THESIS
CALIFORNIA ST A TE UNIVERSITY SAN MARCOS
THESIS SIGNATURE PAGE
THESIS SUB1\.11TTEDIN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE
MASTER OF
ARTS IN SOCIOLOGICAL PRACTICE
TITLE: The Experiences ofKratom Users in Southern California: A Sociological Explanation
AUTHOR: Claudia Lacher
DATE OF SUCCESSFUL DEFENSE: April 30, 2021
THE THESIS HAS BEEN ACCEPTED BY THE THESIS COM1\.11TTEEIN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN SOCIOLOGICAL PRACTICE
Christopher Bickel 05/07/2021 COM1\.11TTEE CHAIR SIGNATURE DATE
Richelle Swan 05/07/2021 COM1\.11TTEEMEMBER SIGNATURE DATE
Xuan Santos 05/07/2021 XoaIISaIItos(May 7,202113.371=e,f1 COM1\.11TTEEMEMBER SIGNATURE DATE
COM1\.11TTEEMEMBER SIGNATURE DATE Table of Contents ACKNOWLEDGEMENTS ...... 2 ABSTRACT ...... 4 INTRODUCTION ...... 5 STATEMENT OF THE PROBLEM ...... 6 LITERATURE REVIEW ...... 8 PHARMACOLOGY OF MITRAGYNA SPECIOSA ...... 9 FROM EAST TO WEST: A Historical Tale of Kratom ...... 10 THE SEMI-LEGALITY OF KRATOM ...... 16 THEORETICAL FRAMEWORKS ...... 19 LABELING THEORY ...... 19 SYMBOLIC INTERACTIONISM...... 22 METHODOLOGY ...... 24 SETTING...... 25 GROUNDED QUALITATIVE RESEARCH ...... 27 RESEARCH DURING THE COVID-19 PANDEMIC ...... 31 QUALITATIVE INTERVIEWS ...... 32 Collection of Data ...... 32 Sampling ...... 34 PARTICIPANTS ...... 36 Coding and Analysis ...... 36 Reflexivity...... 38 Limitations ...... 40 FINDINGS ...... 42 THE SOCIAL SIGNIFICANCE AND LEARNING OF KRATOM ...... 43 KRATOM AS AN ALTERNATIVE TO DRUGS ...... 48 Alcohol Cessation ...... 49 Kratom: The Perfect Cup of Coffee ...... 53 Bridge off Opioids ...... 57 Using Kratom to Recover from Pain ...... 61 Nature’s Adderall: Managing ADHD ...... 63 Recognizing Kratom as a Powerful Substance ...... 65 Hiding like a Ghost ...... 71 THE CRIMINALIZATION OF KRATOM ...... 73 SIGNIFICANCE AND RECOMMENDATIONS ...... 80 CONCLUSION ...... 81 APPENDIX A: INTERVIEW QUESTIONS FOR KRATOM USERS ...... 83 References ...... 84
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ACKNOWLEDGEMENTS
The journey to attain this Master’s Thesis has made a remarkable impact on my life. I have many people in which I owe gratitude towards. I have many to be thankful for encouraging me and supporting me through this process. If it were for not these people, this thesis would not be possible. I love you all more than you know and more than I could ever tell you.
I am humbled and grateful for all my participants. I have the deepest sense of gratitude for sharing your stories with me and experiential knowledge. Thank you to all my participants.
To my mom, Tara. I am thankful every day for having such an incredible mother. Thank you for always encouraging me to continue pursuing higher education. I did this for you and work my hardest for you. You have given me the greatest gift of all, and I only want to make you proud. Without your strength and guidance, I would not be where I am today, and I owe it all to you. Making memories with you is one of my favorite things. You have always been my biggest fan and I am eternally grateful for your love. I am forever in your dept. Thank you for always being understanding and patient with me. I love you.
To my love, Christian. Without you, this project would have never come to life. Your soul was placed into my life at the perfect moment, not a second too soon. Thank you for the continued strength, support and love you offered me all throughout this process. I am eternally grateful for the love you have given me. I appreciate you as the genuine, loving, passionate, and gentle being that you are. Thank you for always grounding me. I feel blessed for every day I get to share with you. My love for you is constant, intimate, and infinite.
To my committee, Dr. Christopher Bickel, you have my sincerest gratitude for your support and mentorship throughout this process. You are the best mentor a girl could ask for. From day one you have shown me nothing, but support and I am truly grateful to have you as my chair. Thank you for the enthusiastic support and helpful comments all throughout the writing process. It has been a beautiful journey growing under your mentorship.
Dr. Richelle Swan, thank you for your guidance and suggestions in the process of my thesis. I want to thank you for your unwavering support and encouragement. Thank you for guiding me in the right direction from the start. I am so grateful that our paths crossed.
Dr. Xuan Santos, you were the one who encouraged me to stick with my thesis topic and not to let others bother me about it. I am so grateful for all the time we got to spend together. Thank you for holding space and sharing your knowledge with me.
To my colleagues; Brittney, Cynthia, Daniela, Laura, Nayeli, Nora, Kayli, and Vanessa. You have all become incredible scholars. I truly enjoyed working with all of you. You have made graduate school an unforgettable experience for me. Off to bigger and better things for all of us. Looking back on these past two years, I can’t believe what we accomplished. I am grateful for the support and long nights we have spent together. We all experienced graduate school while surviving a pandemic. We are a prime example of resiliency. Thank you, my fellow scholars.
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To my closest friends, (Taylor, Erin, Blythe, Emily, Molly, Dorian and Melissa) Thank you for always being there for me these past two years, your unwavering support means the world to me. You have been there for me since the beginning and I cannot thank each of you enough. Thank you for understanding my needs and crazy schedule. You all have been amazing friends and I would not have been able to do this without you. I am blessed to have you all in my life.
This thesis is dedicated to my family, friends, loved ones and the thousands of individuals that have been influenced by kratom. Knowledge is power
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ABSTRACT
This grounded qualitative research study explores the social significance of kratom, reasons for kratom use, and the semi-legality of kratom within southern California. Using the theoretical frameworks of Labeling theory, Symbolic Interactionism, and Grounded theory, I examine how kratom is experienced in people’s everyday lives. This study was conducted in one of the only
counties in California where kratom is banned. This work highlights the voices of kratom users
and attempts to change the narrative surrounding kratom use. The aim of this study is to update
the scientific knowledge on the outcomes with kratom use and provide a critical discussion on
the matter based on the results. To have a more conclusive understanding of kratom’s role within
society it would be best to hear from the people who use it themselves. I completed eight
qualitative interviews with kratom users to better understand how kratom fits into their lives.
Previous research on kratom heavily focuses on the pharmacology of the plant and not the people
who use it. This study covers three main themes which highlight the social significance of
kratom, reasons for kratom use, and the criminalization of kratom. This study demonstrates why
we must step into the social world of kratom users.
KEYWORDS: Kratom, Mitragyna speciosa korth, Kratom use in humans, Qualitative methods,
Substance use, Labeling Theory, Symbolic Interactionism, and Grounded Theory
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INTRODUCTION
My first encounter with kratom was with a group of friends. I was in the back of a car
when I saw my friend put a spoonful of green powder into his mouth and wash it down with
water. I asked, “What is that?” and he said it was called kratom and helped with his social
anxiety. I had never heard of kratom and set out to research the plant. Since then, I have learned
much about kratom and my friend has become a key participant in my efforts of researching
kratom users. There is little qualitative research on kratom users. My research is an attempt to fill
this gap in the literature. Little did I know that a single encounter with green powder would turn
into this research project. Since, kratom is a new and emerging plant in the United States, that I
wanted to learn more about, an exploratory study of the social worlds of kratom users.
Kratom (Mitragyna speciosa, korth) is an indigenous tropical evergreen tree native to
Southeast Asia, most commonly found in southern Thailand and northern Malaysia (Griffin 2018 and Saingam et al. 2013). Its botanical name is Mitragynine speciosa Korth and belongs to the
Rubiaceae family same as the coffee tree (Cinosi et al. 2015). Some street names for kratom include biak, thang, krypton, kakuam, thos, and ketum which are commonly used in Thailand
(Frost 2019). The two most prominent alkaloids present in the leaves are mitragynine and 7-a-
hydroxymitragynine (Griffin 2018). These two components activate and interact with opioid
receptors in the brain to provide numerous effects depending on the dosage. In low doses, kratom
produces stimulatory effects, increase in energy levels and sociability, meanwhile, at higher
doses kratom exhibits euphoria, analgesia, and relaxation (Swogger & Walsh 2018). There are
three main strains to kratom; green, white and red. Each strain has various effects on an
individual which also depends on how much is consumed. The plant is most known for
addressing issues with anxiety, pain, fatigue, and insomnia (Coe et al. 2019). There are many
5 reasons as to why people are attracted to kratom, the main one being that it is natural and organic. Although there has been little research, kratom has been known to help fight addictions, decrease anxiety, improve concentration, boost energy levels and alleviate pain.
Kratom has been used for hundreds of years in Southeast Asia for poor and working-class people who work on farms and manual labor (Morris 2017). The natives of Thailand and
Malaysia will pull one leaf from the korth tree, roll or fold it into a smaller size, then they stick it in their mouths and chew for only a couple moments and spit it out. This method allows users to feel the effects immediately. The effects will also depend on an individual’s overall health, metabolism and if there is a history with opiate abuse. The risk, damage and harm are low with kratom. Before the Internet, kratom was regionally confined to countries it grew naturally in such as Indonesia, Thailand and Malaysia. Since the emergence of social media “widespread Internet use makes knowledge of and accessibility to such substances exceedingly simple (Tavakoli et al.
2016). Kratom has the potential to improve people’s lives as a safer alternative to drugs such as opioids. The purpose of this qualitative study is to examine the process, context, and health consequences of daily kratom use for people living in Southern California. Qualitative methodologies offer an important opportunity to center the voices of kratom uses as experts in this analysis. Since kratom is relatively new to the United States, this exploratory study will focus on the social world of kratom users and answer the question: What are the overall experiences and reasons for using kratom and how do they navigate the semi-legality of kratom?
STATEMENT OF THE PROBLEM
To better understand the social world of kratom users, I focus on the general use of kratom, the history of the herb, and the controversies surrounding usage. A new substance has entered the United States and European Union that has simultaneously generated support and
6 backlash. Kratom, botanically known as Mitragyna speciosa comes from the korth tree which grows naturally in Thailand, Malaysia and Indonesia (Griffin 2018). Kratom has unique alkaloid properties that interact with opioid receptors in the brain to exhibit various effects depending on the dose an individual takes (Frost 2019). Kratom allows people to work longer hours by alleviating pain, decreasing fatigue and elevating mood (Grundmann 2017). The use of substances to enhance human abilities have been used for a millennium. For example, various cultures use herbs for religious ceremonies, therapeutic purposes and the improvement or modification of physical and mental capabilities (Cinosi et al. 2015). Substance use for human enhancement has not diminished over time, it has increased. We have seen this in different forms such as coffee drinking, and the ingestion of anabolic steroids and drugs like Ritalin or Adderall.
Although kratom use generally is low risk and low harm, there can still be issues with long term use, especially in high dosages. Long term use of kratom can cause dependency on the supplement.
Kratom is viewed as a cheap and natural substance that has dual properties. It is used as a stimulant to enhance productivity and energy levels, or as an analgesic due to its pain-relieving properties (Singh et al. 2014). Since kratom has the potential to be used as a safer opiate- alternative, the plant has become attractive to many people (Webb and Griffin 2019). However, this attention garnered the interests of the media, who often portray it as a legal drug with serious repercussions and side effects.
There is little knowledge about kratom in the public and the media often focus solely on the negative consequences of kratom. This results in misinformation and negative connotations around the herb. The public and media had little interest in kratom prior to federal government concerns over the substance (Webb and Griffin, 2019). Kratom is also largely uncontrolled in
7 the United States at the federal level while only a few states such as Indiana, Wisconsin,
Arkansas, Alabama, Vermont and Rhode Island have moved to ban the herb (Cinosi et al. 2015).
This means that the plant is legal to cultivate, possess, buy and distribute without a license or prescription in most states. When kratom is sold as a supplement, the sales must conform to U.S. supplement laws (Cinosi et al. 2015). Because kratom is not monitored on a national level there is still little information about the plant. This is exactly why we need more research into the social world of kratom user's and how they use it in their daily lives.
Since there is little research on kratom, people have developed a negative stigma and name for the plant. Currently, the amount of kratom consumed by Westerners from the European
Union and United States is unknown. There is a variety of Mitragyna speciosa related products that are easily available for sale through the Internet, however, their content is not always verified. This also includes many variations of kratom such as raw leaves, capsules, tablets, powder and concentrated extracts (Cinosi et al. 2015). The predictions of novel psychoactive drug trends in Western countries specifically suggest that kratom use will increase in the upcoming years (Cinosi et al. 2015). It is important that we begin to understand kratom’s role in
Western society, specifically the United States. By conducting more research on kratom, we can better understand the social world of kratom users to better develop social policies around the substance. Kratom may be used effectively for drug addiction treatment, yet still requires systematic research. The more information and knowledge we gain about kratom, the more informed people will be to make their own decision about the plant.
LITERATURE REVIEW
This literature review will cover three main themes pertaining to kratom. These themes include, pharmacology of kratom (Mitragyna speciosa), kratom from East to West, and lastly the
8 semi-legality of kratom. This section reviews what is known about kratom and the major areas that contribute theoretically and empirically. Because kratom is a relatively new drug in the
West, I take an inter-disciplinary approach to understanding kratom, drawing on Pharmacology,
History and Sociology. This research will be a contribution to the overall knowledge surrounding kratom and the direct impact it has on American lives.
