Kratom (Mitragyna speciosa), a Southeast Asian plant with stimulant and opioid-like effects, is often used for pain relief, mood enhancement, and managing opioid withdrawal. [1][2] However, its safety remains unclear, particularly when mixed with substances like alcohol. Combining kratom and alcohol can amplify their effects, potentially leading to severe and life-threatening side effects. Understanding these risks is crucial for anyone considering this combination.
- Combining kratom and alcohol is not safe, as it increases the risk of severe side effects like respiratory depression, sedation, and overdose.
- The combination of kratom and alcohol amplifies their depressant effects, leading to impaired coordination, increased drowsiness, and potential organ damage.
- To minimize harm, avoid mixing kratom and alcohol; if using either, start with small doses, stay hydrated, and avoid activities requiring focus, such as driving.
What is kratom, and why do people use it?
Kratom leaves contain the active ingredients mitragynine and 7-hydroxy mitragynine, which affects the body's central nervous system (CNS), producing effects that vary by dose. [3][4]][5]
At low doses, it boosts energy and focus, while higher doses provide sedation and pain relief. People commonly use kratom for pain management, mood enhancement, increased energy, and alleviating opioid withdrawal symptoms. However, these uses are largely anecdotal, with limited scientific evidence supporting its safety or effectiveness. [3]
While kratom is also federally legal in the U.S., state and local laws vary. Some states, like Alabama, Wisconsin, and Vermont, have banned it, while others allow or regulate its use. Check local regulations before use.
What happens when you mix kratom with alcohol?
Mixing kratom with alcohol is unsafe, as both impact the central nervous system (CNS) differently. Alcohol is a CNS depressant, while kratom acts as a stimulant at low doses and a depressant at higher doses. [6][7] When combined, kratom and alcohol can have synergistic effects, which means that the depressant effect of each substance is amplified, increasing risks of extreme sedation, suppressed breathing, and accidents. [6][7][9][10]
Alcohol enhances the action of gamma-aminobutyric acid (GABA), a neurotransmitter responsible for inhibitory actions in the brain, slowing down brain function. This affects motor skills, coordination, and judgment.[8] These depressant effects contribute to the sedative and disinhibiting qualities of alcohol.
Kratom’s effects on the CNS are more complex due to its biphasic action, where it acts as a stimulant at lower doses and an opioid-like depressant at higher doses.[2][9] At high doses, kratom’s depressant qualities can enhance the sedative effects of alcohol, leading to compounded CNS depression.
Potential health risks of mixing kratom and alcohol
Combining alcohol and kratom involves many health risks, ranging from mild to severe.
Mild to moderate effects: [6][7][8][9][10]
- Nausea
- Vomiting
- Dizziness
- Drowsiness
- Fast heart rate
- High blood pressure
- Confusion
- Loss of muscle control or coordination
- Tremors
- Altered perception (hallucinations)
- Irritability
Severe and long-term health risks: [2][4][8][11][12]
- Liver toxicity (both substances are metabolized in the liver, increasing strain and potential damage)
- Cognitive impairment over time
- Organ damage like kidney and liver failure
- Acute accident risk due to impaired judgment and coordination.
- Dependence and potential for addiction, given the abuse potential of both substances
- Risk of overdose, particularly as users may underestimate the compounding effects
- Mental health problems, like suicidal ideations, emotional instability, and unpredictable mood swings
Can you overdose from mixing kratom and alcohol?
While fatal overdoses from kratom alone are relatively uncommon, the combination of kratom and alcohol significantly heightens the risk of overdose. This is due primarily to the compounded depressant effects on the CNS, which can lead to life-threatening consequences: [6][8][10][11]
- Respiratory depression: Slowed or shallow breathing that may lead to respiratory arrest.
- Cardiac arrest: Irregular heartbeat that may cause the heart to stop beating.
- Coma: Loss of consciousness and unresponsiveness.
Signs and symptoms of an overdose from mixing kratom and alcohol: [2][6][8][9][10][11][12]
- Rhabdomyolysis or muscle breakdown
- Hallucinations
- Irregular heart rate
- Slow, shallow breathing
- Nausea and vomiting
- Confusion and agitation
- Clammy skin
- Loss of consciousness
- Seizures
The signs and symptoms presented here are biologically plausible and are reported in case studies. However, more controlled studies are needed to confirm the full range and prevalence of symptoms specific to this combination, especially regarding overdose.
If you suspect someone is overdosing on kratom and alcohol, seek immediate medical attention or call 911 immediately.
Kratom and alcohol for pain relief: A dangerous combination
People use kratom for pain relief due to its opioid-like effects; however, combining it with alcohol increases the potential for adverse health risks. Alcohol and kratom (at high dosages) have sedative properties and depress the CNS, which may cause temporary pain relief.
Using alcohol with kratom can lead to acute intoxication and mask pain in a way that dulls the body’s natural response to injury or illness, usually expressed as discomfort or pain. This may delay seeking medical attention. The risk of developing tolerance and dependence on both substances is imminent with combined use, making it harder to manage pain in the long term.
Even if a person wants to enhance the analgesic properties of kratom by using alcohol with it, there is no supported evidence that this works to manage pain. The risk of adverse effects far outweighs any potential long-term analgesic benefits.
One should not mix alcohol with kratom if you are experiencing pain. There are no benefits to this combination. Rather, seek advice from a health professional if your pain is not appropriately managed.
Safe practices and harm reduction
Mixing kratom and alcohol may lead to adverse effects. This necessitates safe practices to minimize potential harm. Understanding harm reduction techniques can help reduce adverse effects for those who choose to mix the two substances.
- Start small and keep it small
- Avoid doubling up on doses
- Use a sober buddy to help you stay safe
- Avoid driving or operating machinery
- Drink lots of water
- Eat beforehand
- Space out your doses
- Avoid adding substances
- Know the signs of overdose
Treatment options for kratom and alcohol abuse
For a person who is struggling with kratom and alcohol abuse, professional help is essential, as these substances carry unique risks when used together in harmful ways. Treatment involves medical intervention (medically supervised inpatient detoxification), therapy, and peer support tailored to treat polysubstance use.
Since kratom-specific research is limited, treatment approaches are adapted from other substance use disorders, emphasizing the need for a personalized treatment plan from an addiction-specialized healthcare professional.
