The Ultimate Guide to

Kratom

(Mitragyna speciosa, Ketum, Biak-biak, Kakuam, Thom, Ithang)

Mitragynine and 7-hydroxymitragynine

C23H30N2O4 and C23H30N2O5

Disclaimer:
Kratom is a potentially illegal substance, and we do not encourage or condone the use of this substance where it is against the law. However, we accept that illegal drug use occurs, and believe that offering responsible harm reduction information is imperative to keeping people safe. For that reason, this guide is designed to ensure the safety of those who decide to use the substance.

Overview

01
Kratom is the common name for Mitragyna speciosa, a tropical evergreen tree native to the marshy jungles of Southeast Asia. The tree grows wild in central and southern Thailand, Malaysia, Indonesia, Myanmar, and elsewhere in the Pacific Rim, where it has been used as traditional medicine since at least the 19th century.

The psychoactive compounds of kratom are found in the tree’s broad green leaves, which are picked, dried in the sun, and brewed as a tea, or crushed and mixed into water. The effect of the substance is often compared to both opioids and stimulants and is lauded for offering relief from pain, depression, and anxiety.

Kratom advocates regard the substance as an invaluable aid for mental and physical health, but it’s also used as a recreational drug. Though it’s been used in traditional contexts since at least the 19th century, kratom’s global popularity has grown in recent years.

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Experience

02

What to expect

At low doses, kratom has a stimulating effect, making users feel more energetic, sociable, and motivated. Some also report feelings of euphoria. The stimulant effects of kratom can be a little too “edgy” for some people, at least at first. Other unpleasant effects include sweating, nausea, dizziness, and dysphoria, which mostly occur at the onset.

At higher doses, kratom has a sedative effect. Users may feel euphoric and content, and emotions and sensations may be dulled. Some people report experiencing a kind of “waking-dreaming” state, especially when listening to music. In fact, ethnobotanist and author Daniel Siebert compared this state to the one prized by 19th-century Romantics, who used opium to keep one foot in dreamland and the other in the real world.

Kratom can also induce some mild visuals (both open- and closed-eye), a warming sensation, increased empathy, and possibly sexual arousal. Many also find that sex on kratom lasts longer, but that it can also feel impossible to climax. Erectile enhancement is common, but so is erectile dysfunction. Frequent use and higher doses can substantially diminish libido—sometimes completely. But many do enjoy the combination of sex and kratom, and some men take it to increase the enjoyment of their partner even if it means sacrificing their own.

On an empty stomach, the effects of kratom are felt after about 15-20 minutes, though stronger doses may have a shorter onset. After, the intensity builds gradually and peaks for around two to four hours.

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Effects

03
Like other phytochemicals, kratom contains the indole alkaloids mitragynine (9-methoxy-corynantheidine) and 7-hydroxymitragynine. Mitragynine is often compared to psilocybin and ergine (LSA) for its 4-substituted structure, and was previously thought to be the primary active compound in kratom.[1] More recently, however, the terpenoid 7-hydroxymitragynine has been found to be 46 times more potent, with greater oral bioavailability and blood-brain barrier penetration.[2][3]

Receptor binding

7-hydroxymitragynine is a highly selective mu- and kappa-opioid receptor agonist, acting mainly on the former subtype.[3][4] Mitragynine is a partial mu-, delta-, and kappa-opioid receptor agonist, but can also act on the 5-HT2A serotonergic and alpha2-adrenergic receptors, as well as neuronal Ca2+ channels.[2][3][5][6]

The mechanism behind kratom’s stimulant effects is unclear. Since both compounds interact mainly with the opioid receptors, there’s likely to be some other alkaloid involved.[4]

Dosage

How much kratom to take depends on your physiology, tolerance, and other factors. Chances are that as a newbie your tolerance is nil, but there may be a cross-tolerance effect with other opioids.