PHARMACOLOGY OF MITRAGYNA SPECIOSA
Before we explore the people who use kratom, we have to understand the plant itself.
Most of the literature on kratom consists of toxicology and pharmacology reports. This is helpful in understanding the genetic makeup of kratom. Kratom’s pharmacology is complex because the alkaloids bind to mu, delta, and kappa opioid receptors, serotonin receptors, and adrenergic receptors (Boyer et al. 2008). “Although mitragynine can act on the mu ( ), kappa ( ), and delta
( ) opioid receptors, it is structurally different from morphine and other components𝜇𝜇 𝜅𝜅 from the opioid𝛿𝛿 family; the reason why it has been suggested is that it might also present with a more broad receptor binding activity (Cinosi et al. 2015).
The two most prominent alkaloids in kratom are mitragynine and 7-hydroxymitragynine, both alkaloids are claimed to have opioid-like effects (Kreugel et al. 2016). These two alkaloids have a broad affinity with different receptors (Cinosi et al. 2015). Since mitragynine does not recruit β-arrestin-2 mediated pathways upon receptor activation, it is considered as a safer analgesic to classical opioids (Kruegel et al. 2016). When 7-hydroxymitragynine was isolated by photochemical oxidation of mitragynine, only trace quantities were observed in the extraction of raw plant material (Kruegel et al. 2016). This means that 7-hydroxymitragynine is unlikely to account for the psychoactive properties of the plant (Kruegel et al. 2016). Mitragynine and 7-
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hydroxymitragynine account for most of the properties kratom is known for, such as the energizing effects, pain relief and analgesic effects.
Mitragynine is responsible for the analgesic activity mostly due to its potent opioid agnostic property (Takayama 2004). Mitragynine potency differs depending on the type of strain, maturity of the tree and how kratom is ingested (Cinosi et al. 2015). The mitragynine content in kratom, is roughly 12% in leaves commonly found in Malaysia, but it could go up to 66% in leaves found in Thailand (Singh et al. 2019; Brown et al. 2017; Takayama 2004). The quantities of these major alkaloids, along with a wide variety of minor alkaloids, are considerably varied among different regional varieties (Kruegel 2016). Subjective effects of kratom depend on the
dosage: at low to moderate doses (1–5 g) it has a mild pleasant stimulant effect; at moderate high
doses (5–15 g) the compound has opioid-like analgesia and sedation (Sabetghadam 2013).
Because of these properties, kratom can be classified as a novel psychoactive substance. There
have been little studies to determine blood concentration of kratom users. Further clinical
research on kratom is necessary for overall understanding. Grundmann (2017) suggests that
kratom, mitragynine, and/or mitragynine analogs should be evaluated as potential medications
for treating pain and Opioid Use Disorder (OUD). More research is necessary in determining
whether there are therapeutic uses of kratom.
FROM EAST TO WEST: A Historical Tale of Kratom
As an indigenous psychoactive plant of Southeast Asia Mitragyna speciosa korth
(Rubiaceae) has been used for millennia as a stimulant, in traditional medicine, and in social
contexts (Grewal 1932; Jansen and Prast 1988). There is a long history with kratom in Southeast
Asia. Kratom is a plant with a well-established traditional use in Southeast Asia to enhance work
abilities as well as support traditional medicine and culture. Kratom has been used for hundreds
10 of years in Southeast Asia for poor and working-class people who work on farms and manual labor (Coe et al. 2019). The local natives of Southeast Asia have chewed kratom leaves daily and view kratom as part of life and culture. Thai National Household Surveys indicate that approximately 90% of kratom users are men and 10% of kratom users are women
(Asnangkornchai & Siriwong 2005). Since its emergence, kratom has had different legal and social status in parts of the world (Tanguay, 2011). Kratom has been used in countries like
Thailand and Malaysia, to manage opiate withdrawal symptoms. Among rural folk, kratom is viewed as a better alternative to illicit drugs like heroin and methamphetamine (Cinosi et al.
2015).
Kratom was first placed under regulatory control in 1943 under the Kratom Act in
Thailand (Saingam et al. 2013). At the time, the government was levying taxes from users and shops involved in the opium trade (Saingam et al. 2013 and Tanguay 2011). This led to increasing costs of opium products and former opium users switched to using kratom to manage their withdrawal symptoms. The Thai government was impacted by the declining revenues from the opium trade (Saingam et al. 2013). This led the Thai government to exclude kratom as a competitor to opium and make kratom an illicit substance (Saingam et al. 2013 and Tanguay
2011). In 1979, kratom was classified in Category V of a five-category classification of narcotics by the Thai government in the Narcotics Act (Saingam et al. 2013). This categorized kratom in the same class as cannabis, opium, and hallucinogenic mushrooms (Saingam et al. 2013).
Classifying kratom made it illegal to buy, sell, import, grow, own, or harvest kratom. Existing trees were mandated to be cutdown. Having a kratom tree on your property was illegal. With the increase of opium taxes, people started to use kratom instead of opium, which had a visible impact on the government’s income (Tanguay 2011).
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At the turn of the 21st century, there was an increase in the number of arrests and seizures
related to kratom. The highest number of arrests for kratom related crimes took place in the southern provinces (6,112 persons out of a national total of 7,388) (Tanguay 2011). According to
Tanguay (2011), “After arrest for kratom related crimes, access to drug treatment is not possible given that the Narcotic Addict Rehabilitation Act 2002 does not recognize kratom dependence as requiring treatment” (6). The criminalization of kratom has caused division between the law enforcement authorities and communities across southern Thailand. Because of prohibition efforts and criminalization of kratom, a growing black market has emerged. This continuing demand for kratom leaves from the three southernmost provinces has meant that leaves from further north in Thailand and Malaysia are being trafficked across provincial and national borders (Tanguay 2011).
In Thailand, kratom is viewed as a part of life in the south. “In southern Thailand, traditional kratom use is not perceived as ‘drug use’ and does not lead to stigmatization or discrimination of users” (Tanguay 2011). Eating kratom is a tradition that has been practiced for centuries in southern Thailand and up to 70% of the male population in some districts use kratom daily (Tanguay 2011). Many people in southern Thailand compare chewing kratom to drinking coffee. The criminalization of kratom was initially used as a tool for economic control at the end of the opium trade, and later as a tool for law enforcement to target particular populations
(Tanguay 2011).
Kratom has been used for many different reasons in traditional indigenous medicine in
Southeast Asia for years for the treatment of a variety of maladies, including malaria, cough, hypertension, diarrhea, depression, analgesia, and fever reduction (Webb and Griffin 2019). By destigmatizing kratom, this plant can help people fight off opiate addiction. Although kratom has
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helped people with addiction such as opiates, there still is the risk that they become dependent on
the herb itself. The criminalization of kratom has not stopped people from continued use in
Thailand. The criminalization of kratom has created barriers for research as well.
Given that kratom is relatively new in the West, my research has the opportunity to speak
to social process of how drugs become legalized or criminalized, and the social interactions that
undergird this process. It is still undetermined exactly how many people use kratom in the United
States. Many people chose to use kratom privately and are discreet about their use. We know
kratom use is increasing because Anwar and Schier (2016) stated that U.S. poison control centers
received 660 calls about reported exposure to kratom during the time period of 2010 to 2015.
“The number of calls increased tenfold from 26 (calls) in 2010 to 263 (calls) in 2015” (Anwar
and Schier 2016). Based on these numbers, kratom use within the U.S. is increasing. Public and
healthcare providers should be made aware of the potential dangers associated with the adverse
effects of kratom (Webb and Griffin 2019). Just like with any drug, there is a risk that an
individual's body chemistry will not agree with certain substances. Although kratom can be
useful to some people, it is still not void of risk. While kratom can produce negative side-effects, kratom seems primarily dangerous when users engage in polydrug use (Boyer et al. 2008; Cinosi et al. 2015; Webb and Griffin 2019). The takeaway here is that kratom becomes much more dangerous when combined with other substances.
Grundmann (2017) conducted an anonymous online survey and found that kratom users were between the ages of 35-50 years of age. The mean income of kratom users earned $35,000 a year and 68% of them reported kratom use to manage pain. A commonality among users was that kratom was consumed to avoid opioid withdrawal symptoms of opiate addiction. This is because kratom acts on the opioid receptors of the brain to exhibit similar opioid-like traits when
13 consumed. This study found that people who use kratom, use it to manage chronic pain and mood conditions like depression and anxiety (Grundmann 2017). The kratom user population in the US is diverse, but tends to be middle-aged, middle-class and white. One limitation to this survey was that it was only sent to members of the American Kratom Association (AKA) who are generally older folk and pro-kratom. This excludes younger people who may not know about the AKA. Grundmann’s (2017) online survey provided detailed information about the reasons for use, duration, and effects of kratom. This survey found that “kratom was primarily used for medical conditions leading to or being associated with acute chronic pain” (Grundmann 2017).
We know that people will find ways to manage their pain and are often prescribed opioids which can cause further damage. Giving people another option such as kratom can be beneficial. People are willing to risk using an unregulated product like kratom to help them get through their day- to-day lives.
Imported to western countries from Southeast Asia, kratom has become more popular in the United States. Kratom is attractive to many people as an all-natural alternative to other substances like coffee and opioids. With that being said, not everybody who consumes kratom is going to have a similar reaction to the plant. Another study conducted by Smith and Lawson
(2017) had obtained slightly different results than Grundmann’s (2017). Their study included
500 people living in a residential drug treatment program and they found that 20.8% admitted lifetime kratom use and 10.2% had used kratom in the past year. Some of those participants were younger, about 30 years old.
An anonymous survey conducted by Marion Coe (2019), assessed the reasons for kratom use. Reasons for kratom use were assessed with response options such as; to relieve pain or withdrawal symptoms, help with anxiety, depression, PTSD, insomnia, to cut down or quit using
14 prescription pain medicine, and lastly to cut down or quit using illicit or illegal drugs. These variables are appropriate in distinguishing whether people are using kratom to quit opioids or for other reasons. The findings of this survey indicate that many individuals take kratom for conditions that involve self-medicating with opioids (Coe et al. 2019). The results of this survey indicate that kratom may be a useful alternative to opioids for people dealing with pain. The authors also included a section for participants if they had bad reactions to kratom. This includes stomach problems, constipation, heart palpitations, dizziness, drowsiness (Coe et al. 2019). For respondents of this survey, kratom was used to reduce or eliminate their use of prescription opioids and/or heroin and to relieve their withdrawal symptoms, suggesting that kratom may be able to help some fraction of the large number of people with OUD (Coe et al. 2019). Another finding was that “respondents using kratom currently were less likely to have used opioid medications in the past week and month than persons who reported past kratom use” (Coe et al.
2019). This suggests that respondents substitute kratom for opioids.
This survey’s findings are consistent with the known pharmacology and toxicology of kratom and its alkaloids. It is also important to note that serious adverse effects with kratom use are rare and there are no well documented cases of overdose deaths solely caused by kratom
(Babin 2018). However, the absence of documented deaths does not mean that kratom has not contributed to or caused a death or without risk (Coe et al. 2019). There is still not enough reliable information that kratom poses the same risk such as opioids or morphine. This survey suggests further scientific investigation on kratom is warranted.
Furthermore, kratom use and dependence reportedly do not interfere with social, family, and occupational functioning (Singh et al. 2014, 2017; Swogger & Walsh 2018; Vicknasingam et al. 2010) to the extent that conventional opioids do. For some individuals, kratom is the better
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alternative than using other drugs such as opioids. However, even though “it is often considered
a ‘natural’ and thus safer option than illicit drugs or an alternative to opioid treatment, is not
devoid of risks” (Cinosi et al. 2015). Western medicine focuses heavily on prescription pills
which are highly addictive. Treating chronic pain and addiction with more pills and drugs may
not be the safest route. Many have gone down that route and come out of it addicted to opioids
and searching for other alternatives. Further research on kratom is important to demonstrate
whether kratom can help manage opiate addiction in users living in the United States.
The existing literature, however, does not touch on the fact that kratom may be used
recreationally. Coe’s (2019) survey barely touches on recreational use of kratom by including one question if the reason for kratom use was through recreational purposes (i.e., for the feeling the user gets after using). Coe (2019) found only 16.6% of respondents reported recreational use of kratom. There is a gap in the literature about the recreational use of kratom. The recreational use of kratom is explored further in my proposed study.
THE SEMI-LEGALITY OF KRATOM
The Federal Drug Administration (FDA) works to implement appropriate regulatory standards, oversight and communication to prevent unintended consequences of drug usage. The
FDA had its eye on kratom since August 30, 2016 when they first announced their intention to classify kratom as a Schedule I controlled substance (Webb and Griffin 2018). The DEA defines a Schedule I controlled substance as “drugs with no currently accepted medical use and a high potential for abuse” (dea.gov). Schedule I drugs include heroin, lysergic acid diethylamide
(LSD), marijuana, methamphetamine, and peyote (dea.gov).
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In 2016, kratom was declared as a Schedule I drug with the reasoning that it’s likelihood of addiction outweighs its potential medical benefits. Six states; Alabama, Arkansas, Indiana,
Tennessee, Wisconsin and Vermont have already banned kratom (Hadley 2016). The scheduling of kratom would make the sale and possession of kratom a felony. Two of the main reasons for criminalizing kratom into the controlled substances list is because kratom is untested and medical benefits have not been determined. The scheduling caused a public outcry including protests and petitions. A White House petition received more than 140,000 signatures asking that kratom not be made a Schedule I substance (Hadley 2016). Protestors were chanting in front of the White House with slogans like “Kratom Saves Lives” and “I am kratom” (Anson 2016). The
FDA hosted an open forum for kratom which allowed people to voice their opinions in an online poll.
