored for many months if you add some alcohol to it. Adding about 10% alcohol will preserve it for many months (in the refrigerator). That is one part 80 proof liquor (vodka, rum, or a similar spirit) to three parts kratom tea. When refrigerated, some components may precipitate out of solution and form a sediment in the bottom of the container. This sediment may contain active alkaloids so it should be redissolved before consuming the tea. This is easily done by warming the tea and stirring.

How can I powder dried leaves?
Dried leaves, whether whole, crushed, or coarsely ground, can easily be powdered by putting them in a kitchen blender or coffee grinder and processing for a few minutes at high speed. Many suppliers offer kratom that is already finely powdered.

How does one measure dosage?
The best way to measure dosage is with a scale. Since a typical dose of kratom is just a few, or several, grams, one should ideally use a scale that can measure down to a single gram and is accurate to at least 1/10th of a gram. Low-cost, highly accurate, digital scales are widely available, and purchasing one is a great investment, since they can last a lifetime and are useful for many other things besides weighing kratom. These can be obtained from Sage Wisdom Botanicals, as well as many other suppliers.

Measuring kratom by volume is less accurate than measuring by weight because the amount contained in a given volume depends on how finely ground the material is. Obviously, a teaspoon of finely powdered kratom will weigh more than a teaspoon of loosely crushed or coarsely ground leaves. That said, here are some rough guidelines. On average, 1 LEVEL teaspoon of most commercially available, finely powdered kratom will weigh about 2 grams (very finely powdered kratom may weigh closer to 2.25 grams). Since there are 3 teaspoons in a tablespoon, that means that a LEVEL tablespoon of finely powdered kratom will weigh, on average, about 6 to 7 grams. That is a mid-sized dose for kratom of average potency (possibly a strong dose for high-potency kratom, or a mild dose for low-potency kratrom).

Coarsely ground leaves weigh less than finely powdered leaves (when measured by volume). A LEVEL teaspoon of typical, commercially available, coarsely ground leaves typically weighs about 0.8 grams. If the leaves are loosely crushed they will weigh less, possibly much less, depending on how finely (or coarsely) crushed they are.

What are the effects?
Kratom is a rather unique drug in that a low to moderate dose will usually (but not always) be stimulating, while a high dose is almost always quite sedating. This is apparently because the active alkaloids have both stimulant and sedative effects. Which predominates probably depends both on dosage and individual differences between users. Many people report that the effects are very similar to opiate drugs. From a pharmacological perspective this is not surprising because kratom contains alkaloids that act as opiate receptor agonists. Interestingly, although kratom has a similar mechanism of action as many opiate pain medications it does not appear to be nearly as addictive. In fact many people use kratom to overcome opiate addiction.

The stimulant level: At the stimulant level, the mind is more alert, physical energy (and sometimes sexual energy) is increased, one feels more motivated to get things done, ability to do hard, monotonous physical work may be improved, there is an elevation of mood (it has an antidepressant effect), one is more talkative, friendly, and sociable. The stimulant effects of kratom are different from typical CNS stimulants, such as caffeine or amphetamine drugs. Kratom is more of a cognitive stimulant tnan a physical stimulant.

The sedative-euphoric-analgesic level: At this dosage you will be less sensitive to physical or emotional pain, feel and look calm, have a general feeling of comfortable pleasure, and may enter a pleasant dreamy reverie. You may experience some itching or sweating. Your pupils may be constricted (small). It is possible you may feel nauseated, but if you lie down and relax the nausea should quickly subside. You may find your appreciation of music is increased. It will be very pleasant to lie down on your back in a semi-darkened room, with eyes closed, and just listen to your favorite music. If you do this you may be fortunate enough to enter the delightful mixed-state of ‘waking-dreaming’ where you have one foot in dreamland and the other foot in the real world. This state was much prized by the 19th century Romantic writers, who, lacking knowledge of kratom, resorted to the much more habit-forming narcotic, opium, to achieve it.

What effects are associated with different doses? (dosage guidelines)
That depends on the potency of the kratom. The following dosage-guidline charts are typical for the kratom varieties offered by Sage Wisdom Botanicals, the sponsor of this page.