Generally speaking, a moderate dose of plain dried leaf (powdered) is 3-6 g, but anything above 5 g is considered strong.[7] The recommended starting dose is one to two grams. If you’re sensitive, you’re probably better off starting with one gram. Ideally, you should measure out your dose on a digital scale. But if you don’t have one on hand, you can use this kratom dose chart to estimate the teaspoon or tablespoon equivalents. Capsules tend to contain between 350 and 750 mg, so you may need one to three for a starting dose.

Kratom powder (dried ground leaf) is consumed either by swallowing with a drink, taking it in capsules, or brewing a tea. (For the pros and cons of each method—and the best way to take kratom—see FAQ.)

It’s best to wait 30-45 minutes after your first dose to see how it affects you. Then, if you feel you need more, take up to one more gram. After waiting another 30-45 minutes, take up to one more final gram if desired. And if this dose still fails to satisfy, start with three grams another day and repeat the process from there; don’t take any more on day one. And don’t take more than eight grams on any one day.

Interactions with other drugs

Although kratom is generally safe on its own, combining it with certain medications and substances could potentially be dangerous. Mixing kratom and opiates together, for example, can lead to fatal respiratory depression, as well as vomiting while unconscious, which can cause suffocation.[8]

These dangers apply to other opioids too⁠—and depressants or sedatives in general. Interactions between kratom and oxycodone (OxyContin), hydrocodone, tramadol, DXM, and more are all potentially risky. The same goes for benzodiazepines, such as Klonopin, Valium, and Xanax.

Kratom and alcohol are not a good mix because of alcohol’s depressant effects. It could potentially lead to respiratory failure. There’s also the heightened risk of throwing up and choking on your vomit.[7][8]

Kratom is sometimes used to treat addiction, in which case combining kratom and suboxone may seem unavoidable. This isn’t an ideal combination, but a careful balance of titration and dose timing can apparently be effective.[9][10]

On the positive side, Kratom is reportedly a good alternative to Adderall for managing ADD/ADHD. Some also find it helps relieve an Adderall comedown. While it’s generally unsafe to combine kratom and stimulants, there appear (anecdotally) to be few if any negative side effects with Adderall in particular. However, it probably best to stagger your intake of each, i.e. taking kratom several hours after Adderall.[11][12]

Many people also combine kratom and cannabis to enhance the relaxing effects of each.[13] In fact, the pharmacological actions of these substances seem to be synergistic. As with other substances, though, you might want to stagger them. One recommendation is to eat some food in between taking kratom and cannabis to avoid feeling faint or lightheaded.[14][15]

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Benefits & Risks

04

Potential Benefits

Kratom has long been used for healing purposes, and these days its reputation as an aid to psychological healing is growing. In a traditional context, the plant has been used to relieve pain, soothe fevers, treat diarrhea, manage diabetes, and treat addiction. Though there’s not much clinical evidence backing up these use cases, many people believe that kratom shows great potential as an analgesic, especially in place of more addictive—and arguably more dangerous—drugs such as opioids. In fact, kratom is commonly used as an aid to the withdrawal symptoms of prescription medications and heroin, and it’s thought that the substance could replace methadone. Anecdotally, people also report that kratom is great for treating depression and anxiety.

Beyond strictly therapeutic applications, kratom is also considered a catalyst for personal growth—in both the short and the long-term. In fact, one of the most popular traditional uses has been to chew the leaves for energy, and people today also report using kratom to boost their energy and productivity.

Like other psychoactive substances, kratom can also facilitate deep emotional, psychological, and interpersonal healing by liberating the user from the confines of everyday thought patterns, and drawing attention to often-ignored issues that can be resolved.

