#kratom

I'd really like your take considering how you're working in substance abuse etc rn. Do you think this is a real hazard or just blown out of proportion.

People like to use substances that alter their feelings, thoughts, and behaviors. Not everyone, of course, but enough people. And many of those people, for a variety of reasons, will not want to use "street drugs" directly to do this.

That is why in the United States (and I assume other places) there is a thriving industry of "legal highs": not-regulated and regulated-as-a-supplement substances you can buy at smoke shops and online with the promise of a "high".

For example, there are prescription medications from other countries that you can inexplicably purchase at gas stations and smoke shops on most US states, usually without any restrictions. I am not stating their names here but if you see substances sold at gas stations with the promise of a high, be very suspicious. Obviously these are not approved by the FDA and cannot even be prescribed by a doctor in the US, but they exist in kind of a legal grey area: they haven't been either approved or declared a controlled substance, so until one of those things happens, well, you can buy them, just with no guarantees of efficacy or purity or guidance as to what to use them for or whether they are safe.

NOTE: They're not safe just because they're prescription in other countries. People have died using them and many more have become addicted to them.

Other things, like kava, creatine, or L-theanine, are regulated as dietary supplements, which in the US means regulated as foods. That means they can be sold completely legally, and are often found in grocery stores. Because they are regulated as food, it is up to the manufacturer to make sure of their purity and proper labeling.

Now, on to your question.

The two main ingredients in the energy drinks you describe are kava and kratom. There are many, many different brands of these drinks and shots, and kava and kratom are both sold extensively in many parts of the US as a variety of different products, from the vegetable matter itself to extracts, drinks, candy, capsules and pills. Some of the drinks and products have both kava and kratom, and some will just have one or the other.

Kava is regulated as a dietary supplement in the US. It is a root of a plant in the pepper family which is frequently dried, powdered, and soaked in cold water to make a beverage. Kava has kavalactones as the main psychoactive component. Kavalactones interact with a variety of neurotransmitters and produce a sense of calm, muscle relaxant, and sedative effects such as those experienced with alcohol, however generally without the same degree of cognitive impairment. Kava has been used in the Pacific Islands for over 3000 years as a ceremonial and social beverage. According to the World Health Organization, kava has a low risk for abuse and low risk of associated health problems. This does not mean it can't be used to deleterious effect, just that it is potentially lower risk than other substances.

Kratom is not regulated (exists in that legal grey area) in most parts of the US. In its traditional form, it is a leaf, which is dried and steeped to make a tea or dried and powdered to mix with water. Mitragynine is kratom's main psychoactive component. It is a partial opioid and acts as a stimulant at low doses and a sedative at higher ones. People have used kratom for a little over two hundred years in Southeast Asia. While kratom overdose is technically possible and has happened at least twice, it seems to be a lot more difficult to overdose on than other opioids. Using it consistently for long periods of time does however seem to produce tolerance (needing more of the drug to get the same effect) and a withdrawal syndrome, which tends to be more mental (severe anxiety and depressive symptoms) and less physical than the withdrawal syndrome of other opioids, but can still be very unpleasant.

Kratom danger seems to exist on a spectrum. On one end, you have the dried leaf without any added mitragynine. This tastes terrible and you have to eat or drink a lot of it to get an effect, making it difficult (though not impossible) to consume the increasing amounts necessary to develop a tolerance. If you keep taking the same amount every day, it just stops "working". On the other, you have 7-hydroxymitragynine, a powerful opioid extracted from kratom and sold as pills that quickly produces tolerance and dependence and has severe withdrawal.

Now, if I had to guess, I would say the energy drinks being sold likely contain extracts of kratom instead of the powdered leaf or tea. This is because, as stated above, kratom doesn't taste good. This puts it kind of in the middle of the spectrum of danger, because you could potentially consume a lot of mitragynine without being aware of how much you were consuming.

Ultimately I think any time you repackage a potentially addictive substance to make it more appealing to a wider audience you're doing public health a disservice. We've seen this with vaping (many people who wouldn't smoke a cigarette are fine with consuming nicotine through vaping), which is becoming a huge problem. Kratom is rapidly gaining new users who are using extracts and appealing products like gummies and drinks, which have a higher potential for addiction than the traditional dried leaf.

barfing my kratom...

10 grams of piracetam...