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InvisibleAll41
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Dried kratom dangers
    #27166776 - 01/24/21 07:26 AM (3 years, 2 months ago)

https://theconversation.com/amp/kratom-what-science-is-discovering-about-the-risks-and-benefits-of-a-controversial-herb-152677

Kratom: What science is discovering about the risks and benefits of a controversial herbChristopher R. McCurdy, University of FloridaJanuary 22, 2021 8.29am EST

Kratom, a traditional Southeast Asian herbal medicine from the leaves of the tropical tree Mitragyna speciosa, has gained favor in the U.S. as a legal high over the past decade. Almost two metric tons of kratom are imported from Southeast Asia monthly. A typical dose of kratom consists of three to five grams, suggesting over 15 million users in the U.S.

In Southeast Asia, people have safely consumed kratom by chewing the leaves or brewing them into tea for centuries. But in the U.S., where it is widely available, the herb has been linked to many poison control center calls and even deaths. As a pharmacist and professor of medicinal chemistry, I wanted to study why.

Our team has been researching kratom for over a decade to determine the scientific validity of beneficial and harmful claims that have been made. Why would there be a history of safe kratom use in Southeast Asia while there are documented reports of harm in the U.S.?

Our recent studies suggest a difference in kratom products available in the U.S. and traditional preparations that may contribute to these risks. Traditionally prepared kratom is from freshly harvested leaves, whereas kratom in the U.S. is from dried leaf material, which changes in chemical composition as it dries and ages.

The two faces of kratom

In Thailand and Malaysia, people for centuries have enjoyed kratom as a “tea” to treat a variety of conditions or to increase stamina for outdoor laborers. It is difficult to determine exactly when kratom first appeared in the U.S., but, because of the traditional reports of kratom being an opium substitute, interest grew. There seemed to be no thought that kratom in the U.S. could be different from kratom in Southeast Asia.

However, kratom gained federal attention in the early 2000s when the U.S. Drug Enforcement Administration listed the plant as a drug of concern.

Because of increasing concerns for public health and safety in 2016, the DEA planned to place the plant and specifically two alkaloids from the plant – mitragynine and 7-hydroxymitragynine – into Schedule 1 of the Controlled Substances Act. This action would make kratom and these two alkaloids (if purified from the plant) illegal, with no legitimate medical use.

Just six weeks later, the DEA made an unprecedented announcement that it was withdrawing its notice of intent. This was due to thousands of public comments, mostly from individuals, urging the DEA to reconsider. Importantly, the DEA said that it would also consider conducting a scientific and medical evaluation of kratom.

So what has science taught us since this pause?

One thing that’s clear is that there is a difference in the chemical composition of traditionally prepared kratom and the dried leaf or extract products sold commercially. According to our recent analyses, the traditionally prepared tea does not contain detectable levels of 7-hydroxymitragyine, the alkaloid the DEA cited (along with the major compound, mitragynine) in its decision to list kratom under Schedule 1.

Leaves from the kratom tree are dried and then ground into a powderlike substance. Many people add hot water to this and drink a kratom tea. Louis Anderson/AFP via Getty ImagesTraditional use of kratom in Malaysia

In July of 2019 I visited a kratom plantation in Malaysia and gained firsthand experience in the traditional preparation. Fresh leaves are picked each day and, within minutes, placed in boiling water for a couple of hours. The resultant “tea” is ladled out and generally placed into plastic bottles or bags for use throughout the day. Most traditional users prepare three glasses spaced out during the day by diluting each glass with an equal amount of water.

Kratom is also a recreational drink there, much like coffee or tea. People also have used it traditionally to avoid withdrawal symptoms when opium users would exhaust their supply. This also fueled use in the U.S., with individuals seeking alternative methods to treat pain or wean themselves from opioids. The real question we had to ask as researchers was whether it was just a replacement or a legitimate treatment.

In the U.S., kratom is sold in capsule, powder and liquid form. Joe Raedle/Getty ImagesKratom in the U.S. has varying amounts of opioid activity

According to scientific reports of analyses of commercial kratom products available in the U.S., the amount of 7-hydroxymitragynine can vary drastically in those products. Because freshly harvested kratom leaves had no detectable amounts of 7-hydroxymitragynine, we wondered why.

There is evidence that the plant does not produce 7-hydroxymitragynine but, rather, that the alkaloid is generated after leaves are harvested and dried. According to the previous scientific literature, 7-hydroxymitragynine has been reported to be present in up to 2% of the total alkaloid content of the dried plant material.