Premium Quality Kratom
(oral dosage)

Threshold 2-4 grams
Mild 3-5 grams
Moderate 4-10 grams
Strong 8-15 grams
Very Strong 12-25 grams

Ultra-Potent Kratom
(oral dosage)

Threshold 1-3 grams
Mild 2-4 grams
Moderate 3-7 grams
Strong 6-10 grams
Very Strong 8-16 grams

Kratom Extract
(oral dosage)

Threshold 1 gram
Mild 1-2 grams
Moderate 2-4 grams
Strong 3-6 grams
Very Strong 5-8 grams

Threshold = The effects are clearly apparent, but subtle.
Mild = Typically the effects are stimulant-like.
Moderate = The effects can be stimulant-like or sedative-euphoric-analgesic.
Strong = Sedative-euphoric-analgesic effects; too strong for highly sensitive people.
Very Strong = Sedative-euphoric-analgesic effects (TOO STRONG FOR MOST PEOPLE)

Caution: People vary in sensitivity to kratom, and kratom from different sources can vary in potency (sometimes quite a lot), so these dosage estimates should be regarded as loose approximations. One should always start with a low dose when experimenting with a new batch of kratom. One can then increase the dose gradually with subsequent experiments until one obtains the desired level of effects. DO NOT take a strong, or very strong dose, the first time you are sampling a new batch of kratom. Most people experience nausea when using very strong doses. Sensitive individuals may experience nausea at lower doses. For this reason, it is best to take kratom on an empty stomach when using strong doses (i.e. wait about 3 hours after eating). Some people are hypersensitive to kratom, and may experience adverse reactions (such as severe and prolonged vomiting) when using very strong doses.

What is duration of kratoms effects?
The effects of kratom usually last 5-6 hours. When taken on an empty stomach, the onset of effects is typically felt 30-40 minutes after ingestion. If there is much food in the stomach, it may take 60-90 minutes before it begins to take effect. When taken in capsules (gelatin or vegetarian), the onset of effects may be delayed a little because it takes time for the capsules to dissolve in the stomach.

What are the risks? How safe is it?
When kratom is taken by itself (without mixing it with other drugs), the greatest risk is falling asleep while engaged in hazardous activities. NEVER drive while under the influence of kratom, even if you feel stimulated, rather than sleepy, for sleepiness may come on you without warning. Use common sense. Do not use power tools or climb ladders while under the influence of kratom. Be careful not to leave a pot on a lit stove and then fall asleep.

Pregnant women should not take any drug or medication except on medical advice. Since there have been no studies of the risks of kratom use by pregnant women, it is not known whether it could cause birth defects or fetal death. We strongly recommend that any woman who could possibly be pregnant NOT use kratom.

Is kratom an effective pain medication?
Yes, kratom is an effective pain medication (analgesic). In fact, except for opium, kratom is probably the most effective herbal analgesic available. Many people use kratom to alleviate aches and pains, and to help manage painful conditions such as arthritis and fibromyalgia.

Is kratom an effective treatment for opiate addiction?
One of the traditional uses of kratom in Thailand is as a treatment opiate addiction. Opiate addiction is a widespread problem. Not just for people who use opiate drugs illegally, but also for people who are prescribed opiate pain medications. Unfortunately, people who use opiate drugs daily often become addicted. Understandably, many people do not like being addicted to these drugs and are looking for ways to overcome their addiction. Many people report that kratom is effective for this purpose. Because it contains alkaloids that act as opiate receptor agonists it can be used as a substitute for opiate drugs, both as a pain medication and to avoid opiate withdrawals. After switching to kratom for a while, people say that they are able to reduce and then end their kratom use completely without suffering through difficult opiate withdrawal. This suggests that although it contains opiate receptor agonists, the pharmacology of kratom differs from opiate drugs in an important and potentially useful way. Before using kratom to overcome opiate addiction, it is obviously a good idea to discuss this with an open-minded physician.