Risks

Kratom is generally considered safe, but as with many psychoactive substances, more research is needed to know for sure. What we do know is that mitragynine—one of the active compounds in kratom—shows very little toxicity, even at high doses.[16] No fatalities were recorded in rats given 1000 mg/kg oral doses of kratom leaf extract or 806 mg/kg of isolated mitragynine. There were also no fatalities in rhesus monkeys injected with 9.2 mg/kg of mitragynine.[6]

But this doesn’t mean kratom is totally safe. For one thing, different preparations may contain different amounts of phytochemicals and adulterants.[2] There’s also been relatively little research into the long term effects of kratom taken regularly.[17]

There are some reports of seizures, but most kratom-related seizures are attributed to adverse drug combinations. Still, there is cause for concern.[5][18][19]

Longer-term use of kratom also appears to affect the liver.[2][4] After two to eight weeks of regular use, some people have reported experiencing nausea, itching, dark urine, abdominal pain, and jaundice. Heavy kratom users might notice a hyperpigmentation or darkening of the cheeks due to the over-stimulation of melanocytes.[2] Kidney damage could also result from chronic use, and the substance might also be cardiotoxic.[20][21]

Some other more rare issues linked to kratom use include sleep problems, hypotension, tremors, temporary erectile dysfunction, sweating, hair loss, dry mouth, and anorexia.[22][23][2][24]

Kratom should be avoided by pregnant or breastfeeding women. Aside from the potential health issues associated with kratom use alone, limited evidence suggests infants may also become addicted to the substance via passive intake (either in the womb or via breast milk)—to the point of suffering withdrawal symptoms once the substance is removed.[25]

Some evidence also suggests psychosis—including paranoid delusions, hallucinations, and confusion—may be caused by regular kratom use spanning a decade or more.[26] Animal studies have also found a link between chronic use and memory/learning problems.[27]

While a number of human fatalities have been linked to kratom use, there are usually other substances present.[7] In one case, 0.6 mg/L mitragynine was detected alongside over-the-counter cold medicines and benzodiazepines.[28]

While under the influence of kratom, driving and other potentially dangerous activities should be avoided—even if you feel stimulated. The effects of kratom can change from stimulant to sedative without warning, so sometimes just turning on the stove could be risky.[22][7]

New kratom users should start with a low dose, precisely weighed out on an accurate digital scale. The same goes for more experienced kratom users trying a new strain, due to the variability between them.[7][29]

Some “kratom products” may also contain adulterants, including morphine, hydrocodone, and fentanyl.[6][7] In Sweden, nine people died from the “enhanced kratom preparation” Krypton—a blend of kratom and caffeine with O-desmethyltramadol.[30][31] The latter, a bioactive metabolite of tramadol, is a dangerously potent opioid. Other “kratom products” have been found to contain no kratom at all.[32]

Chronic long term use of kratom does come with a risk of addiction. Symptoms of addiction include anorexia and weight loss, insomnia, frequent urination, constipation, and darkened skin.[26]

Overdose

Some believe that kratom could come with the risk of overdose. A study in 2019 identified a lethal kratom dosage in mice—or at least a lethal dose of the extracted alkaloids (injected intravenously). For mitragynine, the LD50 (or median lethal dose, the dose that kills 50% of the test population) is apparently 27.8 mg per 1kg of body weight. And for 7-hydroxymitragynine, it’s 24.7 mg to 1kg of body weight. This places the lethal kratom dosage (in mice) roughly in the same region as heroin.

However, it’s crucial to note the uncommon route of administration; few if any inject kratom. When administered orally, the LD50 for mitragynine in mice was 547.7 mg to 1kg body weight. No lethal dose was observed for 7-hydroxymitragynine given orally.[33]

So can you overdose on kratom? Probably not—at least not by accident. These findings uphold the common understanding that a lethal kratom dosage would be physically impossible to reach—at least when using powdered leaf products as opposed to resins or extracts of unknown potency. Doses in excess of 8-9 grams (upwards of 90 mg/kg body weight) will induce vomiting far sooner.[8]