All commercial kratom products in the U.S. are made from dried leaf material or are concentrated extracts of the dried leaf material. Scientifically, purified 7-hydroxymitragyine is an opioid with demonstrated abuse potential. It is also known that mitragyine (the major alkaloid) is converted to 7-hydroxymitragyine by the intestine and liver.

In contrast, purified mitragynine has demonstrated little to no abuse potential, and is able to reduce or block rodents from self-administering heroin or morphine. In other words, mitragynine seems to be reducing the desire to ingest addictive opioids.

So the key question is, how much 7-hydroxymitragyine is too much in a kratom product? This remains unanswered, but the wide variation of 7-hydroxymitragynine content may explain why there is more harm seen in the U.S. from kratom. As the dietary supplement market is poorly regulated in the U.S., it is truly a “buyer beware” situation.

[Get our best science, health and technology stories. Sign up for The Conversation’s science newsletter.]

The most recent findings

My research team has examined the facts, and this is what we have found in our most recent study: Kratom tea does have potential to serve as a treatment for opioid withdrawal and possibly to help wean addicts. However, controlled clinical studies in humans are still absent and are needed to make evaluations of safety and therapeutic efficacy.

The unreliable measurements of kratom products sold in the U.S. create uncertainty. Until there is a standardized product, preferably one that is prepared in the traditional way, our society must weigh the risks against the putative benefits. The risk of kratom addiction appears to be low, but there are people who are are treated for kratom addiction. It is our hypothesis that addiction to kratom is due to the inferior quality and amount of the product ingested. Science is leading the way to these answers, and the fate of kratom is in the balance.

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Offlinemorrowasted
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Re: Dried kratom dangers [Re: All41]
    #27166847 - 01/24/21 08:08 AM (3 years, 2 months ago)

The risk of kratom addiction is not "low" in my opinion.

It can be a highly habit forming drug.

In any case, leave it alone

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Offlinegone-pear-shaped
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Re: Dried kratom dangers [Re: morrowasted]
    #27167003 - 01/24/21 10:28 AM (3 years, 2 months ago)

Quote:

morrowasted said:
The risk of kratom addiction is not "low" in my opinion.

It can be a highly habit forming drug.



But you don't have access to the traditional preparation (fresh leaves), do you? This article claims the western preparations (dried) are more dangerous since an addictive compound forms during drying or storage.

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InvisibleHolybullshit
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Re: Dried kratom dangers [Re: morrowasted] * 1
    #27167608 - 01/24/21 05:01 PM (3 years, 2 months ago)

From a hard reduction standpoint kratom abuse it much preferred to that of other opiates.

While developing a substantial dependence is possible, it's not exactly easy if you haven't been previously habituated to other opiates, or at least haven't developed some tolerance to them. And addiction potential is lower because it's not a particularly euphoric drug, relative to other drugs of abuse.

If you are opiate naive, you have to be almost determined to develop a dependence. And develop a dosing pattern that goes against everything everybody already knows about kratom.

You have to take fairly large doses, every day, possibly multiple times per day, for a significant amount of time. And even if a dependence develops, due to its ease of access and low cost its easy to taper off of and that dependence doesn't necessarily result in a significant impact to one's life.

And for a large portion of the population side effects(gastrointestinal), taste, and the inconvenience of taking large doses repeatedly prevents dosing at these levels.

And WD is generally much less intense, even if one develops a habit from daily use if their doses aren't stupid high the WD's are light.

People with jobs don't end up losing them because of kratom dependence, they don't end up unable to function due to a lack of access, and they don't need to resort to crime to feed their habit.

I mean, what are you comparing kratom to when you say its risk potential isn't "low"? That's an inherently relative value...compared to coffee? No I guess it's not. Compared to tobacco, cannabis, heroin, stimulants, ketamine, even sugar...that's a different story.

edit: I am talking strictly about ground leaf here, not extracts, some of which have been known to be adulterated with far more potent substances

I also question whether it's even true that 7-hydroxymitragynine is strictly a product of drying and storage. I'd like to see confirmation of that. And as I understand it even tea in the producing regions is prepared with, at least partially, dried leaves, if not ground and stored.

Edited by Holybullshit (01/24/21 05:16 PM)

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Offlinemorrowasted
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Re: Dried kratom dangers [Re: Holybullshit] * 1
    #27167640 - 01/24/21 05:18 PM (3 years, 2 months ago)

I hear you but there is a massive online community of people of which I am apart who use(d) kratom in exactly the way you described.