Is kratom habit forming?
Kratom is not habit forming when it is used responsibly. If used occasionally as a recreational drug, rather than daily, there is virtually no risk of becoming dependent on it. But it is very important not to get into the habit of using it every day. For kratom, like many drugs [e.g. alcohol, coffee, tobacco, etc.] if used on a daily basis for a prolonged period of time, could become a habit hard to break. Before starting to experiment with it set yourself usage guidelines. If you ever find it is hard to stay within your usage guidelines immediately quit using kratom. Of course, people who are using kratom to overcome a preexisting opiate addiction may need to use kratom daily to avoid opiate withdrawal. People suffering from chronic pain may need to take pain medications on a daily basis, and some people choose to use kratom instead of pharmaceutical pain killers. Interestingly, studies have found that opiate drugs (morphine and its relatives) are rarely addictive for pain sufferers except among people with a history of substance abuse. This is probably also true for kratom, because like opiate drugs, the effects of kratom are due to opiate receptor agonist activity.

Is it possible to develop tolerance to kratom?
Yes. Like many drugs, if kratom is used on a daily basis one will eventually develop some tolerance to its effects and will gradually need to take increasingly larger doses to obtain the same level of effects. Tolerance does not develop when kratom is taken occasionally (no more than twice a week). Since the active constituents in kratom are opioid receptor agonists, there is likely to be cross-tolerance with other opioid drugs. This means that people who have developed tolerance to other opioid drugs will probably need to use higher doses of kratom than people who have not. Tolerance is not permanent. Normal sensitivity resumes after a few weeks of abstinence.

I have heard that tolerance can be avoided by taking different varieties of kratom on different days. Is that true?
No. Mixing up different kinds of kratom is not going reduce tolerance. All varieties of kratom contain the same active constituents, although their concentration varies with different batches.

I have heard that the potency and quality of kratom's effects is correlated with the color of the central leaf vein. Is that true?
The color of the central leaf vein ranges from various shades of green to various shades of red. This is partly determined by genetics, but it also varies depending on how mature the leaf is, how much sunlight the tree receives, and other environmental factors. The same tree can have leaves with pale green, dark green, and red veins. Usually the young leaves have red veins, but the red color disappears as the leaves mature, changing to green. Eventually the leaves fade to yellow, then to brown. Since the leaves cycle through these various colors as they mature, they can all occur on a tree at the same time. Obviously, one can select a particular color when harvesting the leaves. Some trees do not produce leaves with red coloration, so that is probably a genetically variable trait. We have not seen any consistent connection between vein color and potency or type of effects. It appears that such correlations are mostly marketing hype invented by kratom merchants. We do see variations in potency between different batches of leaves, but those differences do not correlate with color in any consistent way. Since the effects of kratom do vary based on dosage, differences in potency will cause a week batch of leaves to seem like it has different effects than a stronger batch, when the same amount of both are compared.

Is it true that some kratom products are adulterated or mislabeled?
Chemical analysis has shown that some kratom products are adulterated with other substances. In some cases the kratom has been "cut" with less expensive herbs to reduce the seller's cost and increase profits. In some cases synthetic drugs have been added to enhance the effects. In some cases products labeled as kratom or as a kratom extract don't contain any kratom, but other, less expensive, substances instead. Disturbingly, some products labeled as kratom extracts have been found to contain the "designer drug" O-desmethyltramadol, which is a dangerously potent synthetic opioid drug. Sadly, products containing this compound have resulted in several deaths (first reported in Sweden). Similar compounds have been detected in some other kratom products. Analysis has also found kratom laced with hydrocodone and morphine. Since these are opioid compounds, the effects they produce would be somewhat similar to those of kratom, but obviously far dangerous (there is not a single case in which a death could be attributed to kratom by itself). Obviously, it is important to obtain kratom from a trustworthy source, preferable someone who routinely tests the kratom obtained from his or her own suppliers before reselling it. Kratom is a tremendously helpful and relatively safe herb. It is sad that some unscrupulous merchants are acting so recklessly.