Kratom is not endorsed by the FDA as an effective treatment for pain, OUD or any other medical condition. It has not been evaluated in a clinical setting or trials for therapeutic use by the FDA or any national drug regulatory agency. Kratom requires a nationally representative assessment before any kind of scheduling occurs. Researchers must assess the prevalence of kratom use, the effectiveness of kratom for managing pain, OUD, and withdrawal. Since kratom is sold in the U.S. with few regulations, there is this perception that using kratom is safe, there have been several reports of self-medication without medical consultation (Webb and Griffin
2018; Boyer et al. 2008). Even though there is a strong push for criminalizing kratom, it remains widely used in the U.S. as a legal opioid substitute (Coe et al. 2019; Grundmann 2017; Singh et al. 2017; Smith and Lawson 2017; Boyer et al. 2008).
Banning kratom may pose public health risks including increased use of opioids by people who had successfully terminated or cut down their use (Coe et al. 2019). A ban on kratom
17 would lead to the emergence of an illicit market for kratom. In Coe’s (2019) survey, respondents were asked “If kratom were no longer legally available, what would you do?”. Responses included: get it where it was legally available (36.4%), try to get it illegally (26.7%), or replace it with something else (24.0%). If the FDA regulated the market of kratom it would reassure consumers that kratom products are what they claim to be and not adulterated by fentanyl, heavy metals or other substances. “It may be in the interest of public health to ensure continued access to kratom while FDA works to implement appropriate regulatory standards, oversight, and communications to minimize unintended consequences” (Coe et al. 2019, p. 30). We have to ask ourselves; Why is the FDA and its commissioner getting involved with something like kratom?
Banning kratom from the U.S. would significantly impact the future research including important pharmacological and toxicological testing. This would impose barriers on potential development of kratom as medicine and treatment. For now, kratom is widely available on the internet and legal in many states.
It should also be noted that most of the research I am pulling from is survey based. This is useful in breaking down the demographics of kratom use, however, this does not provide the sociological basis for understanding use. This leaves a gap in the sociological research on the social world of kratom users. My work will contribute to the sociological knowledge of drug use and how individuals come to use kratom. This research will also explore the legality of kratom and how users perceive the legal status of the drug. In this way we can possibly determine when or if a drug will become legalized or criminalized. This study begins to help us understand how people view the legal status of kratom and whether they care about the legal status when they are drawn to kratom.
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Kratom has not been the subject of in-depth study or clinical trials which is why kratom
needs more attention. The literature on kratom is substantial in centering on the pharmacology of
the plant and not so much on the people who use it. People will continue to use kratom in the
United States and there has to be more conclusive scholarly research. There is a high need for
evaluating the risks and benefits when it comes to using kratom. Although kratom has not been
clinically proven to ease withdrawal symptoms, many people are self-treating with kratom from
opioid withdrawals. Data and research can differentiate whether kratom can work for people and
their needs. With the proper research, kratom can be another option for people instead of using
prescription drugs. Understanding the influence kratom has on people and their well-being is
important for evaluating its role in society.
THEORETICAL FRAMEWORKS
Focusing on the human experience with kratom, I employ two theoretical frameworks:
Symbolic Interactionism and Labeling theory. My research sheds light on kratom consumption in
the United States. Labeling theory will be useful in understanding the idea of deviance. Symbolic
interactionism will be useful in understanding how kratom users shape meaning around kratom
through social interaction. The application of these two theories will help us understand why
people use kratom and their various experiences with using the substance.
LABELING THEORY
Labeling theory is a sociological approach that focuses on the role of social labeling of
crime and deviance. This theory was introduced by Edwin Schur (1971) and was expanded by
Howard S. Becker in his book Outsiders (1963) which defined deviance “as outsiders are created
by the development of society’s view of crime” (p. 7). The basis of this theory lies in the
criminalization and social conditions where people are defined as “criminals” – a process which
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leads to further criminalization (Rafter & Brown 2011). With substance use, there is a fine line between acceptable usage like medication and other drugs that are heavily criminalized such as
heroin or methamphetamine. People in positions of power, or moral entrepreneurs, use labels to
classify individuals as deviants which will then make them self-identify as deviant. Moral entrepreneurs are those that benefit from instilling a moral panic to the public. These are people with the power to impose labels among the public. A moral entrepreneur may press for enforced norms for altruistic or selfish reasons. They consist of people in powerful positions that manipulate what the public believes in their favor (e.g. crime, drugs, pro-life messages).
Labels risk becoming self-fulfilling prophecies, forging criminal identities by making
conformity difficult through processes of exclusion and isolation (Rafter & Brown 2011). The
more a person is labeled a deviant, the more likely they are going to identify with said label.
Labeling produces a transformed self-image and altered social situation (Knutsson 1977). When
an individual is treated as having certain qualities attached to deviance, their identity is
transformed (Knutsson 1977). This labeling process then gives rise to the “self-fulfilling prophecy” and the likelihood of continued deviant behavior.
We often do not question the term deviant and accept it as someone who breaks the rules or strays from the norm, when, deviance is created by society (Becker 1963). The label of deviance changes over time, as Becker presented with marijuana users and how the behavior is deemed deviant by non-users. Deviance and criminality are social constructs. Crime and deviance changes across time, societies, and context (Rafter & Brown, 2011). There are two
effects that come from labeling which can be broken down into two categories: primary deviance
and secondary deviance. The behavior which becomes the object of labeling is known as primary
deviation (Knutsson 1977). Primary deviance occurs when an individual's social situation is
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changed, and they break the norm. Secondary deviance is when the behavior is a result from
labeling (Knutsson 1977). This occurs when the labels affect a person’s self-image and they conceive themselves as deviant.
Labeling kratom users as addicted to a dangerous drug will be detrimental to the community. This can lead to the criminalization of a plant that is helpful to the user's overall quality of life. We have seen the criminalization with marijuana but have not seen a decrease in use over the years. Criminalizing kratom will not only inhibit future research on the plant, but also impose unnecessary regulations on kratom. The labeling effects of kratom users as criminals or drug users will impact the psychological and social development of the individual. As the war on drugs rages over, many people have concluded that legal drugs can be quite harmful, such as opioids, while other illegal drugs such as marijuana or kratom are harmless. Even though tobacco and alcohol are drugs, the public’s view on these drugs are much different than LSD or marijuana. The use of different drugs evokes different degrees of public or official reaction
(Williams 1976). Labeling has typically been associated with the ascription of a negative status to a person as a result of “societal reaction” to some real or imagined deviant activity (Williams
1976). Labeling someone as a deviant alters the status of a person through societal reactions.
Labeling someone as deviant has implications for social policy and further deviancy.
Labeling theory will be significant to my research because it highlights the importance of deviance of a group. Although kratom users have not yet been labeled as people “taking illegal drugs”, labeling theory will be useful in understanding deviance behind kratom usage.
Depending on the kind of drug, addiction is labeled a crime and the users as criminals. The labeling of kratom users can create different reactions and rehabilitations. Highlighting the significance of labeling theory in my research will show the importance of deviance in relation to
21 substance usage such as kratom. A critique of labeling theory is that it does not include an analysis of race and ethnicity. This led me to include an analysis of race with this research project.
SYMBOLIC INTERACTIONISM
Symbolic interactionism is a micro-sociological theoretical perspective that addresses the manner in which individuals create meaningful interactions. The perspective emerged in the mid- twentieth century by its greatest influence George Herbert Meade (1934) and his theory on the relationship between self and society. This perspective gained social significance because it was a response to the mainstream media that dominated sociology at the time. These dominant and positivists approaches examined society from the ‘top down’ focusing on the impact of macro- level institutions, social structures and how they impose on and constrain individuals (Carter &
Fuller 2015). Symbolic interactionism focuses on the small-scale perspective of individual interactions between individuals instead of large-scale structures like education or government.
Symbolic interactionism was developed to understand society from a ‘bottom up’ perspective and shifting the focus on micro-level processes.
Symbolic interactionism became a valuable and socially significant theoretical framework to analyze our social world. The theory has been influenced by many other scholars such as Herbert Blumer, Erving Goffman, Charles Horton Cooley, Howard Becker, and Sheldon
Stryker. Symbolic interactionists are often less concerned with objective structure than with subjective meaning – how repeated, meaningful interactions among individuals come to define the makeup of ‘society’ (Carter & Fuller 2015). Following the work of Herbert Blumer, who was a student of George Meade, Blumer expanded on Meade’s original philosophically based social behaviorism leading towards to conception of symbolic interactionism. Blumer (1969)
22 summarized the basics of symbolic interactionism as (1) individuals act based on the meanings objects have for them; (2) interaction occurs within a particular social and cultural context in which physical and social objects (persons), as well as situations, must be defined or categorized based on individual meanings; (3) meanings emerge from interactions with other individuals and with society; and (4) meanings are continuously created and recreated through interpreting processes during interaction with others. Symbolic interactionism shifts the interpretation of subjective viewpoint of how individuals make sense of the world from their unique perspective.
Blumer laid down the groundwork for a new theoretical paradigm which challenged sociological epistemology and methodology.
Symbolic interactionist theory is a perspective with historical and contemporary significance for the field of sociology. The diversity of sociological work that has emerged from symbolic interactionism is evidence of its adaptability within the discipline. As a methodological approach, it has been argued that symbolic interactionism is best suited for qualitative research methods. This is because theoretically, to study human behavior it has to be through intimate interaction with others. Different people derive different meanings based on the interactions and experiences they have experienced. These interactions, depending on the situation, are how individuals derive meaning from these interactions. Symbolic interactionism has been incorporated into many social scientist’s research.
One of the more popular interactionist studies was done by Howard Becker (1953) in his work on becoming a marihuana user. Becker showed that “feeling high” while using marihuana is a social construction rather than physiological state caused by the drug. Becker’s study reveled that marihuana users’ sense of feeling high requires both the presence and recognition of the drug’s symptoms which are conducted socially through interactions with others. In a broader
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sense, Becker shows how the role behavior is socialized and learned through interaction with
others. Becker’s study on marihuana users had a massive influence on symbolic interactionists and the field of sociology. This study challenged previous knowledge and widened the boundaries of what was considered acceptable. Becker inspired scholars to research unique and taboo phenomena which is not studied by others. Becker’s work on marihuana users was
instrumental for my research. Kratom is similar where introduction of kratom happens through
social circles. I will later discuss in my findings how my participants learned how to use kratom
and how to think about kratom through social interactions.
My research uses a symbolic interactionist approach to explore the experiences and
reasons for kratom use, while also navigating the semi-legality of kratom. By using symbolic
interactionism as a theoretical framework, helped formulate how individuals define meaning to
themselves and their social world. In my grounded qualitative research of people who use
kratom, symbolic interaction is implemented as a framework to understand the how kratom fits
into my participants’ lives. This research project demonstrates how kratom has developed a
social significance through the framework of symbolic interactionism. Having a better
understanding of what kratom’s role is will give us a clear idea whether kratom will be
criminalized or legalized.
METHODOLOGY
Interviewing people who use kratom turned out to be very rewarding for me. Our
conversations were informative and exciting. I will first describe the setting of the kratom shops
that participated in this research project and then I will dive into my reasoning behind using
qualitative methods. This research project provides social insight into the lives of kratom users. I
have utilized grounded qualitative research methods to explore the experiences and reasons
24 behind kratom use. In this section, I will first discuss how I sampled, interviewed, and coded/analyzed data. I will then provide examples of questions I used for the interview. Also included are COVID-19 implications on this research project. Lastly, I have included a discussion of my reflexivity as a researcher. Before diving into the methodology, I will discuss the setting of my research and interviews as well as explain how using a grounded methodological approach to kratom use is appropriate for this project.
SETTING
There are three local places that sell kratom in my area. The first is in the center of town, the second is tucked away in a business district and the third is located in a busy village area.
When you walk into any of these establishments you are always greeted by an employee. They are eager and willing to answer any questions or make recommendations. Bob’s Smoke Shop has three to four rows of kratom product on the wall. In this store you will find a variety of strains and grades of kratom. They have red, white and green vein kratom that comes from Indonesia or
Malaysia (Southeast Asia). The kratom packaging at Bob’s Smoke Shop is in semi-clear bags that allows you to see the color of kratom. Different varieties of kratom come in slightly different shades of green. Here you could also find powder kratom in capsules as well as liquid concentrate kratom in small tincture bottles. Kratom looks like finely crushed leaves then turned into a powder that smells like green tea. You can compare kratom to matcha with a more earthy tone.
Space Kratom has gone through a glow up since my first visit with the business. They have merchandise like hats and T-shirts as well as a surfboard with their logo on it. They even sell powder Ashwagandha capsules. Ashwagandha is botanically known as Withania somnifera
25 and belongs to the Solanaceae family and is a revered herb of the Indian Ayurvedic system of medicine (Singh, Bhalla, de Jager, Gilca 2011). Ashwagandha can produce pharmacological actions like anti-stress, neuroprotective, antitumor, anti-arthritic, analgesic and anti-inflammatory properties (Singh, Bhalla, de Jager, Gilca 2011). Space Kratom promotes health and wellness to their customers and they offer other herbs like Ashwagandha as well as kratom. Space Kratom is located in a business district with wood furnishings and big windows letting lots of light in. It is a large office space with a few more rooms in the back. Space sells multiple strains of kratom including green, red and white vein kratom which is available in powder, capsule or leaf form.
You can purchase kratom powder in a small bag containing 30 grams (1.05 oz) for around $12 or a big bag that has 120 grams (4.23 oz) for $60. There is the option to purchase prepackaged kratom capsules in a small or large bag for slightly similar prices and weight. Space sells kratom in completely solid gray plastic packaging that has red or green outer space planets on the front.
On the package you will see the percentages of mitragynine and 7-hydroxmitragynine including an expiration date. If you write a nice review of their business, they will supersize your order.
