here ya'll go, hope you enjoy. Sources are at the bottom. EDIT: Also please let me know anything I missed, miss represented, or ya'll think I could have gone more in-depth on (except for formatting, putting it on Reddit screwed that up a bit). I already turned the paper so whatever but I would like to know for myself. Thank you). **Abstract** Kratom or _Mitragyna speciosa_ is a tropical tree that has traditionally been used for managing pain, to keep away opioid withdrawal, and starve off fatigue- usually in cases of large amounts of manual labor. Natively found in Southeastern Asia and parts of Africa this leaf-based tree is part of the Rubiaceae family, which includes coffee. Much like coffee kratom contains many alkaloids, a few of which act on the central nervous system and can cause diverse physiological and behavioral effects. Since 2008 kratom has been listed as a “Drug of Concern” due to the US’s growing opioid crisis (it has opioid-like effects, more on that later) along with an introduction of dangerous _synthetic_ psychoactive substances (like K2, Spice, 25I-NBOMe). According to [1](https://link.springer.com/article/10.1007/s00213-017-4813-4) since 2016, the DEA has been attempting to make kratom a schedule I drug (highly addictive and no medical value) because the FDA has yet to recognize any medical effects from it. But as of right now there are many groups fighting for kratom legislation like the American Kratom Association (AKA) because it has helped with a variety of their ailments. Right now, kratom is not illegal, legal, or controlled in anyway, it’s in the grey-market—anyone can sell kratom and put whatever they want in it with no repercussions because as of now the FDA refuses to recognize and regulate this substance. My objective is to sort through the many inconsistencies that can be seen in kratom research to state clearly what’s true and what’s not. Once that has been done, I hope to offer a solution to correct these problems and decide whether kratom should be legalized or not in the United States from a biological, cognitive, and social standpoint. **Main Body** Kratoms effects seem to vary slightly from person to person. Research suggests that kratom has both stimulating and sedative effects depending on the dose. 1-5 grams of raw leaves, a low-moderate dose will produce mild stimulant effects including increased concentration, manage pain, decrease fatigue, slight euphoria, help with social interactions, and act as an anxiolytic. Doses between 5-15 grams usually exhibit opiate-like effects including, managing pain, euphoria, an anxiolytic effect, managing fatigue, and some users even report that the effects are similar to a psychostimulant drug (although the page that was cited explaining it was a psychostimulant drug got removed [https://www.deadiversion.usdoj.gov/nflis/NFLIS2013AR.pdf](https://www.deadiversion.usdoj.gov/nflis/NFLIS2013AR.pdf) , so I think it’s fair to say take that last effect with not a grain, but rather a bottle of salt). Kratom has about a 0.5-1.5% alkaloid content, usually consisting of over 25 alkaloids (depending on the conditions it’s grown in). The analgesic effects that have been reported are mainly thought to have come from the most plentiful alkaloid found in the plant at around 60% of total alkaloids, mitragynine. Mitragynine interacts with supraspinal μ- and δ-receptors ([2](https://www.sciencedirect.com/science/article/pii/S0149763412002023?via%3Dihub)) which opiates also interact with, along with a handful of receptors that kratom leaves untouched. The unique specificness of receptors suggests that kratom is among the substances recently referred to as receptor-biased agonists, a new category of more specific, _supposedly_ safer analgesics due to their specificity and the greater amount of control the doctor has over what the patient feels. The reported stimulant activity may be due to the blocking of stimulation from serotonergic 5-HT2A receptors and to the postsynaptic stimulation of the a-2 adrenergic receptors, but as of now not enough research has been done on the other alkaloids included in kratom to confirm this. ([3](https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00062/full#B6)). Additionally, it has been found that naloxone counters the antinociceptive effects, however, mitragynine was found to produce remarkably lower respiratory depression than codeine (not to mention oxycodone or heroin) so it’s unlikely that there will ever be any use for naloxone combating kratom, but it _can_. The other main active alkaloid in kratom is 7-hydroxy-mitragynine (7-OH-MG) which only makes up about 2% of the alkaloids found in kratom. It is considerably stronger than mitragynine but there’s only trace amounts of it in the plant. The negative effects in kratom vary between user-to-user and it’s unlikely a daily user will report all of these effects, especially at once. Some negative effects are considered positive effects for some users and visa versa, for example the fatiguelessness after kratom has worn off, for some people it helps them go to sleep, for others they take kratom to be alert and don’t want those languorous effects. The most common negative effects, usually from taking too much kratom are, nausea and sometimes vomiting, dry mouth, weight loss (although in many cases after years of using