When I got hooked on kratom I had tried opioids before, but only a few handfuls of times over the course of kany many years. I just tried it, the shit got me high as a kite in the beginning at a dose of about 7 grams. And like a dumbass, I would just use it all the time. And frankly it kept getting me high as a kite for quite a while.


After about 2.5 years I had to take 40gpd just to avoid being sick. When I tried to quit I would have horrible panic attacks and RLS and other opioid WD symptoms. The only time i would ever feel high was after waking up sick and taking my first dose of the day, and then only for like an hour. By the end of the day i would feel like shit despite having continually dosed.

There are many many other people I have met online who fall into this pattern. Not trying to demonize kratom, just being realistic.

It took me over half a year of trying to quit before I could finally pull it off. I felt normal again about 15 days after quitting

In those large doses it alao made my hair brittle, skin gross looking, and destroyed my libido.

But sure kratom dependence is probably a lot better than heroin or oxy dependence if for no other reason than it is nearly impossible to OD on

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OfflineHappyHigh
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Re: Dried kratom dangers [Re: morrowasted]
    #27167723 - 01/24/21 06:03 PM (3 years, 2 months ago)

would be nice to know if there is a easy conversion back to the first substance.


--------------------
Had I the heavens' embroidered cloths,
Enwrought with golden and silver light,
The blue and the dim and the dark cloths
Of night and light and the half light,
I would spread the cloths under your feet:
But I, being poor, have only my dreams;
I have spread my dreams under your feet;
Tread softly because you tread on my dreams.

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OfflineFailboat
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Re: Dried kratom dangers [Re: HappyHigh]
    #27168291 - 01/25/21 12:28 AM (3 years, 2 months ago)

Grow your own, free your mind?

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InvisibleHolybullshit
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Re: Dried kratom dangers [Re: morrowasted]
    #27168533 - 01/25/21 06:49 AM (3 years, 2 months ago)

Yes, but as you said..."like a dumbass". And you probably kept taking it everyday, multiple times per day, at ever increasing doses even after your tolerance made it where you weren't getting much out of it anymore...but there would have still been a sizable window where you could have quit at that point without being more than uncomfortable for half a week. But you kept taking it, nearly everyday, despite that.

Even among people who take kratom chronically for a substantial amount of time, they usually work in tolerance breaks here and there to stave off full blown dependence.

I know kratom isn't a miracle drug, it isn't harmless, and people should be properly educated about its risk. But compared to other drugs of abuse and psychoactive substances I would still rate its addiction potential as "low" to possibly "moderately low" if only for the fact that its an opioid.

Quote:

I hear you but there is a massive online community of people of which I am apart who use(d) kratom in exactly the way you described.




Yes, but just because most kratom addicts/dependants/chronic users find their way to these communities...doesn't mean most users of kratom become addicted.

That doesn't mean no one will get addicted to it, nor that that addiction can't develop into a dependence. But those most at risk of this are people prone to addiction and poly substance abuse. The vast majority of people who try kratom, even the vast majority of them that use it repeatedly, will not develop a dependence, and if an addiction begins to develop it will fizzle out as their tolerance increases.

And I would be willing to bet that many, if not most, of them are college aged, possibly ignorant to the potential for dependence, with a still developing prefrontal cortex that is unable to properly weigh risk vs reward and is wired for impulsivity and sensation seeking.

To put it shortly, much of the risk for kratom addiction lies in the user, and is not innate to kratom itself.

Edited by Holybullshit (01/25/21 07:22 AM)

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Offlinegone-pear-shaped
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Re: Dried kratom dangers [Re: Holybullshit]
    #27168878 - 01/25/21 11:06 AM (3 years, 2 months ago)

Quote:

Holybullshit said:
That doesn't mean no one will get addicted to it, nor that that addiction can't develop into a dependence. But those most at risk of this are people prone to addiction and poly substance abuse. The vast majority of people who try kratom, even the vast majority of them that use it repeatedly, will not develop a dependence...



This argument has always bothered me. If it's only dangerous to some segment of the population, does that actually make any difference? How do you know whether you are in that segment? How do you know whether your mom is in that segment?

You're probably not wrong about kratom, but our moral calculus can't just be "don't be the type of person that gets addicted", since people don't actually have control over that. (I.e., being bored and unhappy all the time isn't something people choose.)