Therapeutic Use

05
Though there are no mainstream medical uses for kratom, it shows great therapeutic potential. The ethnobotanist and pharmacognosist Daniel Siebert described it as one of the most effective herbal pain killers, second only to opium.[7] 7-hydroxymitragynine in particular is 13 times more potent than morphine and considerably less addictive.[2] Withdrawal symptoms from kratom are also far milder and short-lived. Mitragynine, meanwhile, is seen as a potential replacement for codeine, offering comparable analgesic effects without the risk of fatal respiratory depression.[34][35][36] Curiously, synthetic mitragynine is less potent than extracted mitragynine.[37]

Kratom could eventually come to replace methadone in the treatment of heroin addiction—especially given its relative ease of production, making it ideal for poor and developing countries.[1][5][7][38][39] The use of kratom for heroin withdrawal has become fairly common around the world, and it can also be helpful for getting off prescription opioids.

Kratom could be a viable alternative to alcohol as well since it promotes relaxation and sociability without the emotional/physical hangover.[40][41]

At least one study supports the growing use of kratom to manage anxiety and depression. Mice injected with mitragynine were found to have lower levels of corticosterone, a hormone involved in the regulation of stress responses and energy.[42] The open, introspective mindset that kratom creates could also prove useful in psychotherapy.[1]

Kratom also shows potential for treating other conditions, including diarrhea,[22][43] chronic pain,[23][44] inflammation,[2] arthritis,[45] migraines,[46][47] and even cancer.[2][48]

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Personal Growth

06
While most users take kratom for pain, anxiety, or some other specific condition, it’s also considered a “plant teacher”—a tool for exploration and growth. Described by one kratom user as a “nurturing mirror,” it can gently draw attention to areas of personal and interpersonal dysfunction.[49] These can be explored within the context of an emotionally honest, “entactogenic” high.[50] Some kratom users also report that kratom can reduce social anxiety, and even improve sexual performance.

People also find that kratom gives them a greater appreciation for being alive.[41][51]

One user reported that their “mildly therapeutic” kratom experience helped them to “explore my own mind in a positive and euphoric mood as opposed to in my normal state of anxiety/mild depression.” Another called it an “excellent tool for self-healing” after the substance gave them insight into the imbalances in their life that were hindering well-being. Yet another used kratom nearly every day for two years to heal from opioid addiction, reporting that it changed his life.

Legality

07
Kratom isn’t federally controlled in the United States, but it is a “drug of concern.”[23] Individual states, including Indiana, Wisconsin, Vermont, Arkansas, Alabama, and Rhode Island have banned the plant in various forms, while others have legislation pending.[52] For the latest developments, bookmark this kratom legality map.

In the UK, kratom is criminalized under the Psychoactive Substances Act.[53] The plant and its active alkaloids is controlled by various measures in a number of EU member states, including Denmark, Poland, and Sweden. It’s also illegal in Australia, New Zealand, Malaysia, Myanmar, and Thailand, among other countries.[23]

History and Stats

08
Though we don’t know for sure when kratom use began, the practice is thought to be ancient.[26][22] In its native growing regions, the plant has been used to numb aches and pains, soothe fevers, treat diarrhea, manage diabetes, and alleviate addiction. It’s also been applied as poultices to wounds or spread across the abdomen to drive out worms.[54]

Perhaps the most popular traditional use has been to chew on the leaves for energy—similar to the way coca is used in the Andes. In Thailand, farmworkers have been known to chew up to ten times a day while working outside in the sun.[23] From at least as far back as the early 19th century in Malaysia, kratom has also been used as a sedative—especially as a replacement for opium.[1]

The active constituent mitragynine was isolated in 1921 and tested on humans in 1932 as enthusiasm for kratom’s medical potential grew. It was likened to cocaine for its stimulant effects on the central nervous system.[1]

By the early 1940s, Thailand’s government saw a massive decline in opium tax revenue as addicts turned to kratom—an unregulated drug—to manage their withdrawal symptoms.[55] The Kratom Act was passed in August 1943, forbidding anyone from cultivating the plant and ordering the destruction of all existing specimens.[26]

