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Updated: Mar 27, 2019

#hamiltonspharmacopeia #kratom #recovery #makingthejump #opiates #suboxonewithdrawal #harmreduction

I recently watched an episode of Hamilton's Pharmacopeia about kratom. I was interested in seeing what Hamilton had to say about this plant. It was very informative, but after the first time watching it, I was left wanting to look at other sources. A few years ago I learned about kratom from a friend of mine that suffers from chronic pain. It appeared to be magic, relieving her from pain, and it wasn’t an opiate. She offered me a dose of it, which tasted like shit, and I remember it being quite stimulating. After this, I started noticing kratom everywhere. It’s like when you buy a particular type of car and all of the sudden you realize just how many of your new car are on the street. After watching the episode a second time and looking into other sources on kratom, I felt Hamilton imparted upon us a good foundation regarding this controversial plant


Kratom comes from the leaves of the kratom tree, or mitragyna speciosa, which is in the same family as the coffee tree. The principal alkaloid in Kratom, mitragynine is a partial µ-opiate agonist and has a similar 3-dimensional structure to that of morphine, but it is not an opiate (it's a member of the coffee family). Mitragynine binds to the µ-opioid receptors but not all opiate receptors, making it less potent than morphine. Hamilton spoke with Thai scientists that were studying the pharmacological effects of kratom and even filmed one of their experiments on mice for the show. They noticed that the morphine changed the electrical activity in the nucleus accumbens, the reward circuit part of the brain, while the kratom did not. This means that kratom might not be as addicting or as easy to become addicted to as morphine. This does not mean that kratom gets a pass. Just search YouTube for “kratom withdrawal,” and you will see plenty of evidence, albeit anecdotal, that kratom is indeed addicting physically and psychologically.


The history of kratom in Thailand is fascinating. It has been used in traditional medicine for a very long time, think millennia, to treat diabetes, diarrhea, fever, and pain. However, kratom fell into disfavor with the government in a politically tumultuous time in Thailand's history. Kratom was first made illegal in 1943 when the government relied heavily upon the opium trade for revenue. They levied steep taxes on opium that working-class users did not want to or could not afford to pay. These users switched to kratom, not only to ease withdrawals but also as a substitute for the opium. The government did not like being in competition with a tree that grew in the wild, thus it was made it illegal and the government started chopping down trees. In 1979 kratom became a category 5 narcotic, the most benign category—heroin and meth are category 1 narcotics in Thailand.

To understand kratom in modern Thailand, it is also essential to understand the politics in southern Thailand, where the last remaining Thai kratom forest lies, and most of the traditional kratom chewers live. Currently, in southern Thailand, there is an insurgency. This most recent uprising began around 2004, though the tension dates further back than the 1909 Anglo-Siamese treaty. The 1909 treaty is a catalyst for current tensions. Great Britain and Thailand drew the border between Thailand and Malaysia without consulting the Malays. This would leave most people feeling disenfranchised. The Thai government passed laws to assimilate the people of the Patani region, now southern Thailand, as well as other ethnically non-Thais, in an effort to "Thai-ify" them, denying them their claim to their ethnicity. Tension built and came to a violent head in the early 2000's leading to a declaration of martial law in 2004.

In 2013 the Thai Minister of Justice wanted to decriminalize kratom. However, there was not the support he was looking for; kratom remains illegal. Kratom is seen to be interwoven with the insurgency, an idea spread by the media and the government. This has given it a bad rep. Could it be that the insurgents are using the illegal kratom trade to fund their insurgency? If they were, would it not make sense to legalize it, taking away the power it has? Or, is it that the government is using kratom's illegal status as a means to search homes of suspected insurgents?

The violence that surrounds kratom because it is illegal is astounding. When Hamilton travels to the last wild kratom forest in Satun Province, Thailand, he is accompanied by armed park rangers who are heavily armed. The village chief, Chamroon Songduang said, “it’s not the kratom that is dangerous but the impact of prohibition.” He understands this personally as “kratom bandits” killed his son and severely injured his daughter five years prior to the making of the episode. Amidst all of the violence surrounding kratom, he is still not against it but is against those that abuse their power to benefit from the tree.

Sii Khun Roi

The other media sensation surrounding kratom is a drink called 4x100 (sii khun roi). 4x100 is a drink made from a strong infusion of kratom leaves, Coca-Cola, cough syrup, and ice. The media has sensationalized this drink saying that many mix it with things such as mosquito coils, ashes of dead people, phosphor from fluorescent lights, etc. These stories are not corroborated. There are some people that are adding benzodiazepines and other tranquilizers to the brew, but this does not appear to be the norm. When teens were asked about mixing random stuff into their 4x100, they usually laugh and deny it saying that as they want to catch a buzz, but do not want to get sick; however, would someone really admit to adding such oddities to their brew? In Hamilton's Pharmacopoeia, the person brewing the 4x100 said that they learned to make it from the news, go figure. They too denied adding anything other than the main ingredients into their brew.

The highest rate of drug addiction in Thailand, according to the Thai military, lies in the 3 southern provinces, Pattani, Narathiwat, and Yala. This is also the same area that is involved in the insurgency, the same area that was given to Thailand in the 1909 treaty, and the same area that is predominantly Muslim in a Buddhist country. The correlation between trauma and drug addiction in these southern provinces is an easy line to draw. Perhaps it is too easy to escape the violence, the sordid history of the land, and the denial of ones ethnicity with drugs like heroin, methamphetamine and 4x100.

4x100 seems pretty benign put next to methamphetamine and heroin. Though the media has run a smear campaign against kratom and 4x100, it is difficult to find unbiased information documenting the path of destruction that 4x100 has supposedly caused as it cannot be isolated from much more powerful drugs. Neither can unbiased information be found of people overdosing on 4x100. All of the cases of overdose on kratom involve multiple intoxicants such as methadone and tramadol.

Kratom in the US

Kratom's popularity has been steadily growing in the US. At the same time, the DEA is conducting research on whether or not to schedule kratom as a drug. In September 2016 they tried to classify kratom as a schedule 1 drug; however, due to protests, kratom' s destiny was changed, and it remains federally legal. Before buying kratom, make sure it is legal where you live at it is illegal in 6 states and 5 cities here in the US.

Harm Reduction

Kratom should not be tossed aside because of its sordid relationship to getting high and misinformation. It does have massive potential for use in harm reduction, not only in Thailand but also with the current opiate epidemic in the US. It has a been touted as "a miracle" for people getting off of opiates and meth. Though getting completely off of drugs is the best option, this ideal is often not realistic. Kratom can come in as a place holder of sorts, a harm reducer, as addicts get back on their feet and create a distance from heroin and methamphetamine.

Kratom and Suboxone Withdrawal

If you are getting off of Suboxone, I would tread lightly where kratom is concerned. Trying to detox from an opiate by taking something that fills your opiate receptors doesn't make sense, unless it is for harm reduction, which in this case, it probably isn't. Suboxone withdrawal can be a bitch, mainly due to the sheer length of it. When I was at a point where I was going crazy because of insomnia or anxiety and nervine herbs like valerian and passionflower weren't cutting it, I tried kratom. I then decided it wasn't worth it and decided to call my doc for some sleep meds instead of using it. A good nights sleep was life changing. Taking something like kratom during withdrawal is like picking at a scab. It will eventually heal, but it will take longer and won’t heal as well as it would have if you just left the damn thing alone. Ultimately it is up to you whether you decide to use kratom during withdrawal, but if you are thinking about it, check in with yourself and ask what your motives are.


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