Space also sells extract kratom which is liquid stored in a small glass tincture bottle. The store has a nice air freshener too.
The last establishment located in the village is called Aroma Kratom. The store is located on the second floor of a building. Aroma Kratom has a variety of kratom strains with huge glass jars that hold the kratom. In this store you will find a variety of strains and grades of kratom.
Their store front is decorated in flowers and the popular ceramic Rae Dunn product which include mugs and tea pots. They have red, white, green as well as gold extract kratom that comes from Indonesia or Malaysia (Southeast Asia). The kratom powder packaging is solid brown with a stamped label of the Aroma Kratom’s business name and address. With the kratom stored in
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large glass jars it is easy see the difference in color between the various strains. Since Aroma
Kratom only sells kratom they have a “Powder Bar” with large glass labeled jars of kratom
placed along a wall. Right across from the powder bar there is a large shelf with jars of kratom in
veggie capsules. These capsules come in all different veins of kratom that are available to
customers. Also, there is always a large candle burning in this store. Aside from powder kratom,
the store front is decorated in ceramic products with cups on it that say “sip, drink and enjoy”.
One aspect of kratom that should be noted are the different ways kratom can be
purchased locally. Space Kratom sells three main strains of kratom, green white, and red. This
vendor feels much like a dispensary in the sense that people are coming to buy kratom for
medical reasons. This medicinal approach to selling kratom is an attempt to legalize the plant.
The same pattern happened with marijuana when everyone had to get a medical card or a
prescription from a doctor to purchase from dispensaries. What this does is normalize the plant to
the public while attempting to promote kratom as a medicinal supplement. This helps initiate the
legalization process with state and federal government showing there is a need for kratom in the
community. No one single view on substance use is absolute, there are always two sides to a
coin. Therefore, we need to consider kratom use from a sociological perspective which will bring
a greater understanding towards the social world of kratom use.
GROUNDED QUALITATIVE RESEARCH
Grounded theory has been a popular and emerging theory since the late 1960’s. The
practice of grounded theory has been implemented into qualitative research and spread across
sociology, anthropology, social work, education, law, management, nursing, and medical
research (Timmermans & Tavory 2012). The Discovery of Grounded Theory by Barney Glaser and Anselm Strauss (1967) has spread across many different fields and approaches to research.
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Grounded theory can be applied to many research endeavors that includes, coding, qualitative analysis as well as any kind of theory construction. Grounded theory is structured yet flexible depending on a researcher’s approach. Grounded methodology is appropriate when little is known about a social phenomenon; the aim is to produce or construct an explanatory theory that uncovers a process inherent to the substantive area of inquiry (Chun Tie et al. 2019). Research that claims to be grounded often has very little to do with the original methodological precepts, using the label “grounded theory” as a shorthand for qualitative research and the lack of a well- articulated analytical strategy (Timmermans & Tavory 2012; Hood 2007; Titscher et al. 2000).
Grounded theory informs the framework of research design to guide the novice researcher (Chun Tie et al. 2019). A defining characteristic of grounded theory is that it aims to generate theory that is grounded in data (Chun Tie et al. 2019). By utilizing my data from interviews, I have constructed three themes that emerged from my conversations with people who use kratom. There are various stages of data collection, coding and analysis with a grounded methodological approach. There are other approaches to grounded theory that recognize the value of participants in the co-construction of data with a researcher (Chun Tie et al. 2019). The implementation of grounded theory will be instrumental in understanding the theoretical and sociological role of kratom use in the United States.
By utilizing grounded theory, I am attempting to emerge a new theoretical understanding from the data without theoretical preconceptions (Timmermans & Tavory, 2012). Some may call this a weakness with grounded theory in that the process of induction has not delivered what it has promised with developing theories. However, in implementing grounded theory methodology, a researcher will immerse themselves in the participant’s world. Grounded theory offers useful tools with the organization of qualitative research. According to Timmermans and
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Tavory (2012), “grounded theory’s lasting contribution to qualitative sociology, provides
researchers with opportunities to develop novel theoretical insights” (169). In regard to my
research, I chose grounded theory because I wanted to explore and make sense of the data. I am
interested in the emerging themes that will come up through interviews. Kratom is relatively new
to the U.S., which is why using grounded theory is the best approach to studying kratom usage.
Kratom use and users have not been explored which leaves room for more theorizing.
Previous research from Coe et al. (2019) and Grundmann (2017) has shown that people use kratom for medical reasons, such as pain management and relieving withdrawal symptoms. My research project has the potential to explore these reasons further and highlight the social significance of kratom. If people are using kratom in a recreational sense, this then opens a much larger conversation around kratom use. However, if people are using kratom for medical reasons such as pain relief, it would lead kratom as a potential alternative towards holistic healing.
Therefore, grounded theory would be most appropriate for my research because it allows the research and theorizing to come from the data collected. Using a grounded theory approach lets the research question come out of the data collected. Grounded theory starts with interviews first and then has the theory come from the data. Using a grounded theory approach, I examined the data and tried to develop major themes from my interviews. Kratom has had little comparison to other substances in the U.S. which leaves room for more open critical discussion and contrast.
Implementing grounded qualitative research is necessary for this study because kratom is a new drug in the United States. Since there is so little social research on kratom users, I will be open to what participants want to share with me. My research has the opportunity to analyze kratom
users’ reasons for using and highlight whether there is a connection with social structures such as
rehabilitation or healthcare.
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To conduct this research, I used grounded qualitative research methods to answer: What are the overall experiences and reasons for using kratom and how do they navigate the semi- legality of kratom? The participants in my research project were kratom users who used kratom daily or weekly. Each participant shared their own unique experience during interviews. I am interested in understanding the rationale behind kratom use, the social world in which they use the substance, and how they navigate their use of this quasi-legal substance. I conducted interviews over Zoom at a place of the participants’ choosing. According to Lupton (2020),
Zoom interviews “can be conducted with audio-visual interactivity and textual synchronicity” to start a conversation. Phone or Zoom interviews were implemented to collect data on the reasons for kratom use. Interviews ranged from thirty to sixty minutes depending on how much participants were willing to share. Since this research project was conducted during the COVID-
19 pandemic, interviews were held over Zoom. What made online interviews different from in- person interviews was the role of technology in facilitating real-time co-presence and interactivity and the approach I took to build rapport and curate a conversation (Lupton 2020).
Qualitative methods were the desired method of research to further understand the rationale surrounding kratom use. Previous literature in the U.S. focuses on the pharmacology and toxicology of kratom, but not the people who use it. The use of semi-structured interviews allowed the researcher and participant to hold a semi-structured conversation. Utilizing semi- structured interviews provided the opportunity to solicit certain types of responses such as personal, lived experiences with period details in structures such as story based, historic narratives (Saldaña & Omasta 2018). Using structured interviews would have inhibited further discussion on questions that participants felt were most relevant to them. Semi-structured
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interviews allowed the conversation to flow more naturally while following a systemic order
(Saldaña & Omasta 2018).
RESEARCH DURING THE COVID-19 PANDEMIC
This research project has been adapted to the conditions imposed by the COVID-19 pandemic. This methods section shares the opportunities and challenges involved in conducting social research during the COVID-19 pandemic. Due to COVID-19, social research projects that
originally relied on face-to-face forms of human interaction to collect data, can no longer take
place due to the dangers posed by the pandemic. Qualitative researchers are now faced with
modifying their data collection instruments and have to consider alternatives methods to conduct
research. Qualitative researchers are relying on technology, online platforms or telephone calls
for data collection. These tools offer new opportunities, but now researchers must gauge their
methodological fit to their research questions, technical requirements, and ethical implications.
Some limitations to conducting qualitative research online are the difficulty of building
trust and rapport with participants and the inability to observe the social environment and body
language of the participants. According to Garcia and Barclay (2020), normal routines are
disrupted, as many people feel uncertain and worried. They may be ill or caring for ill family
members. Participants may be living in abusive households who may be subjected to harassment,
violence or surveillance. Being at home may not ensure correct privacy standards. For example,
persons in the background or objects showing personal information may pose an issue.
Confidentiality poses a big issue because how do we share qualitative data safely with the
consent of participants? Privacy issues are very important to consider in these circumstances.
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However, while people are more confined, feeling restless or bored, but in good health, they may welcome the opportunity to be a part of a research project (Garcia & Barclay 2020).
They may be more eager to share their experiences with kratom use. I noticed that many of my participants were willing share about their experiences with kratom. This research project will help determine what is the “new normal” for qualitative research in terms of adapting methodologies. Further insights will provide quality local knowledge.
Given the circumstances with the pandemic, there are bound to be dilemmas while conducting this research project. It was not that challenging to find participants, but there were limitations when it came to recruiting participants during a pandemic. I worried people would not want to participate in a study because they were concerned about their daily lives and would not have extra time. Building trust between participants posed a challenge due to the informal communication of email and Zoom. After finding my first participant, I utilized snowball- sampling to relieve participants’ anxiety about the interview process because someone they knew had already interviewed with me. In order to build a sustainable project and trust, I aspired to be genuinely myself with all my participants. Before each interview, I shared with my participants how I got introduced to this topic and why I want to study kratom users. This allowed participants to understand my point of view and reasons for interviewing them.
QUALITATIVE INTERVIEWS
Collection of Data
Before interviews begin, I reached out to participants with an information sheet debriefing them of their various options in participation and obtained informed consent. For this research project, I utilized semi-structured Zoom or telephone interviews. During interviews, I
32 asked questions regarding history of kratom use, preference, reasons, and thoughts on criminalization of kratom, and changes in their kratom use since the pandemic. My goal with the semi-structured interview questions was to allow participants to openly discuss their experiences and reasons for using kratom (see Appendix A for my interview questions). Interviews ranged from about 30 to 60 minutes and were recorded using Zoom video or Zoom phone. Interviews were audio recorded through Zoom call and or video recorded through the Zoom video meeting.
Participants were reminded that they had the option to stop and request to delete any recorded material at any point in the interview if they changed their mind about being involved in this research study. There was no incentive to complete the interview.
Interviews with participants were informative and casual. I interviewed participants so they could share what they felt was most important about their kratom use. Semi-structured interviews provided participants the opportunity to share their views and beliefs regarding kratom. I told my participants that they would be provided with a link to the final culminating experience once it is available online. The reason for choosing qualitative research methods was to understand the presence of kratom on a personal level by learning from the very people who use kratom. I would not be able to capture the emotion or reflection had I implemented quantitative methods. The open-ended interview allowed participants to guide the conversation to areas that they found most important. Participants may have been wary about interviews which may have led them to withhold information. To get participants to speak more on a question, without pushing boundaries, I would probe participants to further elaborate and engage in the conversation.
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Sampling
The participants of this study were active kratom users and locals of San Diego county.
There is a current kratom ban in the city of San Diego and the IRB suggested I stay outside of
San Diego city to recruit participants to keep the risk level of my study appropriate for the
exempt application I submitted. My key participant, Childan, put me in contact with local kratom
vendors and other individuals that use kratom. I then distributed flyers at various kratom vendors
in North County San Diego to reach potential participants. After interviewing participants, I utilized snowball sampling to find other kratom users who could be potential participants as well.
Snowball sampling was instrumental in finding four participants for my research project. I also had success in finding four other participants by distributing flyers at various kratom vendors in
North county San Diego. The only challenge with distributing flyers was that I had to wait for participants to reach out to me. I had collected an even number of participants by distributing flyers and utilizing snowball sampling.
Snowball sampling is a method used among researchers “in which participants are asked to recommend other similar participants to take part in the study in order to gain a larger pool of participants than the researcher had access to” (Saldaña & Omasta 2018). When a population is difficult to reach, snowball sampling is a popular method to utilize. Some limitations to snowball sampling include participants may be difficult to locate due to the pandemic. This was the case with one individual I was in contact with for a brief period. Snowball sampling had put me in touch with an additional individual from one of my participant’s contacts, however, the connection fell through and I had to move forward with this study.
My rationale for using snowball sampling was to have more accessibility to kratom users through my participants. The use of snowball sampling turned out to be more diverse than
34 expected. I utilized my participants’ contacts and they have diverse contacts in their social circles. For this research project, it was my goal to find people who use kratom for various reasons, such as pain management, relieving withdrawal symptoms, anxiety or depression or if they use kratom recreationally.
At the end of my interviews, I collected demographic data such as age, gender, ethnicity, employment status, and education (See Table 1). My sample population was representative of the kratom user community. The kratom community is comprised of many walks of life but is mainly made up of white men according to surveys like Grundmann (2017) and Coe et al.
(2019). There were three women (37.5%) and five men (62.5%) that made up my population sample. The average age of my participants is 29.1 years old and the mode age of my participants is 24 years old. I had six participants who were in their early to late 20s. Breaking down the race/ethnicity of my sample population there were five white (62.5%) participants, two
Hispanic (25%) participants, and one Chinese American (12.5%) participant. As far as education, there were three who had their Bachelor’s degree (37.5%), two working on their Bachelor’s
(25%), two with an Associate’s degree (25%), and one with their High school diploma (12.5%).
My sample population was split evenly between those who worked full time versus who worked part-time.
My participants’ reasoning for kratom use was also representative of the kratom community and was recorded in the interviews. However, I found that my participants all used kratom for different or similar reasons. To better understand kratom’s role in society, hearing from users themselves is crucial. Their experiences and reasons for kratom use sheds light onto the underlying issues of our society. Through my research I was able to document larger structural forces at play. It is important to consider that their reason(s) for kratom use are
35 personal, and I want to honor my participants by hearing their story and the kind of relationship they have with kratom. Some limitations with this sample include lack of internet access, feeling uneasy discussing kratom, and living through a pandemic. This is where grounded theory became useful with the process of being open to what participants shared. Some benefits about this study include an open invitation to reflect on their journey so far with kratom.