Outside of Thailand, scientific interest in kratom grew. More than 20 alkaloids were isolated during the 1960s and, in 1994, the second of kratom’s primary active compounds was identified: 7-hydroxymitragynine.[23][1] The first synthesis of mitragynine was produced the following year.[34]

Knowledge of kratom spread throughout the early 2000s, mainly through online message boards. In 2005, however, both M. speciosa and mitragynine were scheduled in Australia, banning them for sale or possession without a license.[22] Enforcement of the Kratom Act also ramped up in Thailand, where arrests quintupled between 2005 and 2009.[55] In 2012, when Thai police ordered the destruction of hundreds of wild kratom trees in a protected area of forest in Satun Province, locals resisted their attempts.[56]

In the United States, various advocacy and campaign groups, including the American Kratom Association, Botanical Education Alliance, and United Kratom Association, have sprung up to protect kratom’s legal status. Thanks to efforts like theirs, the DEA was forced to withdraw an August 2016 “notice of intent” to place kratom into Schedule I of the Controlled Substances Act.[57][58]

Current use

Interest in kratom spiked when the DEA threatened to ban it. A survey of 6,150 kratom users conducted around the same time found that 51% used it for pain, 14% for anxiety, and 9% for opiate withdrawal.[59]

Kratom is commonly sourced from online “legal high” vendors, but it’s far from widely used.[30] In 2014, it ranked among the top 20 drugs only in Hungary, where just 1.5% of the sample had used it.[60]

It does, however, remain popular in Thailand—despite its criminalization and the social stigma attached.[61] Of 1,000 teenagers surveyed, 94% used kratom, mostly as an ingredient in “4×100” cocktails, a homemade concoction that blends kratom tea, Coca-Cola, cough syrup (including codeine or diphenhydramine), and an anxiolytic, antidepressant, or analgesic drug. Served ice cold, it may also contain road paint, pesticides, powder from fluorescent tubes, and pretty much anything else rumored to “enhance” its effects.[55]

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Myths

09

“Rotating strains lowers tolerance”

It’s commonly thought that rotating strains throughout the week so that no strain is taken on two consecutive days supposedly sidesteps tolerance. But in truth it’s more likely to increase it. While different strains have varying levels of the active indole alkaloids, those same alkaloids are still present in all of them.[7] To avoid tolerance (not to mention addiction), it’s best just to moderate use.

“Addicts are injecting kratom powder”

In 2018, the Ohio Substance Abuse Monitoring Network claimed in their report on drug abuse trends that “out of 10 kratom users, seven would shoot the drug.”[62] Admittedly that was just an estimate from one particular region of Ohio, but similar claims are repeated elsewhere.[63] And they’re simply not true.

Although kratom injection isn’t unheard of, it’s far from common. In fact, it’s not even a viable route of administration. As Dave Herman, chairman of the American Kratom Association (AKA), put it: “No one injects it. It’s a plant material, it would tear you up.”[64] Molecular biologist Jane Babin agrees, saying “there’s too much insoluble plant matrix/cellulose” in powdered leaf, and injecting ethanol extracts would cause tissue damage.[62]

In other words, we’d be seeing many more kratom-related health issues if injecting was actually common. We’d also see kratom users talking about it. But a quick search of the kratom Reddit group returns very few posts on injection and the AKA forum ridicules and dismisses the idea.

“Reports of kratom overdose death are increasing”

In 2019, a government study found that between July 2016 and December 2017, kratom killed 91 people, signifying a rise in kratom-related deaths. However, of these 91 people only seven took kratom on its own. The overwhelming majority combined it with other drugs. And, as the report noted, even in those seven cases of alleged kratom overdose death, “the presence of additional substances cannot be ruled out.”[65]

Meanwhile, prescription opioids remain one of the leading causes of overdose death in America, killing nearly 47,000 people in 2018. So if anything’s increasing, it’s Big Pharma’s lobbying to finally get kratom banned. For more on this, check here.

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FAQ

10

Does kratom show up on a drug test?