What are safe usage guidelines?
It is best to err on the side of caution. Therefore, we recommend that people not use Kratom more than once or twice a week. Preferably, no more than once or twice a month. This will insure that Kratom does not become a habit. In other words, kratom should be reserved as a special, but OCCASIONAL treat. By using it infrequently, you will avoid habituation and get more pleasure from it.

Are there any reported health problems?
Health problems are unlikely unless one is consuming large quantities of kratom every day. In Thailand, where there are some people who use kratom every day, those dependent on it can develop weight loss, dark pigmentation of the face, and have physical withdrawal symptoms if they quit abruptly. The withdrawal symptoms may include muscle aches, irritability, crying, runny nose, diarrhea, and muscle jerking. Health problems are unlikely to occur in occasional kratom users. Like any drug or medicine, people's reactions vary and some people could possibly have an allergic or other unusual reaction to kratom, even if they used it responsibly.

Can kratom be combined safely with other substances?
In general, combining drugs can be risky. We recommend that kratom not be combined with yohimbine, cocaine, amphetamine-like drugs, or large doses of caffeine, because of the possibility of over-stimulation or increased blood pressure. We recommend that kratom not be combined with large amounts of alcohol, with benzodiazepines, opiates (other than possible use with red poppy tea—see below), or any other drugs that depress the nervous system. This is because of the possibility that such combinations might cause over-sedation or even possible respiratory depression (slowed breathing, or possibly death), We recommended that kratom not be combined with Syrian rue, Banesteriopsis caapi, or any other MAO inhibitor drug. Serious, even fatal, reactions can occur if MAO inhibitor drugs are combined with monoamine drugs. The combination of MAO inhibitor drugs with kratom, which contains monoamine alkaloids, has not been studied.

Certain combinations have been reported by users to be pleasant and supposedly safe. Kratom can certainly be combined with ordinary tea without risk. It has been used with a tea made from red poppy flowers (Papaver rhoeas), which itself has an extremely mild narcotic effect, and with a sedating-euphoriant tea made from ‘blue lotus’ (Nymphaea caerulea). It has been safely combined with SMALL quantities of alcohol, however large quantities of alcohol must be avoided. Some people report they like to smoke tobacco or cannabis while under the influence of kratom. But anyone smoking under the influence of kratom must be very careful not to nod off and drop lit smoking materials.

What is kratom's legal status?
Kratom is illegal in Australia, Denmark, Malaysia, Myanmar (Burma), and Thailand. It is legal in most of the United States (it is only illegal in Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin). Some of these countries impose sever penalties for possession of this herb. It is legal in most other countries. Laws can and do change, so be sure that kratom is legal where you live before using it.

What are kratom's active constituents?
There are many closely-related tryptamine alkaloids in kratom. The most important ones are mitragynine and 7-hydroxymitragynine. These are primarily responsible for kratom’s pain relieving, sedative, euphoric, and stimulating effects. These alkaloids resemble yohimbine in structure, but do not have the same effects.

Is kratom use detected on drug tests?
Although kratom does contain alkaloids that bind to opiate receptors, they are structurally unrelated to opiate drugs and therefore would not be detected by opiate drug tests. It is technically possible to detect the alkaloids in kratom in body fluids, but since kratom is a legal herbal drug (in most places), it is not normally tested for. This may change, especially if kratom becomes a controlled substance in the United States.

Where can kratom be purchased?
There are a number of online merchants, in countries where it is legal, who sell the dried kratom leaves, extracts, or both. But, beware of misleading labels and marketing hype. It is important to find a trustworthy source. There have been problems with some vendors selling bogus "kratom" (misrepresenting other herbs as kratom) or adulterating kratom with other herbs and/or chemicals. One of the authors of this guide now offerskratom through his online herbal products company, Sage Wisdom Botanicals.

Can kratom be cultivated?
Kratom can be grown as a house plant (but will have to be cut back because they can grow quite large). They prefer a humid environment. They dislike cold weather and do not tolerate frost. Potted plants can be grown outdoors in temperate climates when the weather is sufficiently warm, and grown indoors the rest of the time. Kratom can be grown outdoors all year in tropical climates. Potted plants should be lightly fertilized every few weeks, but only when actively growing. They can be propagated from cuttings.