PARTICIPANTS Demographic Characteristics:
Name Age Gender Race/Ethnicity Highest Degree Current Completed Employment Anthony 24 Male White Bachelor’s Full-Time Degree Bonnie 22 Female Chinese Working on Part-Time American Bachelor’s Degree Booker 27 Male White High School Full-Time Degree Childan 24 Male American/ Associate’s Part-Time Hispanic Degree Jacob 24 Male White Associate’s Part-Time Degree Pearl 51 Female Hispanic Bachelor’s Full-Time Degree Lauren 28 Female White Working on Part-Time Bachelor’s Degree Sean 33 Male White Bachelor’s Full-Time Degree
Coding and Analysis
I began the coding process by keeping a log of memos after each interview. This helped me keep track of the overall themes or points made during the interviews that fit my research question. As interviews went on, prominent themes emerged out of my participant group.
Interviews were downloaded from Zoom and transcribed by me to ensure the transcription was exactly as stated during the interview. The transcripts were scrubbed of any identifying
36 information such as names, workplaces, and hometowns to ensure participant’s total confidentiality. Participants were given pseudonyms to protect their identity. I gave participants the options to choose their own pseudonym, but only two chose a pseudonym for themselves, which were Booker and Childan. Data will be retained for up to three years from the interview date. After three years, all electronic copies will be destroyed and disposed. Paper copies will be shredded.
Once I transcribed the interviews, I coded the text using inductive and deductive methods. The inductive method was used on the themes that emerged from the data such as kratom introduced through participants’ social circles. The deductive method was used for themes that emerged from the literature review of this study such as kratom used as a way to manage pain. After transcribing the interviews, I used open coding to highlight and code responses that fit my research question. I initially highlighted all the significant quotes in yellow highlighter to narrow down my quote hunt. The codes were decided based on my initial research in preparation for this thesis and what was echoed in the literature review. Through the use of open coding, I was able to explore how people experience kratom in their everyday life and how they navigate the semi-legality of kratom.
After interviewing and reading the transcripts, I discovered some of the main themes that were prominent all throughout the interviews. These themes were later used to create the findings section for this study. While reading the interview transcripts, I highlighted and coded responses that resonated with myself and all the participants in this research study. Some of the themes that I came across during interviews were: kratom was introduced through social circles, discreetness, addiction, opioid use, withdrawal symptoms, kratom used as an alcohol deterrent, pain management, ADHD, productivity, coffee, and the business side of kratom. I also coded
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responses with reactions such as holistic alternatives to pharmaceuticals, kratom as a substitute
for other substances, criminalization does not deter participants from continued kratom use, and
kratom used to kick start days. Anytime these codes were mentioned, they were highlighted and
organized into a separate document. It was from these different codes I attached to quotes that
provided meaning and highlighted the intersecting issues experienced by kratom users. These
codes shaped the themes sections in the findings. I used this process to create a coding scheme
for which the data were categorized. After completing the transcription and coding process, I
developed three themes that illustrated the main findings of the research study.
Reflexivity
Before conducting my research, I reflected on my positionality towards kratom. I do not use kratom, which makes me an outsider. Additionally, I do not have health issues that could lead to chronic pain or opioid misuse, which is often the reason for kratom usage. However, I found that my positionality did not hinder participants from sharing their stories with me. My connection with kratom users is personal in the sense of wanting to understand kratom use on a deeper level. As a researcher, I must reflect on my interpretations of the world prior to commencing research. Since I do not use kratom, I may not be aware of crucial aspects such as dosing habits, preference and how they navigate judgement from others for using kratom. Even though kratom users hide their kratom use from outsiders, I found that my participants they were more than willing to interview with me and happy that I was researching kratom. I had a number of participants thank me after the interview for showing interest and shedding more light on the use of kratom. Receiving gratitude from my participants kept me motivated in completing this research project.
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Being an independent and non-judgmental outsider poses an issue with navigating this
topic. The outsider role, addressed by Adler and Adler (1994), is an effective method of building
rapport with participants and increasing opportunities for in-depth discussions and observation of
‘everyday actions.’ The outsider member role has the advantage of not judging the individual,
but objectively observing events and gathering data. As an outsider, I felt like the kratom
community was more than willing to share about their struggles and experiential knowledge
regarding kratom use. For example, my participant Sean was very open about his past drug use
and how kratom helped reduce the cravings of drugs. I had another participant Childan share
about the struggles he had with his excessive consumption of alcohol. Lastly, Pearl was willing
to share her story about how an accident led her to start using opioids to manage her chronic pain
and kratom had helped her wean herself off opioids. These are just a few examples of how my
role as an outsider did not deter my participants from sharing their stories.
One strategy I used to minimize the effect of being an outsider included; I informed all
my participants about my key participant Childan, who has been useful in helping me understand
the basics of kratom. This helped participants with sharing their experiences because I have
knowledge and close relationships with another kratom use. I assumed right that informing my
participants about my relationship with my key participant made them feel more at ease with the
interview process. Making the interview a casual environment helped participants share their
experiences in a non-judgmental way. The above strategies were useful in minimizing the
potential researcher effects of this research project.
Another aspect to my social location is that I am a white college-educated woman, which has a combined set of statuses that might hinder participants, specifically male participants, from opening up or sharing their experiences with kratom. I understood that these issues may have
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been a potential barrier to connect with my participants. However, I strove to be a non-
judgmental outsider. I found that my researcher role and social location did not deter my
participants from opening up about their experiences with kratom, including male participants.
Often times people do not know what kratom is outside of their social circles and my participants
were happy to share their knowledge regarding kratom use. I was open with my participants, so
they know where I’m coming from and why this research is important to me. Also, I do
understand the struggles people face in their daily lives. I found that participants, including male
participants, were not shy about opening up to me about their past relationships, addictions, and
health issues. My goal is to amplify the experiences of the participants in this study so that their
stories could be heard. By utilizing a grounded qualitative approach this project will help better
understand the social world of kratom use. This project explored what kratom’s role is within our
country. Much of the literature previously on kratom focuses on the pharmacology of the plant
but has missed the perspective from the individual’s that use kratom. This project helps fill in the
gap of research around the social worlds of kratom users.
Limitations
I encountered some limitations while conducting this qualitative research. One of the
limitations to this study was that the research was conducted during the COVID-19 pandemic.
This meant that the interviews had to be done over the phone or virtually through Zoom. Due to the informal communication through email or text messaging, building trust or rapport with participants was something I was concerned about. However, I found that once we were in touch, my participants were more than willing to share their kratom story and even thanked me for doing this kind of research. This validated why I am conducting this kind of research.
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Using a software like Zoom, I came across some hiccups during interviews. Some days
my internet connection was not the best and my participants could barely hear me through Zoom,
and I had to use headphones with a microphone. Other times the internet connection would lag
out and participants did not hear the question I had asked, and I would have to repeat the same
question. Little things like internet connection were an issue that would not be a problem if
interviews were done face-to-face.
In regard to recruitment, I had to wait for potential participants to reach out to me after
leaving flyers at various kratom vendor locations. I was worried that people would not want to
take a flyer because they could be potentially exposing themselves and their loved ones to
COVID-19. This meant that I was waiting and hoping that people would remember to reach out
and follow through with the interview process. This was the case with many of my participants
who had reached out to me after picking up a flyer.
Another limitation to this research was using semi-structured interview questions. There
are advantages and disadvantages when it comes to using semi-structured interview questions.
One of the disadvantages was that participants may have constructed responses to questions that fit the needs of the research. Another disadvantage being that certain questions from the interview may have deterred the participants from sharing something they did not feel was relevant. Another limitation was that most of my participants were men. I had 3 women and 5 men for this research project. I would have liked an even number of men-to-women ratio or even gender non-conforming people, but that is not what my sample came to be.
This research method will highlight the issues kratom users face in their everyday lives.
Qualitative research methods provide a look inside the life of a kratom user and what they may
41 experience. Due to new COVID-19 restrictions, this research project has been adapted to meet new measures. My goal with this research project was to amplify the voices of kratom users and change the narrative around kratom use. Hearing what they had to say and analyzing participants’ responses with the tools provided by symbolic interaction and labeling theory was the overarching purpose of this study. This study will display what kratom’s purpose and role is in U.S. society. My positionality as a white female researcher may have hindered participants from sharing their experiences. I was as open and honest as possible with my participants and hopefully reached through to them about why this project was important to me.
FINDINGS
“In my experience, kratom has three attributes, that is consistent across, no matter what strain you get because there are three basic strains of them, and those three attributes would be a small amount of pain relief. The second would be I guess what I'd call like a mood enhancer or like that motivator or you know slash anti- anxiety situation. Where you're not you know you're not anxious or it gives you a I know I just said it, but the motivation to go do something, and the third attribute I'd say would just be some energy, a stimulant” (Booker).
Booker has been using kratom for over ten years, and like many of the kratom users I interviewed, he highlights the multiple reasons why he uses kratom. While interviewing kratom users, I discovered several themes including the social significance of kratom, criminalizing kratom, and using kratom as an alternative to other drugs. These interviews displayed the similarities that exists in the kratom user community. This project highlights how people view kratom, pharmaceuticals, and the use of substances. The purpose of this project was to understand the reasons for kratom use and significance of kratom in my participant’s lives. In this section, I will be discussing the findings of my research on kratom users. Qualitative interviews allowed for a look into the complex lives of kratom users. This research project gave
42 me a new perspective of how kratom users implement kratom in their lives. All throughout the process of interviewing kratom users, I discovered several themes that kratom users experienced similarly or differently. The three major themes of my findings include the social significance of kratom, reasons for kratom use, as well as the criminalization of kratom. In regard to the social significance of kratom, I am referring to how people learn and think about kratom through their social circles. The second theme of my findings explores the reasons for kratom use with my participants. With the criminalization of kratom, I discuss how criminalizing shapes how people use kratom and criminalizing does not deter continued use of kratom. These three major themes highlight the experiences of kratom users living in southern California.
THE SOCIAL SIGNIFICANCE AND LEARNING OF KRATOM
There is a social aspect that comes with learning about kratom. What I gathered from my interviews is that learning about kratom happens in small social settings. Social interaction leads to new connections, conversations, and experiences. People in the kratom community are willing to share their experiences with kratom. The way people are introduced to kratom is through social circles from friends or colleagues. I found that these friends are usually close in age and willing to share their kratom with other people. For instance, Childan learned about kratom from a neighbor; “Our next-door neighbor he was close to my age or he was like a little older than me and he was recommending kratom.” Childan had a history of past substance use and was looking for alternatives to end his use of substances like alcohol. His neighbor had mentioned that kratom may be useful for what he was looking to accomplish.
Kratom is relatively cheap and you can purchase a small pack for $12 or a large pack for around $25. Some people learn about kratom from the internet and informational websites. In my own experience I learned about kratom from my key participant Childan who uses the substance
43 as a coffee substitute in the morning. I found many groups on websites such as Reddit and
Erowid.com with kratom forums discussing all things kratom. There is a large kratom community online where people share what has worked best for them regarding kratom strains and dosages. This community is welcoming and understanding of one another’s needs. I have had interactions with members of this community both online and in person. Kratom usage is a product of interaction both face to face and online. Even though kratom is introduced in all kinds of ways, I found that word of mouth was the most popular way of learning about kratom aside from the internet. This is because in the U.S. kratom is not relatively well known.
Seven out of my eight of my participants were introduced to kratom through their social circles. My participants’ social circles are abundant with knowledge regarding recovery, herbal medicine as well as natural remedies and practices. Five of my participants were introduced to kratom because of an existing health issue such as alcoholism, opioid dependency, and mental health. Pearl, who is a registered nurse shared how she learned about kratom:
I actually heard it about two years ago, when I um I was actually at the Four Seasons in a swimming pool with another group of ladies and we started sharing how I you know I had been on high doses of opioids two years ago, and how I had tapered off, but I still have was still dealing with chronic pain, and um she had been in an accident and she also same thing, she was on high doses of opioids and her husband, she was starting to get sick coming off the opioids and her husband had told her about kratom.
Pearl and the woman she met shared a similar experience being prescribed opioids to manage their chronic pain. This story “tickled” Pearl’s ears and resonated with her. Pearl was looking for relief from the chronic pain she experiences daily in her back and shoulders. She was using opioids to manage the pain and noticed that she began to build a tolerance and would have to take more to get the same pain relief as before. This
44 encounter with the woman in the pool gave Pearl the opportunity to try kratom which is a non-traditional substance for pain relief.
After the initial introduction of kratom from friends or colleagues, people who use kratom tend to continue using kratom behind closed doors. People who use kratom often do so alone, so they tend to keep their use on the down-low. For instance, Pearl prepares her kratom in a hot tea and drinks it before she has to go to work. Since this research project was done during the COVID-19 pandemic, Pearl has been working from home as a case manager. She uses kratom three to four times a day to alleviate her chronic back pain while working at a desk for most of the day.
Like many of my other participants, Lauren was first introduced to kratom from a friend. “I didn't really think a whole lot about it until a few years ago, when I had a friend who just had like a bottle of the capsules in like their medicine cabinet. When I tried it once and I was like ‘oh, this is really not like a big deal’ or you know, like something scary or the way that I thought it was”.
Lauren became curious about kratom because she had heard of it through the internet and friends.
When she tried kratom with her friend, she had a mild kratom experience. Later, Lauren was reintroduced to kratom while in college, “I had heard of it before, but I had never like taken it or use it or whatever, but a friend of mine, a classmate of mine had some.” Lauren was experiencing high anxiety one day at school, and after these two experiences, she sought out kratom out on her own. I asked Lauren “How did you know how to use kratom?”:
I did most of it like I went online and was just like Googling and just like various people like online and like Reddit and all those places where people kind of talk about. Talk about that kind of stuff, like my friend just gave me a couple of them I don't think she was like super familiar that first time with like how much you were you're supposed to take or how much I should have taken or whatever.