Kratom won’t be detected by either standard or enhanced drug tests. And despite its similarity to opiates, it’s unlikely to trigger a false positive.[7]

You’d need a specialist kratom drug test to detect it. Tests such as GC-MS (gas chromatography-mass spectrometry) are able to detect kratom in urine, for example, but they’re not routinely used.[23]

How long does kratom stay in your system?

There are conflicting reports on how long kratom can be detected in urine. Some say as little as one day and others upwards of two weeks.[66][67][68] A safe bet would be at least a week.

Can kratom cause psychological trauma?

Evidence suggests there may be a link between prolonged, regular kratom use (or addiction) and deluded thoughts.[26] While moderate use isn’t likely to be problematic psychologically, some kratom users have developed anxiety (although others use kratom to treat it). The kratom “high” itself is actually pretty mild and manageable compared to many other psychoactive substances.

Where can you buy kratom online?

The majority of kratom users probably buy kratom online. It’s very much a buyer’s market with a full range of options and plenty of reviews. However, there’s also a lot of inconsistency and misinformation.

This isn’t to say these issues don’t exist offline, of course; it’s just important to note that not everyone listing kratom for sale online actually knows what they’re selling. And, unfortunately, the kratom Reddit group⁠—once a great source of vendor recommendations—is now forbidden from sharing such tips. The same is true of the AKA forum.

Going by kratom vendor reviews, however, some of the top kratom vendors and brands are (in no particular order):

  • Kraken Kratom (according to many the best kratom vendor for price)
  • Moon Kratom (one of the more reputable sellers from which to buy kratom bulk orders cheap)
  • KratomCapsules.com (perhaps the best place to buy kratom capsules online)
  • OPMS Kratom (another place to find kratom capsules for sale, alongside liquid kratom and fresh products)
  • PurKratom (reportedly among the highest quality kratom vendors)
  • Kratora (offers a 30-day money-back guarantee and a loyalty rewards program)[69][70][71][72][73]

Is it legal to grow at home?

It depends on state law. But even in states where kratom is banned it may still be legal to grow for aesthetic purposes.

For growing tips, check out The Kratom User’s Guide. The KratomGarden on Reddit is another good place to get advice and keep up with legal developments.

What is the best way to take kratom?

Newbies wondering how to take kratom powder have three basic options—all of them oral.

The “toss and wash” method, i.e. swallowing the powder with a drink, is generally the quickest and easiest. But even with fruit juice, the taste can lead to nausea. And stomach upset is common.

Capsules deal with the issue of taste and they’re more discreet. However, they can also be expensive to buy, or else time-consuming if you make them yourself. The biggest con, though, is the fact they take longer to work. (Oblate discs are similar to capsules but supposedly faster-acting.[74])

The third option is to brew your powder as a tea. Kratom tea has the fastest onset of any method, as well as (reportedly) the least stomach upset. Of course, the taste can still be unpleasant.

Another potential drawback of kratom tea vs capsules and the “toss and wash” method is the lengthy process of making it. However, some feel this adds to the allure.

Whichever option you choose, generally the best way to take kratom powder is on an empty stomach. You should also remember to stay hydrated.

What about kratom resins, extracts, tinctures, and leaf?

The high potency of extracts like kratom resin can increase your tolerance more than kratom powder⁠—meaning you’ll need higher and higher doses to achieve the same effect. The chances of addiction and physical harm increase, too. For this reason, experienced kratom users generally steer newbies away from extracts, resins, tinctures, enhanced blends, and so on until they’ve found their optimal dose. For more information, see the kratom Reddit wiki and linked threads.

Can you smoke kratom?

Smoking kratom powder is unlikely to produce much of an effect due to the destruction of alkaloids when burnt. Vaping kratom, either as a powder or kratom vape juice, is also said to be ineffective.[75][76]

Usually, dried kratom has to be brewed, filtered, and evaporated before it can be smoked. The resulting substance—a kind of syrupy resin—is traditionally added to palas palm (Licuala grandis) leaves in the bowl of a long “madat” pipe.[54]

That said, smoking kratom resin (as an alternative to opium) is one of the traditional routes of administration.[77] It’s just not advisable due to safety concerns.

