Yes, kratom is addictive, especially at higher dosages. While some people use it to wean off more potent opioids, it can itself become a substance of addiction and be difficult to come off of. The addictive potential varies between individuals.

How does kratom compare to other opioids like morphine and hydrocodone?

Kratom, morphine, and hydrocodone all bind to the mu-opioid receptor, responsible for opioid-like effects such as sedation and analgesia. While kratom has lower potency (about one-sixth that of hydrocodone), its effects on the mu-opioid receptor can lead to similar addictive potential. It also indirectly activates reinforcement pathways involving dopamine and serotonin.

Can kratom cause respiratory depression?

Kratom is not known to suppress respiration at low to moderate doses. However, when combined with other opioids or alcohol, it can suppress respiration. There is some evidence suggesting kratom-induced death can be caused by respiratory suppression, especially at higher dosages or in combination with other substances.

What is the Huberman Lab Premium channel?

The Huberman Lab Premium channel is a subscription-based service that provides support for the standard podcast and funds research. Subscribers gain access to full AMA episodes, transcripts, and exclusive premium content, with a dollar-for-dollar match from the Tiny Foundation for research funding.

If you haven't tried kratom, it is strongly advised to avoid it due to its addictive potential. If you are already addicted to stronger opioids, you should consult a physician. For those already using kratom, thoughtful consideration of dosage and potential for addiction is essential.

Key Moments

AMA #9: Kratom Risks, Does Infrared Sauna Work & Journaling Benefits

Andrew Huberman

Science & Technology3 min read27 min video

Jul 28, 2023|166,915 views|3,101|1,032

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Key Moments

TL;DR

Kratom is an opioid with addictive potential; avoid if possible. Consult doctors for opioid cessation.

Key Insights

Kratom acts as an opioid, with stimulant effects at low doses and analgesic/sedative effects at higher doses.

While some use kratom to wean off stronger opioids, it carries its own significant risk of addiction and withdrawal.

Individual responses to opioids, including kratom, vary significantly, with a notable percentage being more susceptible to addiction.

Kratom's pharmacology involves binding to mu-opioid receptors, similar to morphine and hydrocodone, indirectly activating reward pathways.

The lack of regulation in kratom supplements makes dosage and alkaloid concentration inconsistent and potentially dangerous.

Kratom, especially at higher doses or when combined with other substances, carries a risk of respiratory depression, though less than potent opioids.

KRATOM AS AN OPIOID SUBSTANCE

Kratom, derived from the Mitragyna speciosa tree, exhibits dual effects: mild stimulation at low doses and pain relief (analgesia) or sedation at higher doses. Critically, kratom functions as an opioid in the body, binding to opioid receptors. This classification places it within the controversial landscape of opioid use, particularly given the ongoing opioid crisis associated with substances like morphine and oxycodone. While it can offer pain relief, its opioid nature necessitates caution due to its potential for dependence.

ADDICTIVE POTENTIAL AND WITHDRAWAL SYMPTOMS

Kratom is not only habit-forming but also addictive, especially when consumed at dosages that induce euphoria or analgesia. Users can develop tolerance, requiring increased amounts for the same effect. This can lead to significant withdrawal symptoms if consumption is stopped abruptly. The addictive potential is a serious concern, echoing issues seen with other opioids, and it underscores the importance of avoiding kratom if one has not previously used it.

INDIVIDUAL VARIABILITY IN RESPONSE

A crucial aspect of kratom's effects is the significant individual variation in response. While some individuals may experience mild effects or find it a tool for opioid cessation, a substantial subgroup (estimated between 10-40%) responds very potently to opioids. These individuals are at a much higher risk of developing addiction. It is imperative to recognize that a blanket statement about kratom's safety or risk cannot apply to everyone, emphasizing the need for personal assessment and caution.

PHARMACOLOGICAL MECHANISMS AND RECEPTOR BINDING

Kratom's effects are primarily mediated by its interaction with the body's endogenous opioid system. It binds preferentially to mu-opioid receptors, similar to potent opioids like morphine and hydrocodone, though often with lower potency. This binding indirectly activates brain reward pathways involving dopamine and serotonin. Despite some misconceptions, its action on mu-opioid receptors is the primary driver of its opioid-like effects, including pain relief and potential euphoria, making it functionally akin to other opioids.

REGULATORY ISSUES AND DOSAGE UNCERTAINTIES

A significant concern surrounding kratom is the lack of stringent regulation in the supplement market. Products can vary widely in their alkaloid content, meaning one gram of kratom from one brand may have a vastly different effect than the same amount from another. This inconsistency makes dosage management difficult and increases the risk of unpredictable effects and higher-than-intended opioid receptor activation. The over-the-counter availability further complicates safe usage.

RISKS OF COMBINATION AND RESPIRATORY EFFECTS

While kratom is not typically known to suppress respiration at low to moderate doses, this risk increases significantly when combined with other opioids, alcohol, or other central nervous system depressants. Although deaths directly attributed to kratom are rare, suppressed respiration during sleep is a known mechanism for opioid-related fatalities. The potential for respiratory failure, particularly at higher or combined dosages, highlights that kratom is not a benign substance and warrants careful consideration of its risks.

AVOIDANCE AND PROFESSIONAL CONSULTATION

The most prudent advice regarding kratom is to avoid it entirely if you have never used it before. The principle that one cannot become addicted to a substance never consumed is paramount. For individuals struggling with addiction to more potent opioids, consulting a physician is essential. While some have used kratom as a transitional tool, the ultimate goal must be complete cessation from all opioids, including kratom, to avoid falling into a different cycle of dependence.

Mentioned in This Episode

●Organizations

●Concepts

●People Referenced

Common Questions

At low doses, kratom has a mild stimulant effect. At higher doses, it acts as a painkiller and sedative, similar to other opioids. Long-term use can lead to habit formation and addiction, with withdrawal symptoms similar to other opioids. It can indirectly activate dopamine and serotonin pathways, contributing to its addictive potential.

Topics

Health & Longevity Neuroscience & the Brain Pain Management Substance Abuse Medicine & Clinical Opioid Addiction Drug Pharmacology Addiction Mechanisms Supplement Risks Mental Health Research

Mentioned in this video

People

Andrew Huberman

Host of the Huberman Lab podcast, professor of neurobiology and ophthalmology at Stanford School of Medicine.

Jack Feldman

A professor at UCLA and pioneer in the neuroscience of respiration, who discussed why people die when taking opioids.

Robert Malenka

An M.D. and Ph.D. and colleague at Stanford School of Medicine, who is an expert on addiction mechanisms, dopamine, and drug reinforcement.

Concepts

Opioid crisis

A term referring to the overconsumption and widespread addiction to opioids, primarily in the United States.

Drugs & Medications

Oxycodone

A potent opioid drug often sold under the brand name OxyContin, used for pain relief and known for its addictive properties.

Vicodin

A prescription opioid painkiller that the speaker personally dislikes due to side effects.

Supplements

THC

Tetrahydrocannabinol, the primary psychoactive compound in cannabis, which the speaker warns young males prone to psychosis should avoid.

Kratom

A substance from the Mitragyna speciosa tree, acting as a mild stimulant at low doses and analgesic/sedative at higher doses. It is an opioid.

Morphine

A potent opioid drug used as a painkiller and sedative, with high addiction potential.

Organizations

Tiny Foundation

A foundation that has offered to match dollar-for-dollar all funds raised for research through the Huberman Lab Premium channel.

Stanford School of Medicine

The institution where Andrew Huberman is a professor.

Products

OxyContin

A brand name for oxycodone, a potent opioid painkiller associated with the opioid crisis.

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