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So here we have Lauren learning the basics of kratom from her friend as well as doing her own additional research. Since kratom interacts with individual’s system and metabolism differently, this could explain why her friend was not sure about the dose that Lauren should take. One person can take two grams of powder kratom and feel the energizing effects, while another person can take two grams and not feel anything.
Learning about kratom can happen through friends, colleagues or even the internet. I found that my participants’ social circles are abundant in knowledge surrounding substances and recovery. It is common for people to deal with their own substance use and addiction. When friends or colleagues recognize the signs of substance abuse it is only natural to want to aid those struggling. This was the case with one of my participants, Booker. He had learned about kratom from a family friend:
I graduated high school and moved out to California and lived with my father and my father had a friend who ran multiple businesses, one of which was a kratom company and he was nice enough to hire me on the spot. And yeah that's how I got introduced, I had no idea what it was especially working there for over a month or so before I even tried kratom or really knew what it was, I was just kind of in the back end doing random stuff for them. But yeah, I tried kratom, and you know it's probably close to 10 years ago and still really enjoying it.
For Booker, who grew up in a small town in Connecticut, moving out to California was a great opportunity for him. He had never heard of kratom before, yet he got a job working for his father’s friend. After learning the ropes of working in the kratom business, Booker went to start up his own kratom business with his brother and business partner:
I mean my brother who I run the kratom business with now he moved out to California, maybe three or four years after me and he needed a job, so I got him a job doing sales for the company and I, so I introduced him to it, and he didn't know what it was, and now you know, he was kind of a partier when he moved out here drinking a lot doing stuff like that kind of similar how I was back in high
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school. And he found kratom when I showed him I showed him kratom he kind of took on that that health and wellness lifestyle like he completely 180’d his lifestyle into this natural products and stuff like that, and now he you know that's his whole life he's very enthusiastic and passionate.
Through social interaction, people are not only introduced to kratom, but also, they are taught a
narrative that justifies the substance as a healthier alternative to traditional medicine and street
drugs. Booker told his brother about the job he had working in a California kratom warehouse.
Booker’s brother later moved out to California and went through this party and drinking phase.
After Booker had introduced kratom to his brother, he took on a completely different lifestyle.
He was no longer partying or drinking every weekend. Booker’s brother began to live a more
holistic lifestyle. Holistic is defined as “relating to or concerned with wholes or with complete
systems rather than with the analysis of, treatment of, or dissection into parts” (Merriam-
Webster, 2011). What I have learned in conducting this research project is that kratom can help
people avoid using other substances which I will discuss further into this section. For Booker’s
brother, kratom helped him not have that urge to go out drinking and partying all the time. This
is one of the benefits of incorporating kratom into one’s life in the eyes of some participants.
Similar to Booker’s brother, Childan had a similar experience with partying and drinking
on the weekends with his friends. Childan had a phase of abusing alcohol in his early twenties.
His neighbor recommended he try kratom to help him end the alcohol abuse. Childan explains
how kratom has been helpful to him; “That's kind of like where the position I was I needed something to help me get things done and stay consistent with all the work I need to get done every day from school to music to going out with my friends at the time, people were going out every single weekend like party or hang out and listen to music, so it just kept the continuous vibe goin.” For Childan, kratom was what kept his continuous good “vibe goin” throughout his
days and nights. I would describe a good vibe as a positive, happy and safe feeling perceived
47 from people, places or ideas. Many young people face peer pressure to party and drink in social settings. Childan experienced this because his friends were going out all the time and not wanting to feel left out, Childan would partake. So instead of drinking alcohol, Childan began to use kratom, which he viewed as a healthier alternative.
For Childan, kratom is “helpful for me to maintain a solid stable mindset. Especially in social situations when I have no energy to mingle or give people my energy.” Kratom has given
Childan a whole new experience when going into social settings. Kratom can give users energy and stimulating effects which can be used for being more productive, social and active. This is one of the many reasons why kratom is so attractive to people. Kratom has the ability to keep users away from other substances while also uplifting their mood and energy. Childan and
Booker are great examples of why kratom can help improve people’s lives. Even though kratom use is seen as a positive influence by Childan and Booker, they are not fond of sharing their kratom use with just anybody.
KRATOM AS AN ALTERNATIVE TO DRUGS
The second theme of my findings will discuss how my participants have used kratom as an alternative over using other drugs. My participants have given their testimony reporting the several benefits of kratom in managing their pain, opioid use, consumption of alcohol as well as coffee. Kratom has become much more widely used as a way to curb the cravings of other substances such as alcohol and opioids. My participants revealed that they used kratom for a variety of reasons, which included, managing chronic pain, managing ADHD, as well as reducing intake of alcohol, opioids and coffee.
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Alcohol Cessation
Alcohol is a well understood substance and while it is poisonous it is still legal to drink in the U.S. Alcohol is a very well-known substance and there is no mystery around how alcohol works in a human’s system. Although there are laws and regulations surrounding alcohol based off of user’s age and how much can be consumed, alcohol has become a major part of American culture. I had three participants, who use kratom to curb their alcohol cravings and addiction. In preparation for this project, I had heard that kratom can be used as an alternative to curb alcohol cravings. One of my participants Childan, used kratom to get over an alcohol addiction. Childan shared:
I would do kratom instead of drink alcohol because it's healthier than alcohol, in a sense. I would prefer kratom over alcohol. Alcohol it leaves a nasty feeling in your body but kratom has no hangover unless you take a lot and I don't take a lot. I do know people that have taken nine to eleven grams every day and I've done that, for years, that is very harmful for your body. It's people who are not good with um who aren't like used to their own addictive habits, they fall victim to their addictive pleasures.
This comment captures how kratom users prefer to use kratom over other substances like alcohol or opioids. Here Childan understands the harms that both alcohol and kratom can do to his body. Childan said “alcohol leaves a nasty feeling in your body” because he recognizes the effects of alcohol within himself and viewed kratom as a better alternative.
Although kratom can be abused, it would take a significantly large amount and frequent dosing to incapacitate a person. In the U.S., our culture has normalized the consumption of alcohol, but has many restrictions against it. For example, you have to be twenty-one years old or older to purchase and consume alcohol in the U.S. Our states and government have put forward these laws because of the dangers that over-consumption of alcohol can lead to. According to the National Highway Traffic Safety Administration,
49 every day, about 28 people in the U.S. die in drunk driving crashes, that’s one person every 52 minutes (nhsta.gov). Alcohol is absorbed directly through the walls of the stomach and small intestine. Then it passes through the bloodstream until it is metabolized by the liver. A person’s alcohol level is measured by the weight of the alcohol in a certain volume of blood. This is called the Blood Alcohol Concentration
(BAC). If a person’s BAC goes over .08 gram of alcohol per deciliter (g/dL), drunk driving crash risk increases exponentially. We know all this because of the research and science that went into studying the effects of alcohol on the body.
Now imagine if this kind of research went into studying kratom and the effects on the body. We would understand kratom in a whole new light and confirm whether or not kratom can be used as alternatives to kicking opioid, alcohol and narcotic addictions. The kratom community has claimed that kratom is helpful in aiding manage chronic pain, withdrawal symptoms and addictions, but all of these claims are anecdotes from kratom consumers. Kratom has the potential in helping people better themselves. If we were able to research how kratom interacts with the human body and brain, then we could confirm the claims of kratom consumers. Kratom and alcohol are similar in the sense that both communities who partake, recognize the dangers that can come out of consuming too much. Consuming too much kratom and drinking too much alcohol can impair a person’s functionality.
Childan also shared that kratom “satisfies my brain chemistry in the fact that it doesn't let me want to take opiates or want to take alcohol like I feel satisfied and content, but it doesn't have to do with my social life or my being at all, it just has to do with my intake of drugs. You take it and you don't want to do any other drugs basically.” What
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Childan says here is truly incredible. For people who may struggle with drug use or alcohol abuse, kratom can be an option that can alleviate those cravings. This was the case with Childan, he had been using opioids and alcohol because the kratom made him feel content. There is something that kratom does with Childan’s brain chemistry that makes him not want to consume any other substance such as alcohol. We do know that kratom interacts with the mu opioid receptors in the brain which is the same as opioids.
The fact that Childan said “you take [kratom] and not want to do any other drugs basically” is what I want to highlight. This can be beneficial to those who struggle with drug abuse and addiction. Even though Childan claimed that kratom makes him not want to use other substances, he has also recognized that kratom has abuse potential earlier in this findings section. Kratom may not be a solution for everybody but it can be an option for people struggling with Opioid Use Disorder and alcohol abuse.
In our interview, Sean had mentioned that he wanted to cut back on his alcohol consumption. Sean later shared, “I take it before I surf as like a workout enhancer and then recently, I've just been stunned it like totally kills my alcohol cravings it doesn't seem to be it doesn't matter really what strain I do take it daily.” For Sean, he had been working on his relationship with alcohol and surprisingly kratom eliminated any kind of alcohol cravings he would experience. Sean had mentioned that kratom, “totally kills my alcohol cravings, or I don't think about it, so that has been like a total life changing thing.” This benefitted Sean because he was at a point in his life where he does not need alcohol anymore. Based on these two participants, it is clear that kratom is a substance that can help people having issues with an alcohol use disorder. Kratom helped Sean to feel like he no longer needs to have any more alcohol. Later on, Sean shared; “you know it helps me kind of get similar social effects, but it
51 really just like kills any alcohol cravings it's crazy.” Even though using kratom for alcohol cessation was not Sean’s intention, it was an unexpected bonus that benefitted him. Two of my participants in this research study had mentioned that kratom can be used as a tool to curb alcohol cravings. I thought this was really interesting because alcoholism is a present problem in
America. Later in our interview Sean shared, “I just think it's really misunderstood, I think it does have the potential for abuse, but I mean if you look at the risk reward for I mean for so many people it totally changes their lives mine included in ways that I wasn't even expecting like the alcohol cravings.”
As mentioned earlier many of my participants used kratom for boosting their energy and mood. In our interview Sean shared, “I use it, you know I think it's great for energy for anti- anxiety for mood boosting stuff for focus and concentration and then, more recently, as an alcohol craving cessation kind of tool”. For people who use kratom it is multifunctional by booting energy, mood, focus while also satisfying cravings of alcohol and other substances. My participants have made it clear that kratom can be used as an alternative to drugs and substances.
Sean had also shared, “And I thought it was cool, but didn't touch it again for years until a friend, had it and she said she was going out, and she was going to take that instead of drinking or something I was like oh that's cool”. Sean and I were talking about how he was introduced to kratom and he said a friend of his had been using it instead of consuming alcohol. This circles back to early in my findings of how my participants’ social circles have valuable knowledge and resources. This female friend of Sean’s decided to use kratom instead of drink alcohol which is similar to Childan’s situation as well. For Sean and Childan, they both believe that kratom is a better alternative for them than alcohol.
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Here we have Lauren who is uses kratom as a way to relax. For Lauren she is not a big
fan of other substances like marijuana or alcohol, so she uses kratom instead. Lauren shared:
I like it, as far as like I'm not a huge drinker. I don’t like being hung over and I don't like the way it makes me feel and stuff and I'm also generally not into like some of the more common recreational stuff like marijuana or whatever, but um kratom is nice I don't know it's just it's like something to do to relax, but that doesn't make me like I prefer the way it feels compared to like weed or alcohol.
Lauren’s case is similar to Childan’s in the sense that they both would prefer using kratom over alcohol. This is similar to Childan’s reasoning because alcohol “leaves a nasty feeling in your body” and can leave consumers feeling hungover and nauseas.
However, kratom is a natural plant with over twenty-five different alkaloids in it which is enhances mood and energy for users.
Kratom: The Perfect Cup of Coffee
Through interviewing my participants, I found that three had used kratom as an
alternative or enhancer to coffee. This is possible because kratom and coffee both belong to the
Rubiaceae family. Since kratom and coffee belong to the same family they are similar, but
different in many ways. “The coffee family (Rubiaceae) is essentially tropical and comprises an
estimated 13,000 species” (Wikström, Avino, Razafimandimbison, and Bremer, 2010). Since kratom
and coffee are distant cousins, it explains why the effects of kratom are similar to coffee. One of my
participants Booker compared kratom to coffee and shared, “When I describe kratom to people I
describe it as having the perfect cup of coffee, where you drink it you're in a great mood your
social you know, sometimes you're more motivated to do stuff.” Booker is a long time kratom
user and is involved in a kratom business. I enjoyed how Booker described kratom as the perfect
cup of coffee. Many people use kratom as a coffee alternative and Booker is well aware of this.
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Kratom is close to coffee in comparison because both coffee and kratom can give users the stimulating energy.
When interviewing Booker, we began to talk about kratom and coffee, Booker explained;
“usually if I take kratom I don't follow it up with a cup of coffee just because kratom is you know does give you a little bit of energy, so it just kind of unnecessary to double down on that for me.” For Booker, kratom is a coffee alternative. Booker does not enjoy the combination of coffee and kratom together because they are both stimulating, and the combined effects can be a little uncomfortable for Booker. Further into our discussion about coffee kratom Booker mentioned; “I wouldn't say I like to have kratom and then drink a bunch of coffee or anything like that, if anything, it's more of like a substitute for like a cup of coffee.” Booker prefers not to mix kratom and coffee together in his system because doubling up on the two is unnecessary in his eyes. This is not the case for everyone, but Childan is similar to Booker with his coffee and kratom preference.
