Kratom and Kava: A Look at the Science
As kratom and kava gain in popularity and go mainstream, the science is finally starting to catch up. Below you’ll find several studies backing the benefits of both botanicals.
Study: Kratom for Morphine Withdrawal
In a recent mouse study, researchers evaluated any signs of physical dependence or hyperalgesia (a condition of enhanced sensitivity to pain) on mice given a kratom alkaloid extract and the alkaloids mitragynine (MG) and mitragynine pseudoindoxyl (MP). They also looked at how these compounds might help with morphine withdrawal.
They found that mice given kratom had significantly fewer signs of precipitated withdrawal than control mice that continued to receive morphine.
“Users claim the Thai traditional tea ‘kratom’ and component alkaloid mitragynine ameliorate opioid withdrawal without increased sensitivity to pain,” write the authors.
“Testing these claims, we assessed the combined kratom alkaloid extract (KAE) and two individual alkaloids, mitragynine (MG) and the analog mitragynine pseudoindoxyl (MP), evaluating their ability to produce physical dependence and induce hyperalgesia after chronic administration, and as treatments for withdrawal in morphine-dependent subjects.”
Mice were given repeated saline, or graded, escalating doses of morphine, kratom alkaloid extract, mitragynine, or MP for 5 days.
They found that the mice treated chronically with morphine, KAE, or mitragynine showed significant drug-induced hyperalgesia by day 5 in a 48 °C (118.4 °F) warm-water tail-withdrawal test. Mice were then given naloxone (opioid antagonist) and tested for opioid withdrawal signs.
The mice who had been given kratom alkaloid extract as well as the two individual alkaloids demonstrated significantly fewer naloxone-precipitated withdrawal signs than morphine-treated mice.
Other mice who had been made physically dependent on morphine were then used to test the therapeutic potential of combined KAE, mitragynine, or MP given twice daily over the next 3 days at either a fixed dose or in graded, tapering descending doses.
“When administered naloxone, mice treated with KAE, mitragynine, or MP under either regimen demonstrated significantly fewer signs of precipitated withdrawal than control mice that continued to receive morphine,” write the authors.
“In conclusion, while retaining some liabilities, kratom, mitragynine, and mitragynine pseudoindoxyl produced significantly less physical dependence and ameliorated precipitated withdrawal in morphine-dependent animals, suggesting some clinical value.”
Johns Hopkins Kratom Survey
In 2020, Johns Hopkins Medicine researchers released the findings of an anonymous online survey of more than 2,700 self-reported kratom consumers. The study “Kratom (Mitragyna Speciosa): User demographics, use patterns, and implications for the opioid epidemic” is published in the journal Drug and Alcohol Dependence.
Overall, the researchers say the survey suggests that kratom should be studied and regulated rather than banned. It also shows that the active compound in kratom has a lower rate of harm than prescription opioids in the treatment of pain, anxiety, depression and addiction.
Albert Garcia-Romeu, Ph.D., instructor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, says the new survey findings “suggest that kratom doesn’t belong in the category of a Schedule I drug, because there seems to be relatively low rate of abuse potential, and there may be medical applications to explore, including as a possible treatment for pain and opioid use disorder.”
“There has been a bit of fearmongering,” he adds, “because kratom is opioidlike, and because of the toll of our current opioid epidemic.”
About a third of the participants reported having mild unpleasant side effects from kratom, such as constipation, upset stomach or lethargy, which mostly resolved within a day.
Only 1.9% reported that side effects were severe enough for them to seek medical treatment. These effects included feeling withdrawal symptoms such as anxiety, irritability, depression or insomnia when the kratom wore off.
When asked how troubled they felt regarding their kratom use, the mean rating was 3.2 on a scale from 0 to 100.
The research team states that kratom is neither regulated nor approved by the FDA and that scientific studies have not been conducted to officially establish safety and benefits. In addition, they say that U.S. drug agencies should seek to research and regulate rather than ban kratom sales as it appears to have safe therapeutic potential and may potentially be used as an alternative to opioid abuse.
Study: Kava for Insomnia
Kava may help with insomnia, often with fewer side effects than pharmaceutical drugs or over-the-counter sleep enhancers. It is believed that a specific type of kavalactone, called kevain, may be behind kava’s sedative effect.
In a pilot study of 24 patients struggling with stress-induced insomnia , researchers looked at the effectiveness of kava and valerian separately. Stress was measured in three areas: social, personal and life events. Insomnia was measured in three areas also: time to fall asleep, hours slept and waking mood.
According to the findings, total stress severity was significantly relieved by both compounds individually, with no significant differences between them. There was also improvement with the combination, significantly in the case of insomnia.
“These results are considered to be extremely promising but further studies may be required to determine the relative roles of the two compounds for such indications,” write the authors.
Study: Kava for Anxiety
Many people report that kava helps with anxiety. Research is also promising. In a double-blind, randomized, placebo-controlled study, researchers looked at the effectiveness of kava on patients with generalized anxiety disorder (GAD). A total of 75 participants were enrolled in a 6-week trial of a kava extract versus placebo. The findings revealed a significant reduction in anxiety for the kava group compared with the placebo group.
According to a 2002 review of seven clinical trials and 645 people, a kava extract was found to be an “effective symptomatic treatment option for anxiety.” Safety and tolerability were also good, with no drug-related adverse events, according to the authors.
The fact that kava helps with anxiety is welcome news for many people searching for a natural alternative to pharmaceutical anxiety medications, which can be wrought with side effects. While everyone experiences stress and anxiety to an extent, millions of Americans struggle with clinical levels of anxiety. Anxiety disorders are the most common mental illness in the U.S., impacting 40 million adults age 18 and older, or 18.1% of the population each year, according to the Anxiety and Depression Association of America (ADAA).