Kratom and Percocet Interactions

Stimulant effects are generally reported to last between one and five hours and involve a dose-dependent increase in alertness, physical energy, talkativeness, and a greater sense of well-being. These effects are largely thought to be produced by mitragynine, the main active alkaloid in kratom. At lower doses, kratom produces opioid-like effects, mainly in the CNS; at higher doses, kratom produces both opioid and CNS depressant effects.

Dosing regimens and kratom withdrawal symptoms

Most respondents who reported lifetime kratom use endorsed the use of a typical dosing routine that consisted of taking a single dose of kratom at bedtime on a weekly basis. They most frequently consumed kratom capsules (n = 47), grams (n = 37), spoonfuls of kratom (n = 25), tablespoons of kratom (n = 11), or cups of kratom tea (n = 8). On days that respondents took kratom, they consumed 2.6 +- 2.4 doses per day and this dosing schedule had been stable for 65.0 +- 112.9 weeks.

Adverse effects and kratom withdrawal during use were self-reported by respondents as being mild to moderate, and often moderate to severe among a small subset of users. Upon cessation, many respondents reported experiencing withdrawal symptoms such as insomnia, anxiety, restlessness, nausea, and vomiting. In contrast, when kratom use was stopped for at least a day, cessation symptoms such as nausea and dizziness were more common, but these symptoms were typically less severe than those reported during daily use.

Kratom withdrawal and opioid overdose deaths

In US overdose death data from July 2016 to December 2017, 152 of 27,338 fatalities were determined to be kratom-involved by medical examiners or coroners, and seven of these kratom-positive decedents were identified as using only kratom to cause their overdose. This number is likely low but is representative of the broader kratom-involved population.

The majority of kratom-involved overdose deaths occurred in states with higher than average rates of percocet overdoses and/or heroin overdoses; most of these overdoses involved multiple types of drugs. Nevertheless, it is important to note that the presence of a substance such as kratom on postmortem toxicology testing does not necessarily indicate a causal relationship between a drug and overdose deaths, particularly if the underlying causes are unknown or are complex.

Nonetheless, these findings provide an indication of a possible link between kratom and overdose deaths that is worthy of further investigation. Further studies are needed to determine if kratom can be safely used as an alternative to opioids and to better understand how kratom use impacts overdose and withdrawal symptoms in the US population.