kratom the weight loss is within 10 pounds), loss of appetite, excessive sweating, sedation, itching, constipation (especially if taking kratom in gel capsules, the gel capsules will interfere with one’s digestive system), restlessness, unsteadiness, low sex drive (some people choose to use kratom rather than Viagra because it can make you last longer in bed), and being easily annoyed ([3](https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00062/full#B7)). Apparently, in some Southeastern Asian cultures, there is a thing called, “Rain Panic” which is a “great concern” for kratom users (I’m uncertain whether it is or isn’t because after going through all my sources this is the only one that even mentions it) ([2](https://www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub)). Here’s a quote from an Indonesian villager explaining Rain Panic, “…krathom use has affected me with the rain panic. When raining, I feel frozen and trembling, bone pains and numb. As soon as the sky turns grey I stop working and go back home quickly before it rains to protect myself from getting wet” ([2](https://www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub)). Why or how this happens I have no idea (neither does the source), it may be a cultural placebo effect because as far as I know there are not any reports of this in the U.S. Apparently kratom can also make one have ‘darker skin’ which is reported as a negative effect for whatever reason. I found very few sources backing this up and think this may be because in Southeastern Asia usually lower classes of people use kratom for manual labor, which tends to be on farms- I think this correlates because they’re out in the sun more and can work for longer if they get less fatigued, therefore having darker skin. An additional negative effect can be at times, hospitalization. The CDC, FDA, and CPSC ([4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196363/)) agree that in 2015 there were 23,005 emergency room visits involving over the counter supplements ending with 2,154 hospitalizations. But none of these were from kratom! They were all attributed to things like kava, hydroxytryptophan, caffeine, pokeweed, etc. “In a recent review of the toxicology of MG and analogs, Ramanathan and Mansor ([2015](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813050/#CR84), p. 282) concluded as follows: “To date there have been no reports of fatal overdose of kratom _per se_. If there are such occurrences, they are probably the result of kratom products contaminated with synthetic adulterants.” This is consistent with other reviews of kratom pharmacology, toxicology, and epidemiology (Warner et al. [2016](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813050/#CR118)).” So overall kratom may have negative side effects but there seems to be no deaths associated with it. Recently (within two months of this paper being written) this article got published [https://www.cnn.com/2019/04/12/health/kratom-deaths-cdc-study/index.html](https://www.cnn.com/2019/04/12/health/kratom-deaths-cdc-study/index.html). I don’t want to go too in depth on it, just bring up the fact that almost all of the people described in this article had other substances they were taking and kratom wasn’t the _cause_ of the deaths (read the article _closely_, this article came out on most major news outlets within 2 hours of each other including CBS and TIME. A fair article on what happen can be found at the New York Times [https://www.nytimes.com/2019/04/17/us/kratom-overdose-deaths.html](https://www.nytimes.com/2019/04/17/us/kratom-overdose-deaths.html)) According to the DEA kratom can cause withdrawal symptoms usually after daily or almost daily use for a month or more. These symptoms include hostility, aggression, muscle and bone aches, jerky limb movements, and flu-like symptoms. ([3](https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00062/full#B7)) This article also cites there are case-studies done by the DEA with reports of hallucinations, delusion, and confusion—unfortunately the number of case studies, circumstances around these studies (IE are these people taking other substances?, how long/often to they use kratom?, do they have mental disorders?, How much kratom do/did they use?, Where did they buy kratom from?), and when these case studies were done is uncertain because I don’t have a subscription for JAMA Network ([https://jamanetwork.com/journals/jama/article-abstract/2553434](https://jamanetwork.com/journals/jama/article-abstract/2553434)). It’s worth noting that in the DSM-IV and ICD-10 agree that coffee also could be considered to have withdrawals very similar to those of kratom due to caffine. As stated earlier, coffee and kratom are in the same tree family, the Rubiaceae family. Both kratom and coffee affect the user’s central nervous system (CNS). The most common withdrawal symptoms of coffee include a headache, fatigue, decreased energy, decreased alertness, difficulty concentration, and feeling foggy. Even abstinence from low doses, such as one cup a day, produced symptoms of withdrawal ([5](https://www.ncbi.nlm.nih.gov/books/NBK430790/)). Studies further show that the incidence of a headache is about 50% while the incidence of a clinically significant distress or functional impairment is about 13%. So comparing kratom vs