Chewing fresh leaves is a more viable alternative. Effects may be felt from as little as half of a large, 8-inch leaf, although between one and three leaves is more common.[23] The fibrous ribs and veins should be removed before chewing.

What are the differences between strains?

Potency can vary substantially between the so-called “strains,” but they all contain the same active alkaloids. They’re not actually botanical varieties.[78][7] And differences in effect tend to vary from person to person. That said, there is some general agreement around what each strain is good for:

  • Red vein kratom is said to be calming, so it could be the best kratom for pain relief, as well as the best kratom for sleep
  • White vein kratom may be more stimulating; it could be the best kratom for energy, as well as the most euphoric kratom strain overall
  • Green vein kratom is also said to be stimulating, with apparently longer-lasting effects. [78][79]

Can I use kratom to microdose?

It may not be suitable for microdosing due to possible kratom liver damage. It’s also unclear whether kratom is even active at sub-perceptual doses.

Does it produce tolerance?

With frequent use (i.e. more than once or twice a week) tolerance tends to build up. It may take several weeks of abstinence to return to normal sensitivity. There’s also a cross-tolerance effect with morphine.[23]

Footnotes

11

[1] Jansen, K. L. R., Prast, C. J. (1988). Ethnopharmacology of Kratom and the Mitragyna Alkaloids. Journal of Ethnopharmacology, 23, 115-119.

[2] Cinosi, E. et al. (2015). Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BioMed Research International, 2015.

[3] Prozialeck, W. C., Jivan, J. K., Andurkar, S. V. (2012). Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects. The Journal of the American Osteopathic Association, 112, 792-799.

[4] Kapp, F. G., Maurer, H. H., Auwärter, V., Winkelmann, M., Hermanns-Clausen, M. (2011). Intrahepatic Cholestasis Following Abuse of Powdered Kratom (Mitragyna speciosa). Journal of Medical Toxicology, 7(3), 227-231.

[5] Boyer, E. W., Babu, K. M., Adkins, J. E., McCurdy, C. R., Halpern, J. H. (2008). Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction, 103(6), 1048-1050.

[6] Ujváry, I. (2014). Psychoactive natural products: overview of recent developments. Ann Ist Super Sanità, 50(1), 12-27.

[7] Siebert, D., “Sage Student”. (2016, Oct 12). The Kratom User’s Guide. Retrieved from http://www.sagewisdom.org/kratomguide.html.

[8] PsychonautWiki. Kratom. Retrieved from https://psychonautwiki.org/wiki/Kratom#Toxicity_and_harm_potential.

[9] JDP1982. Suboxone and Kratom and finally setting the record straight. [Online forum thread]. Thread posted to https://www.reddit.com/r/kratom/comments/9mps0t/suboxone_and_kratom_and_finally_setting_the/.

[10] Concat09. Kratom while on suboxone [Online forum thread]. Thread posted to https://www.reddit.com/r/kratom/comments/8kgpcp/kratom_while_on_suboxone/.

[11] Mssixty. (2015, Mar 13). Adderall and kratom [Online forum thread]. Thread posted to https://drugs-forum.com/threads/adderall-and-kratom.264444/.

[12] MadTrippin6. Kratom & adderall [Online forum thread]. Thread posted to https://reddit.com/r/kratom/comments/8ec81p/kratom_adderall/

[13] bloodofgore. Mixing kratom with cannabis is probably the best combo yet [Online forum thread]. Thread posted to https://www.reddit.com/r/kratom/comments/6thddo/mixing_kratom_with_cannabis_is_probably_the_best/.

[14] Adams, B.M. (2019, Feb 5). Should You Mix Cannabis and Kratom? Retrieved from https://merryjane.com/health/should-you-mix-cannabis-and-kratom.

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