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Invisibledurian_2008
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Re: Dried kratom dangers [Re: gone-pear-shaped]
    #27169054 - 01/25/21 12:40 PM (3 years, 2 months ago)

Have you ever had to lock up your prescriptions, from that special kind of party person? Do they ask you to take care of their own medicine? A legal opiate, condensed into a tarry resin or freebase is definitely going to be a hard drug, addictive, and subject to abuse. :awesomenod:

Now, that I have covered a permanent law of nature, here is some reverse psychology...

Kratom doesn't have the same street cred as research chemicals and doctor's prescriptions, to be deadly serious.

Right now, you do have access to fresh, dried, or however, because no drug warriors have popularized it.

But, every time there is serious talk of it becoming illegal, people in these forums make bulk purchases. Vendors can't keep up with demand. So, it becomes rare for several weeks. 

Then, when the danger passes, free samples of swag are put in every plant trade, because it becomes worthless, again.

:shrug:

For this safe, relatively-benign flower to become as "popular" as possible with all the masochists, you would have to make it into some version of meth or krokodil.

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OfflineFailboat
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Re: Dried kratom dangers [Re: durian_2008]
    #27169153 - 01/25/21 01:26 PM (3 years, 2 months ago)

Quote:

durian_2008 said:
For this safe, relatively-benign flower to become as "popular" as possible with all the masochists, you would have to make it into some version of meth or krokodil.



Challenge Accepted... :lol:

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Invisibledurian_2008
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Re: Dried kratom dangers [Re: Failboat]
    #27169189 - 01/25/21 01:49 PM (3 years, 2 months ago)

Tell them it's tainted with something, like elephant tranquilizer, and there will be plenty of willing participants for makeworkers/caseworkers, bail/extortion, catch-and-release.

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OfflineYokal
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Re: Dried kratom dangers [Re: durian_2008]
    #27171219 - 01/26/21 03:38 PM (3 years, 1 month ago)

Keaton is fine

The real danger is if dried powder gets in your lung

Easier to drink a beer than get high off Kratom

It's a very gentle nod, you'd throw up before getting anywhere close to messed up. You be inebriated of two beers compared to kratom.

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InvisibleHolybullshit
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Re: Dried kratom dangers [Re: gone-pear-shaped]
    #27172501 - 01/27/21 09:07 AM (3 years, 1 month ago)

Quote:

gone-pear-shaped said:
Quote:

Holybullshit said:
That doesn't mean no one will get addicted to it, nor that that addiction can't develop into a dependence. But those most at risk of this are people prone to addiction and poly substance abuse. The vast majority of people who try kratom, even the vast majority of them that use it repeatedly, will not develop a dependence...



This argument has always bothered me. If it's only dangerous to some segment of the population, does that actually make any difference? How do you know whether you are in that segment? How do you know whether your mom is in that segment?

You're probably not wrong about kratom, but our moral calculus can't just be "don't be the type of person that gets addicted", since people don't actually have control over that. (I.e., being bored and unhappy all the time isn't something people choose.)




Self-awareness mostly. If you find yourself taking kratom daily, you have many, many months to even years before you develop a substantial dependence(unless you go straight to max dosing 3x daily, non-stop, from day one). Once daily use, even if its 7x a week, won't get that out of hand, it's when you find yourself dosing multiple times per day, at ever increasing amounts, that you get yourself in trouble...there are generally multiple red flags arising from one consumption habits before WD's become so bad that it becomes a logistical challenge to quit cold turkey.

It's the stigma of addiction that prevents these people from acknowledging what's happening and getting help, not a desire to keep taking kratom because at that point there is no high. Many people who begin 24/7 dosing are self-medicating, it's likely either the stigma of mental illness or a lack of access to high quality medical care which drove them to that, not kratom's effects.

They aren't trying to stay high on kratom 24/7, they are just trying to avoid being sober. Better kratom than almost any other drug of abuse.

Kratom doesn't cause compulsive re-dosing in and of itself, and developing a dependence takes some time and effort. But I am not saying that there aren't people who won't put in that time and effort.

THOUGH, more to the point, I think you are misunderstanding the argument. It's not that I or anyone is necessarily saying that it's always easy for people who are prone to addiction, self-medicating, poly-substance abusers, etc. etc. to prevent themselves developing a kratom addiction and then dependence...it's that this portion of the population is small enough that protecting them doesn't constitute a compelling reason for restricting the liberty of everyone else.

Believe me, as someone who fits into all the at risk categories named above, has suffered from mental health issues and substance abuse since adolescence, with a long history of poly substance addiction and opioid dependence...I get it. Sometimes no amount of information, good advice, support, ANYTHING is going to stop everyone, or should I say every individual, from becoming addicted/dependent.