Childan is an example of someone who uses kratom to kickstart his mornings. I asked
Childan, when he takes his kratom does he said; “It fits in my last similarly to coffee, I mean when I need it, like most people when they need their coffee they take it and you don't take coffee all day or else you’ll be caffeinated all day it has its uses.” Childan will usually take his dose of kratom in the morning and potentially again in the afternoon depending on what he has going on in his day. But for Childan, kratom is like how other people have a cup of coffee in the morning. Kratom helps kick start his day and stay motivated to accomplish errands or goals.
However, the most he will consume kratom is two times a day maybe three. This is because regular consumption of kratom can increase one’s tolerance to the substance. In order to avoid an
54 increase in tolerance to kratom less frequent dosing is optimal. It is a good idea to try and keep one’s tolerance to kratom down, so they do not have to increase their dosing amount to achieve the same effects.
In his earlier years, Childan had experienced a high intake of substances such as alcohol and caffeine. Kratom helped Childan completely quit his intake of both coffee and alcohol.
Childan shared that he used kratom, “In replacement to things like hangovers from alcohol and bad coffee habits, I used to drink a lot of coffee working at [a Coffee Shop]. Kratom helped me get off of everything.” For Childan, kratom was a good replacement for coffee and alcohol. Since kratom and coffee are related, kratom can help ease people off a coffee habit. This was the case with Childan when he worked for a coffee shop, he had large amounts of caffeine at his access.
This enabled him to consume coffee more regularly and he recognized that his coffee consumption was getting out of hand. Childan later turned to kratom as a way to curb those coffee cravings, but still give him the energy and boost that he needed to work.
I knew people have been using kratom as a substitute for coffee, but I was unaware that some use coffee and kratom together. This was the case with one of my participants Sean. I heard that kratom and coffee are substances that work well with one another. The only time I had encountered this was my first trip to a local kratom shop. This older gentleman walked in and purchased a couple of kratom tinctures as well as an espresso. My key participant Childan was with me at the time and he said some people will use kratom and coffee together. My interview with Sean had later confirmed that some people enjoy the combination of kratom and coffee.
When we were discussing Sean’s kratom use he shared; “I find that kratom has a nice synergy with coffee and I'll take like L-theanine with coffee to help with that sometimes but I drink coffee for the productivity and but if I get anxious I can't focus so kratom helps me keep that
55 anxiety level down, so it definitely has a synergistic effect.” L-theanine (γ-glutamylethylamide) is a non-protein amino acid found in species of Camellia and a “major amino acid in tea and is thought to be a flavourous constituent of tea leaves” (Nobre, Rao, Owen, 2008: 167). L-theanine is mainly known for its relaxing capabilities while reducing anxiety, stress and insomnia. Sean had mentioned L-theanine because it can be used with coffee to increase focus and attention.
These findings suggest that kratom is not only used as a coffee replacement, but as a coffee enhancer.
For Sean he enjoys drinking coffee, but it can make him anxious. So, Sean takes kratom to relieve the anxiety he may feel from drinking caffeine. Sean further explained this, “I drink coffee for the productivity and but if I get anxious I can't focus so kratom helps me keep that anxiety level down, so it definitely has a synergistic effect and I'll just have I'll have like you know one strong cup of coffee, with a couple scoops [of kratom] in the morning.” As mentioned before, coffee and kratom belong to the same family, it makes sense that they can work synergistically. I relate to Sean with coffee because I have a similar experience. Caffeine from coffee can make me anxious so I choose to not drink coffee. So, Sean will use kratom to lower the anxiety levels he experiences from drinking coffee. Sean also shared; “I'll use kratom to have energy but also take the kind of take the edge off the caffeine, a little bit.” In my interview with
Sean, I learned that coffee and kratom work together synergistically. For Sean this was a bonus because he enjoys both coffee and kratom. But for someone like Booker or Childan, the combination of coffee and kratom can be too stimulating.
Many people in the U.S. drink coffee to kickstart their morning routine and give them that extra boost. Coffee is a very popular substance, but no one gives a second thought that caffeine is in fact a drug. If you take away a regular coffee drinker’s morning cup of joe, they
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will experience irritability and headaches. I know this firsthand because I used to drink coffee
regularly. When I decided to quit drinking coffee in 2020, I experienced mild withdrawals
symptoms for about one week. Some of the withdrawal symptoms included headaches, body
aches, upset stomach and irritability. Although these withdrawal symptoms were mild, I
remember being very uncomfortable during this detox. In my interview with Sean, we continued
our conversation about kratom and coffee which he said, “I take it, just like a cup of coffee like you're saying I use it with caffeine, because I find it helps with anxiety.” Sean is an outlier in this part of my research in that he uses kratom and coffee together. The coffee gives him energy and anxiety while the kratom calms down the anxiety levels. As we continued our conversation about coffee and kratom, he said; “But I think that kratom has a huge potential to be used in place of alcohol or even in place of coffee or something like that.” What Sean says here holds some truth.
Kratom can be a good alternative to other substances like coffee and alcohol. Kratom has the potential to replace other substances like coffee or alcohol or even curb the cravings of these two substances.
Bridge off Opioids
Americans have used and abused prescription opioids. The United States is knee deep in
what is known as an opioid epidemic. In 2014, opioids were involved in 28,647 deaths, or 61%
of all drug overdose deaths; the rate of opioid overdoses has tripled since 2000 (Rudd et al.
2016). Opiates tend to be regionally based with problems surrounding rural areas of the United
States, especially in Appalachia (Griffin and Spillane 2012). Opiates or prescription painkillers
are prescribed to people who need help managing pain while doctors know how addictive the
pills can be. Opioid dependence is considered a chronic, relapsing disorder that leads to
increased morbidity and mortality (Garcia-Portilla et al. 2014). Opioid dependence has been
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associated with impaired daily functioning, quality of life, and has social and economic
consequences for users.
Kratom behaves as a partial mu-opioid receptor agnostic and binds to the same receptors as opioids. Since kratom interacts with the same receptors in the brain as opioids kratom is able to alleviate some of the withdrawal symptoms opioid users make experience when they stop using opioids. This is why many people are drawn to kratom to get off opioids. “Current estimates suggest that more than 5 million people in the United States are using a substance called kratom to treat a wide range of ailments, including chronic pain, opioid use disorder
(OUD, formerly termed opioid addiction), mood disorders, and insomnia” (Wadehra 2020).
During our interview, Pearl shared, “For people that are dealing with any type of abuse, you know any kind of abuse of drug abuse or if this is a way to help them bridge over to not using anything, then that would be helpful, you know saving some lives.” Kratom can be used as an alternative for people who were dependent on opioids while managing their chronic pain.
Childan explained that with kratom, “I feel like it helps people with addiction once you're on it, you don't get the feeling of wanting anything else.” As mentioned before this is because kratom interacts with the partial agnostic mu-opioid receptors in the brain which satisfies any kind of
drug craving. Childan also shared that “kratom is the next um replacement to um getting off
drugs.” People turn to kratom as another option in their arsenal to help ease the withdrawals or
cravings from previous substance use.
My participant Sean has experimented with substances and opiates happened to be one of them. Sean informed me that “I had, but yeah aside from the alcohol abuse, I did have some like recreational opiate abuse, and I feel like I've used kratom to kind of although, although those were pretty brief, I feel like I was able to use kratom to wean myself off of those.” Kratom was a
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tool that Sean used to help him stop using opioids. Part of why many Americans are drawn to
kratom is because it can help mediate the craving of opioids. This occurs because kratom
interacts with the same receptors in our brains as opioids do. Kratom can make a person’s brain
feel like it is getting what it is used to without the harmful side effects of opioids.
In our interview, Sean said that kratom, “acts, I think, on the mu opioid receptors so like
a partial opioid agonist if I was talking to somebody little bit more scientifically inclined. So, it
can kind of tickle some of those same receptors without the addiction potential as much as most
opioids it can be used for pretty much reducing or eliminating withdrawal symptoms if somebody's addicted to opioids.” Since kratom and opioids both interact with the mu opioid receptors in a human’s brain this is why kratom has been able to help Sean and many other people end their opioid addiction.
Although kratom has not been recognized in the medical or recovery field as an official alternative to taper off of opioids, many people have used kratom to do so. Two of my participants have used kratom to wean themselves off of opioids. When we were discussing
opiate addiction, Sean shared, “You know I think it's a really good step towards helping not cure
the opiate addiction, but maybe like a bridge to at least give people some breathing room to get
off that stuff.” Sean was able to quit his opioid use by using kratom. I do want to emphasize that
these are the experiences and perspectives of my participants. Kratom has not been recognized as
being medically useful. For Sean and Pearl, they used kratom as a way to stop using opioids.
A common medical method to treat opiate addiction is the use of Methadone. Methadone
was introduced in the 1960’s and is currently the most commonly used and approved
pharmacological maintenance option for the treatment of opioid dependence (Garcia et al, 2012).
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Methadone has been considered a first-line option for opioid dependence treatment and has been well studied over the years. Methadone has been known to aid patients struggling with opioid use disorder in lessening the intensity of withdrawal symptoms as well as lower cravings. In regard to Methadone, “research has shown that it is useful in increasing retention in treatment, physical and mental health levels, functioning and quality of life, and in decreasing the use of illicit drugs” (Garcia-Portilla et al. 2014). Methadone is a drug used to help people fight off their opiate addiction, but it still acts similar to an opiate.
Methadone has been approved by the Federal Drug Administration (FDA) as a treatment
for opioid dependence. Kratom has been attracting increasing attention as an alternative to
medically treat opioid use disorder. “Further efforts from researchers, clinicians and authorities
should turn to new pharmacological options into clinical reality and to overcome the structural
and functional obstacles that maintenance programs face in combatting opioid dependence”
(Garcia-Portilla et al. 2014). Methadone has been well researched while kratom has not. If
kratom got the same attention as some of the other federally approved drugs used to treat opioid
abuse, then we could potentially treat more individuals struggling with opioid use disorder.
Sunali Wadehra, MD, had conducted an interview with Dr. Oliver Grundmann who said ““We
do not have good clinical trial information. That should give us pause and caution in making
solid recommendations about the use of kratom” (Wadehra 2020). We need more research and
clinical trials on kratom and the effect on alleviating opioid use and withdrawals.
Pearl was on opioids prescribed by her doctor due to an accident she was involved in. In
regard to her opioid use she shared; “I don't want to use it long term, I guess, I want to taper off
the opioids and we're talking I’m on a low dose now and I never was on super high doses, but
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you know because of the long term, I just don't want to be dependent on it, so I became
dependent. And I’m still dealing with the pain, but um I wanted another option.” For Pearl,
kratom was the other option that she needed. Pearl knew that she could become dependent on
opioids and was wary of using them long-term. She started looking for other ways to manage the
pain she was experiencing. My next section will cover how Pearl used kratom as a way to deal
with her chronic pain.
Using Kratom to Recover from Pain
Pain is subjective and based on the person experiencing it. When it comes to managing
pain, physicians prescribe medications like opioids. In my research, only one participant, Pearl,
was using kratom to manage her chronic pain. Pearl had been in an accident that had cause her to
have chronic pain in her back and her shoulders. Like many Americans, Pearl’s doctor had
prescribed her Oxycodone to manage the pain. In my interview with Pearl I had asked her what a
typical day looks like for her. Pearl explained, “I start my workday and usually about five hours
later, I could start feeling the pain, a little bit more so I’ll take another I take the white Borneo,
and that one's a little more up game mood enhancer. And so, I do that and then um and then at
nighttime I’ll take it at nighttime I’ll take the red-- the red one is the one that helps me sleep.”
Pearl uses different strains throughout her day to feel energized and pain free. During the day,
Pearl will use a white or a green strain of kratom which is stimulating, mood boosting, as well as increasing focus and productivity. At nighttime, Pearl will use a red strain kratom which is known for relaxation, relief and euphoria. The different strains of kratom can be used to treat or alleviate some of the health issues may be experiencing.
Due to her background as a registered nurse, Pearl knew the risks associated with taking opioids. Pearl had shared with me; “maybe about two months, and it was I was running out of
61 medication and my recovery coach he was the one that was like I think you'll really, really benefit from this like your you'll benefit from using kratom.” Pearl has worked with a recovery coach to help her recover using opioids from her accident. What I want to point out is that
Pearl’s recovery coach was the one who suggested that kratom could really work for her. Pearl’s story highlights how impactful kratom can be for some people. The fact that her recovery coach suggested kratom speaks volumes and reiterates how people learn about kratom through their social circles. According to Nicewonder et al. (2019), “men are less likely to use kratom for acute or chronic pain compared with women.” Considering Pearl’s gender, I wanted to point out that she was the only participant that used kratom to manage her chronic pain. The fact that
Pearl’s recovery coach was able to recognize Pearl’s needs is truly remarkable. This recovery coach of Pearl’s made it clear that kratom is an option when working on opioid abuse.
Pearl shared with me why she uses kratom: “I choose it because I don't want to continue to take a pill. I want to be off of everything you know I mean when I say everything it's like, I don't want to be taking Oxycodone for the rest of my life, you know for pain I want, if the kratom is helping me I’d rather use the kratom and it helps it's helped really does help me with that withdrawal feeling from not taking that pain medications.” Kratom has been a good option for
Pearl since she was on opioids to manage her pain. Because kratom interacts with the same mu receptors in the brain as opioids do, it gives users’ brain chemistry that feeling of getting what it was used to having. Kratom has been a good option for Pearl because in her perspective, “It does decrease the pain, it does help with the pain.”