Has The Kratom User's Guide been plagiarized?
Yes. Several kratom vendors have copied huge parts of the Kratom User's Guide and put the text of it on their own websites without even bothering to credit the original source. We are happy to see that some kratom vendors are providing information about kratom, but they must write it themeselves. It is not okay to copy and republish the work of other people, unless one is clearly quoting and crediting one's sources.
EFFECTS LIST

POSITIVE
Simultaneous stimulation & sedation
Feelings of empathy
Feelings of euphoria
Aphrodisiac qualities for some people
"Nodding", vivid waking dreams
Useful with physical labor
Low doses can result in a lasting "glow" in some people, feeling better than normal the next day
Increased sociability and talkativeness
Reduction of opioid withdrawal symptoms

NEUTRAL
Relatively short duration
Change in ability to focus eyes
Pupil pinning / miosis
Analgesia

NEGATIVE
Very bitter taste
Dizziness, nausea and/or vomiting at higher doses
Mild depressed mood during and/or after
Increase in perceived body temperature, feeling hot and sweaty
Hangover similar to alcohol, including headaches and sometimes nausea (at higher doses)
Itchiness / pruritus
Reduced sexual desire or performance
Desire to repeat use more than intended
Mild to strong opioid withdrawal symptoms upon cessation of frequent/heavy use
Addiction, difficulty controlling use, taking steps to avoid withdrawal symptoms
Tolerance building quickly after a few days in a row of repeated use, tolerance to effects reduced with one to three days of abstinence
Liver health problems (rare / unknown whether due to kratom or product contaminants)

DESCRIPTION #
The effects of Mitragyna speciosa are described as being a combination of both stimulation and sedation. The stimulatory effects may be shorter in duration than the sedation effect, coming on faster and fading sooner.
Kratom (Mitragyna speciosa) is described as being a stimulant at low doses, and narcotic/sedative at higher doses. Dosages can vary greatly depending on the freshness of the leaf and the potency of the particular plant/strain. Fresh or freshly dried leaves are generally considered the most potent, but dried leaves are most common outside of SE Asia. Following are approximate dosages for oral (chewed or tea) dried and transported Kratom leaf in grams (as sold outside SE Asia).

IMPORTANT NOTE: There are four common grades of kratom leaves sold on the commercial market and each is a different potency. Some companies use the terms "Organic Commercial Grade" for the least potent (dosages 5-30 grams dried leaf), "Premium" or "Instant Premium" (dosages 2-15 grams), "Super" (2-8 grams) or "Super Enhanced" (dosages 1-5 grams). Many vendors do not use these labels for their products and the potencies are not standardized in any way. From 2000 to 2003, kratom sales usually were of plain, commercial grade dried leaf and leaf powder. Since then, the potency of products has increased and Enhanced, Super, and Premium are now the norm in 2014.

Nausea, dysphoria and vomiting are likely with strong doses, especially in those not already experienced with the effects of kratom. It is important for kratom-tea drinkers to start low with the specific leaf material they have and slowly work the dosage up to avoid unpleasant effects.

A teaspoon of dried leaf is usually between 1.5 and 2.0 grams. 1 milliliter of dried leaf is usually between 0.3 and 0.4 grams.
Oral Kratom Dosages (dried leaf)
2014 Standard (formerly Super Grade)
Threshold 1-2 grams
Light 2-4 grams
Common 3-5 grams
Strong 4-8 grams

Oral Kratom Dosages (dried leaf)
Enhanced (Extract Added)
Threshold 1 gram
Light 1-2 grams
Common 2-3 grams
Strong 3-6 grams

Oral Kratom Dosages (dried leaf)
Premium Grade
Threshold 2-4 grams
Light 3-5 grams
Common 4-10 grams
Strong 8-15 grams

Oral Kratom Dosages (dried leaf)
Low Potency (very uncommon as of 2008)
Threshold 3-7 grams
Light 5-10 grams
Common 10-20 grams
Strong 20-50 grams