But, if that subset is of such a minority, and(especially) if that addiction/dependence does not come with either significant social harms, or even much harm to the individual, then it's hard to rationalize and defend the loss of freedom to others that comes with any effort to protect them.

And that's without even getting into whether banning kratom would have a positive net effect on said population group.

Edited by Holybullshit (01/27/21 09:24 AM)

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OfflineThe Mycologist
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Re: Dried kratom dangers [Re: All41]
    #27172508 - 01/27/21 09:09 AM (3 years, 1 month ago)

I tried kratom once and the next day I was sooo sick.

IDk if my batch had heavy metals in it, but Im scared of the stuff now.


--------------------
"That you are here—that life exists, and identity;
That the powerful play goes on, and you will contribute a verse.”
― Walt Whitman, Leaves of Grass
:acidfire::tmckenna:

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InvisibleHolybullshit
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Re: Dried kratom dangers [Re: The Mycologist]
    #27172515 - 01/27/21 09:12 AM (3 years, 1 month ago)

Was it an extract or just leaf? How much did you take and where did you get it?

That's not that odd of an outcome, even with quality leaf, especially if you dosed relatively high and don't have much of an opioid tolerance.

Kratom can wreak havoc on many people's gastrointestinal tract...it's kind of a harm reduction "feature", it prevents many people from taking too much, or too often.

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OfflineThe Mycologist
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Re: Dried kratom dangers [Re: Holybullshit]
    #27172894 - 01/27/21 12:46 PM (3 years, 1 month ago)

Yeah i took like 3.5gs i think of leaf.

Yeah felt fine that night, but next morning I was throwing up and sweating like crazy.

And I never messed with opiates so maybe thats it


--------------------
"That you are here—that life exists, and identity;
That the powerful play goes on, and you will contribute a verse.”
― Walt Whitman, Leaves of Grass
:acidfire::tmckenna:

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Invisibledurian_2008
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Re: Dried kratom dangers [Re: gone-pear-shaped]
    #27173605 - 01/27/21 08:57 PM (3 years, 1 month ago)

Quote:

gone-pear-shaped said:
This argument has always bothered me. If it's only dangerous to some segment of the population, does that actually make any difference? How do you know whether you are in that segment? How do you know whether your mom is in that segment?




At the end of every month, when the prescription inevitably runs low, I call it 'pill pms'. If your loved one is covering up withdrawals from something else, I'm gonna say (s)he's certainly in that segment.

I have relatives from drinking cultures, where drunkenness is perfectly-acceptable. I have never seen it get irresponsible, with people, who can consciously, unashamedly retrace their steps, when asked. People who vehemently deny it and hide it all over the place would usually have an issue, imo.

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InvisibleHolybullshit
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Re: Dried kratom dangers [Re: The Mycologist] * 1
    #27174151 - 01/28/21 07:36 AM (3 years, 1 month ago)

I think probably your plasma levels peaked as you were sleeping, and sleep itself has a way of making us more sensitive to peripheral side effects(to all drugs).

3.5g is definitely a large enough dose for the opioid action to cause nausea in many opioid naive individuals...and the sweating, and probably feelings of over-stimulation, are due to it also being an alpha receptor agonist(adrenaline).

It's alpha agonism is another one of the innate traits I've alluded to which limit its abusability.

The level of alpha agonism is hypothesized to be somewhat, if not largely, responsible for the difference in effects between different strains/varieties...with green being the highest, lending more "push" and "energy", red being the lowest and most opioid like, and white being somewhere in between. Of course it remains a hypothesis, and there are different "strains" and regions at play on top of vein color.

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OfflinePs.NoName
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Re: Dried kratom dangers [Re: Holybullshit]
    #27174394 - 01/28/21 11:03 AM (3 years, 1 month ago)

3.5g is a large dose for the first time.  Kratom has a self limiting factor to it.  If you take too much it make you feel bad and you barf.

It is all about harm reduction for me.  I was ruining my life with alcohol before I found Kratom.  I am now like 3-4 years booze free and just kratom in the evening.  Kratom subdued the urge to drink and once I started to drink I would end up shitfaced every time.

It seems to me people that get themselves in trouble with Kratom either had a previous opiate addiction they never dealt with and/or they are impulsive irresponsible and dose every day all day in huge amounts.  "I was eating 5 table spoons spaced out over the day and now I don't know why I can't stop taking it".


--------------------
Set me off, see what I'm worth. Turn me on, I go berserk.


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