Huberman Lab Podcast: Ask Me Anything (AMA) - Episode on Kratom

Introduction

• Host: Andrew Huberman
  • Professor of Neurobiology and Ophthalmology at Stanford School of Medicine.
• Huberman Lab podcast releases every Monday for free on YouTube, Apple, Spotify, etc.
• Premium subscriber channel supports research and funds are matched by the Tiny Foundation.

Kratom Discussion

• Kratom: A substance from the tree Mitragyna speciosa in Indonesia.
  • Consumed for its stimulant and analgesic (painkilling) effects.
  • Acts as an opioid in the body, leading to controversy.

Effects and Dosage

• Low dosage: Mild stimulant effect.
• Higher dosage: Acts as an analgesic and sedative.
• Addictive Potential: High, especially at higher dosages.

Opioid Crisis Context

• Kratom compared to opioids like morphine and hydrocodone (OxyContin).
• Opioids: Painkillers and sedatives, can lead to euphoria, addiction.
• Addiction: Defined as continuing use despite negative consequences; narrows the range of activities that give pleasure.

Kratom’s Role

• Some use kratom to wean off potent opioids.
• Controversy in public opinion: Divided between those who warn against kratom and those who see it as a helpful tool.
• Medical Professionals' View: Acknowledge its use in tapering off opioids but caution against its addictive nature.

Pharmacology of Kratom

• Endogenous Opioid System: Our bodies have natural opioids that bind to receptors.
• Receptors: Mu-opioid and kappa opioid receptors.
• Kratom’s Chemical Action: Binds to mu-opioid receptors, similar to morphine and hydrocodone.

Dosage Concerns

• Variability in kratom’s alkaloid concentrations affects potency.
• Over-the-counter Availability: Different brands may have differing effects.

Risks and Recommendations

• Potential for addiction is real; varies among individuals.
• Death and Respiratory Concerns: Rarely causes death except potentially at high doses or in combination with other substances.

Personal and Public Health Implications

• Not safe for everyone; some individuals have heightened responses to opioids.
• Risk of respiratory failure at high doses.

Conclusion and Recommendations

• Avoid kratom if not already using it.
• If currently using, monitor dosage and be aware of personal addiction risks.
• Consider kratom’s use only as a potential temporary aid in tapering off stronger opioids, with medical supervision.

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