caffeine, the withdrawals seem to be about the same; I actually think coffee looks considerably worse. Unfortunately, kratom withdrawals have not been documented nearly as well as caffeine and until they are it will be hard to make a fully accurate comparison. There are a few concerns that people should be aware of with kratom in the grey market as it is. The first is it can’t _really_ be regulated; people can make reviews and test the products in their free time but it’s not really being regulated and checked for inconsistencies or additives without the FDA agreeing to legalize it. Additionally, because it’s not legalized there’s no tax or import revenue for the government. Additionally, kratom could greatly boost Indonesia and Africa’s economies if it’s used in the medical world. Extracts seem like a scary thing; extracts are basically extract one chemical out of kratom (usually mitragynine due to its wide availability in the plant and recreational potential). This is like extracting morphine out of poppies; a lot of something like that has the potential to be very dangerous. I couldn’t find a scholarly article talking about extracts, this is something that needs to be researched further. Actually, the whole plant needs to be researched further with more consistent methods. As any reader could see from my paper the research isn’t concrete and there are large gaps in academic areas regarding this plant. I think if the FDA were to do unbiased in-depth research on this plant it could eventually replace opiates. The recreational potential for kratom is much lower than things like hydrocodone. Additionally, they could regulate kratom, therefore helping people not consume synthetic, illicit, or potentially fatal substances. Not even to mention, if the government did regulate kratom, the opiate epidemic that has swept the nation could potentially be “cured”, or at least put to a stand-still. People could use kratom to combat withdrawals and give them the gumption to eventually eschew dangerous pain medication. **References** 1. Aggarwal, Geeta, et al. “Death from Kratom Toxicity and the Possible Role of Intralipid.” journal _of the Intensive Care Society_, SAGE Publications, Feb. 2018, [www.ncbi.nlm.nih.gov/pmc/articles/PMC5810870/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810870/). 2. Fluyau, Dimy, and Neelambika Revadigar. “Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom.” _Frontiers_, Frontiers, 4 Apr. 2017, [www.frontiersin.org/articles/10.3389/fpsyt.2017.00062/full#B6](http://www.frontiersin.org/articles/10.3389/fpsyt.2017.00062/full#B6). Geller, Andrew I, et al. “Emergency Department Visits for Adverse Events Related to Dietary Supplements.” _The New England Journal of Medicine_, U.S. National Library of Medicine, 15 Oct. 2015, [www.ncbi.nlm.nih.gov/pmc/articles/PMC6196363/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196363/). Hassan, Zarina, et al. “From Kratom to Mitragynine and Its Derivatives: Physiological and Behavioural Effects Related to Use, Abuse, and Addiction.” _Neuroscience & Biobehavioral Reviews_, Pergamon, 1 Dec. 2012, [www.sciencedirect.com/science/article/pii/S0149763412002023?via%3Dihub](http://www.sciencedirect.com/science/article/pii/S0149763412002023?via%3Dihub). 1. Henningfield, Jack E., et al. “The Abuse Potential of Kratom According the 8 Factors of the Controlled Substances Act: Implications for Regulation and Research.” _SpringerLink_, Springer Berlin Heidelberg, 23 Dec. 2017, link.springer.com/article/10.1007/s00213-017-4813-4. Kruegel, Andrew C., and Oliver Grundmann. “The Medicinal Chemistry and Neuropharmacology of Kratom: A Preliminary Discussion of a Promising Medicinal Plant and Analysis of Its Potential for Abuse.” _Neuropharmacology_, Pergamon, 19 Aug. 2017, [www.sciencedirect.com/science/article/pii/S0028390817303933?via%3Dihub](http://www.sciencedirect.com/science/article/pii/S0028390817303933?via%3Dihub). Mackay, Lindsay, and Ronald Abrahams. “Novel Case of Maternal and Neonatal Kratom Dependence and Withdrawal.” _Canadian Family Physician Medecin De Famille Canadien_, College of Family Physicians of Canada, Feb. 2018, [www.ncbi.nlm.nih.gov/pmc/articles/PMC5964386/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964386/). 1. Saingam, Darika, et al. “Pattern and Consequences of Krathom (Mitragyna Speciosa Korth.) Use among Male Villagers in Southern Thailand: A Qualitative Study.” _International Journal of Drug Policy_, Elsevier, 18 Oct. 2012, [[www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub.\\](http://www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub.)](http://www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub.%5D(http://www.sciencedirect.com/science/article/pii/S0955395912001442?via%3Dihub.)) 2. Sajadi-Ernazarova, Karima R. “Caffeine, Withdrawal.” _StatPearls [Internet]._, U.S. National Library of Medicine, 27 Oct. 2018, [www.ncbi.nlm.nih.gov/books/NBK430790/](http://www.ncbi.nlm.nih.gov/books/NBK430790/). submitted by [/u/Kuyper123](https://www.reddit.com/user/Kuyper123) [[link]](https://www.reddit.com/r/kratom/comments/bhdl12/i_made_a_kratom_paper_for_my_psych_class/) [[comments]](https://www.reddit.com/r/kratom/comments/bhdl12/i_made_a_kratom_paper_for_my_psych_class/) https://www.reddit.com/r/kratom/comments/bhdl12/i\_made\_a\_kratom\_paper\_for\_my\_psych\_class/