Pearl did her own research on kratom in 2019 and most of it was online. She had only two people in her life that had really heard of kratom before and what it can do for people. After doing
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some research on her own she had stated that kratom has “been around for a long time, it's safe it's
better than using a pharmaceutical drug.” Like many others in the kratom community, Pearl views
kratom as a natural and safe alternative than taking opioids. This is one of the main reasons why
kratom is so popular. As we have seen with Pearl, people are becoming more interested in holistic
healing and herbal remedies to try and recover from sickness or injury. Aside from looking for
alternatives to opioids and managing pain, some of my participants have also turned to kratom for
productivity reasons.
Nature’s Adderall: Managing ADHD
Attention deficit hyperactivity disorder (ADHD) can present significant challenges to
adults and children. ADHD is a disorder that comprises a constellation of symptoms including
inattention, impulsivity, and hyperactivity (Davidson 2008). During interviews, the topic of
ADHD and productivity came up with four of my participants. In interviews, my participants
shared that kratom helps them concentrate and be more productive throughout their days.
ADHD is diagnosed through a comprehensive examination assessing psychopathology,
functional impairments, pervasiveness of the disorder, age of onset, and the absence of other
disorders that could better explain the symptoms (Rosler et al. 2006). Symptoms of ADHD
include “procrastination, overreacting to frustration, poor motivation, insomnia, and time- management difficulties” (Davidson, 2008).
Although this is anecdotal evidence, one participant shared how kratom was able to help him manage his ADHD and improve his productivity. In our interview Anthony went on to say,
“I have such bad ADHD, but I know when I took kratom it definitely helps to like calm me down a little bit and just like not think about 100 things at once and I can concentrate more.” Anthony shared he has been diagnosed with ADHD at an early age and was prescribed prescriptions like
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Adderall and Methylphenidate to manage his ADHD. These kinds of stimulant drugs can have
side effects such as lack of appetite and sleep problems. Further into our discussion around
kratom and ADHD, Anthony shared, “I had to get some work done and it literally helped me
concentrate and focus on that and I really I sent that task it was like two and a half hours. And I
went through I did it all so that's why I kind of described it as like nature's Adderall.” Anthony
called kratom “nature’s Adderall” due to its ability to help him concentrate and be more
productive. Kratom has the ability to help people improve their concertation and productivity
similar to other prescription medications like Adderall. Anthony used kratom to knock out a
school assignment in two and a half hours. This same participant shared that kratom helps him
feel more productive throughout his day. Kratom has been known to help people concentrate and
focus on tasks.
Along the same line of concentration, I had three other participants discuss how kratom
was used to increase their productivity. Booker shared,
“And then another really just beneficial thing with kratom is just the focus that I get it really allows me to dial in when I'm doing web design to you know build our website upgrade you know change things improve things, and it really you know when I take kratom and I sit down and look at our website I'm motivated to go into the back end and really work on it and I guess it makes me a better worker is what I'm trying to say.”
In my interview with Booker, he discussed how kratom helps him focus and “dial in” on tasks that are relevant to his work. Kratom helps Booker be more motivated to complete his work and daily tasks. Booker even went on to say that “kratom makes him a better worker” by increasing his productivity and motivation to complete tasks during his workdays. Booker’s experience showcases how kratom can be used to keep him motivated and complete his work.
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When interviewing Sean, he shared, “I started, taking it as a mood enhancer I didn't really use it too much as an alcohol alternative then and I would use it to like get work done and write and kind of as a productivity enhancer.” Sean discusses how kratom is multi-functional for him as a mood and productivity enhancer. Previously, we discussed how Sean also found that kratom eliminates any kind of alcohol cravings he might experience. Sean is someone that uses kratom for many different reasons which also includes increasing his productivity. Sean is an example of how kratom can work in his interest and still be productive throughout his day.
In Childan’s experience with using kratom, he explained that “kratom actually like helped me with my ambitions a little bit, helped me kickstart a lot of my days and get things done.” Childan highlights how kratom is used to kick start his days and keeps him motivated to complete his daily to-do list. For Childan, kratom is what helps him “because it is a tool that helps me accomplish what I need to get done without feeling like without doubting myself.”
Childan’s experience demonstrates that kratom gives him an extra boost to accomplish his goals with little doubt. In terms of productivity, my participants Sean, Booker Anthony and Childan are similar in the sense that kratom has been a tool to help them be more productive and stay focused on tasks.
Recognizing Kratom as a Powerful Substance
In regard to the social significance of kratom, I will discuss how my participants
recognized kratom as a powerful substance. While most participants view kratom as a healthy
solution to pain relief and anxiety, they all argued that kratom is not something to be taken lightly. Kratom is a substance that if used improperly can be harmful for inexperienced users.
One example is how kratom is a mood enhancer. Depending on how a user is feeling, kratom can exasperate those feelings whether they be high or low. I will further dive into this next theme and
65 explain why kratom should not be taken lightly or for granted. Kratom is an incredible plant, but it needs to be used moderately and respectfully.
For instance, Sean was blunt about the risks that are associated with using kratom inappropriately or ill-advised. Sean went on to share; “I don't think that you should be buying it's a pretty powerful substance and pretty incredible one, but I don't think that you should be buying it at a gas station or headshop per se.” It is important to know where the kratom is sourced and whether or not it has been tested for adulterants before it has been put on the shelves. There are kratom suppliers that will put kratom in a package and label it organic and all-natural while not providing sourcing or testing information on their labels. This is what Sean was referring to because some of the kratom sold in gas stations or head shops can be low quality kratom and potentially contaminated with adulterants. There are vendors, like the ones I used to recruit participants from, who regularly test their kratom and can provide those results.
I wanted to research kratom users because there is very little research specifically on
American kratom users. This kind of information is valuable to people who are interested in kratom but hesitant to try it. Sean had even mentioned “I'm not able to find that much information on it like it's really kind of a mysterious substance. I think it doesn't seem like there's that much research on it there's not a ton of anecdotal like ethno like popular ethno-botanical writing.” What Sean is saying holds true, there is not enough anecdotal or scholarly information about kratom use or users in the U.S. This is why I’m studying kratom users because they hold a wealth of knowledge based on their experiences using kratom. Their experiential knowledge with kratom is important in understanding kratom’s significance. In order to fully comprehend the risks and benefits of kratom we have to hear from the users themselves.
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Officials all over the country have begun to ban kratom based on outlier cases and poly-
drug overdoses. This has been common even here in the city of San Diego where kratom is
banned because of six related kratom deaths that were poly-drug overdoses. Even though kratom
can help some people in their current situation, kratom is still a substance that can be that can be
abused. This is dependent on the kratom user and whether they have the will to control their
usage. Sean shared that:
I think that there's a lot of things that were addicted to in society and have incorporated into parts of our lifestyle, maybe because they're legal and I feel like we've kind of unconsciously chosen some of the worst drugs to make illegal just based on effects and danger and social effects and violence and stuff like that, so I think that kratom definitely has a place, at least in my life, and I think, maybe a lot of people's lives in society. So I tried to kind of advocate for it, but people should be aware of the risks like I would disagree with people saying ‘Oh it's non- habit forming it's in the coffee family, don't worry’ it's like no, you can definitely get addicted to it and get some pretty bad withdrawal symptoms.
One of the key takeaways with Sean’s statement is that kratom can have a place in many
people’s life. However, anyone interested in starting to use kratom needs to be aware of the
potential risks associated with consuming kratom. Often times people who use kratom don’t have
enough scientific or anecdotal research in their grasp and therefore have to turn to outside
sources for more information. This shapes a kratom user’s social world in seeking out
information from other kratom users. As sociologists we study the social relations of
communities and how those communities are impacted by outside forces. For example, the U.S.
is an individualistic society and is shying away from building community. This has been the case
with the kratom user community. Kratom users have to rely on their own personal kratom
experience or the experiences of others for reference. With kratom moderation is key and less is
more. Sean is well aware that kratom users can become dependent on the substance, but often
had to rely on his own experience with using kratom. This is part of why I wanted to study
67 kratom users and the kratom community because there still is not substantial scholarly research on kratom.
The withdrawal symptoms that kratom users may experience are; nausea, sweating and chills, muscle and body aches, tremors and twitches, diarrhea, rhinorrhea, and lacrimation, as well as psychological elements such as insomnia, restlessness, irritability/hostility, fatigue, anxiety and mood disturbances, and sometimes hallucinations (Stanciu et al. 2019). Dependency can occur because kratom helps users with “relief from pain and emotional and mental conditions” (Stanciu et al. 2019). Sean warns potential kratom users that, “if you want to not abuse it, I would say, maybe like it can be a great ally, but just like anything can be kind of a cruel mistress if you get if you start abusing it like I have before”. Sean is well aware that kratom can be used abusively because he was in that position before. A kratom dependency is similar to a coffee dependency. If a regular kratom user stops taking kratom, they may experience mild withdrawal symptoms such as headache, irritability, as well as muscle and body aches. Kratom can bring about a dependency based on how much a user takes and how it makes a user feel.
Kratom can have severe withdrawals if users abuse it. Frequent consumption and large doses can have a strong impact on a kratom user’s system. I find that participants in my study have used kratom to feel better in their lives not to feel worse. However, kratom is not a cure all for everyone. It is important that kratom user’s stay cognizant of the abuse potential with kratom that way they are less likely to be gripped by it.
Two of my participants have recognized that kratom is not just an herb, but a drug. We have to remember that all drugs can be abused. My participant Childan shared, “I've seen people take it and become mad and become angry. People some people can't handle the mood enhancements they let their inner demons out during, it’s very similar to someone drunk off
68 alcohol. People should know that it's not something that's very light it's very heavy and consuming, it will consume your mind if you take too much”. Here Childan is explaining how some people can experience kratom to the extremes. This is not the case for everyone, but kratom can enhance the user’s mood or feelings. This was the case with Sean, who had been taking kratom and experienced issues expressing his emotions:
I think I was using it more abusively, but I had like two partners where I had kind of like lost my temper and snipped at them. One of them was actually during a break-up and then after the fact, I was like you know, like, I totally overreacted and I think, maybe the kratom triggered a temper or something. And then another one I don't know, I was like kind of being like moody or something, and my partner didn't like it, and I think, maybe I was kind of blaming the kratom on it more than taking responsibility for it.
Anger is a normal and healthy emotion which is neither good nor bad. Kratom has mood enhancement capabilities and a kratom user’s mood can be enhanced whether it’s for better or worse. In Sean’s case, he increased his kratom use and this affected his past relationships. Since kratom enhanced his mood in that moment, his anger became overbearing. However, Sean was reflexive in our interview about how kratom can trigger a temper and recognized this trait within himself. This is important in a sense that kratom users can take a step back and recognize what trait they are exhibiting and adjust accordingly. This is just two anecdotal experiences of kratom user’s becoming angry, this is not the case with many of my other participants who have had great experiences with using kratom.
My point here is that kratom should not be taken on a whim. Before anyone decides to try kratom they must do research on their own and be reflexive of their own addictive traits. It is important for people curious about trying kratom to be aware of their own addictive habits or behaviors. Kratom is not a fix all solution for everyone. It has helped plenty of people on their
69 road to recovery from pain and addiction, but we have to remember that kratom is a drug that can make users dependent. What I am trying to convey here is that there is no guarantee that kratom will give someone the same effects as an experienced kratom user.
My participant Sean shared with me his views on kratom. I enjoyed interviewing Sean because of his vast experiential knowledgeable on kratom and had many insights to share. Sean went on to explain:
I just think that it warrants further study like I think it's an incredible plant like there's nothing I've encountered that's like it, I think that it definitely has its dangers and you know you can get dependent on it, it can be abused like anything can. But I think that we just need to before we even consider legislation or changing anything, I think that, like the dangers of it are pretty clear where I don't think there's really any clear documented overdoses or deaths associated with it, that I know of.
Sean recognizes that kratom is like no other substance he has encountered before, but it still has the potential to be abused. Sean addresses the risks that kratom poses which I wanted to discuss further in my findings section. Kratom is not devoid of side effects and risks. We need to remember that anything people find pleasurable can be abused, whether that’s watching television, drinking coffee, scrolling through social media. These examples are not in the same category as kratom, but we have to realize that the dependency relies entirely upon the person.
Individuals who decide to try kratom have full autonomy on how it can impact their life.
Assuming that kratom will destroy individual’s lives is farfetched. Sean and Childan are examples of how they are aware of the risks associated with taking kratom yet act accordingly to their benefit. Both do not let kratom have complete control over their lives but use it as way to enhance their life. The key takeaway here is being reflexive about one’s own triggers and whether or not a potential kratom user can control their emotions. If someone is interested in
70 trying kratom they need to be reflexive on past habits and whether kratom would be a good option for them.
Hiding like a Ghost
Almost all of my participants hide their kratom use from coworkers or friends outside of their immediate circle. Childan shared with me about his kratom use that “no one knows I use it.
It's very discreet. The only people that know I use it is my partner, it's very discreet.” This is because kratom is not a well-known substance currently in the U.S. Kratom users want to avoid judgment and discrimination about their use from people who may have never heard of kratom before. Trying to explain to someone why they use kratom puts kratom users in a vulnerable position. They may have to explain past medical vulnerabilities, addiction as well as opioid use.
When people like Childan use uncommon substances like kratom they worry about the stigma that surrounds drug or substance use. Childan went on to share: “No one knows no one will ever know. It’s very personal.” in regard to his kratom use. For Childan, he does not want to be treated differently by others because he uses kratom in his morning routine.
For my participants like Childan and Pearl, it is easier to keep their kratom use to themselves. Part of why people choose to hide their kratom use is also because kratom has a semi-legal status in the United States. Federally kratom is still legal in the U.S., but some states like Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin have banned kratom completely (American Kratom Association 2021). Kratom users don’t want to risk facing legal repercussions from their workplace or law enforcement. Some workplaces have their employees take drug tests regularly. My participant Pearl shared that kratom “doesn't come out in your blood your you know your blood tests or your urine, and so I was happy about that too.” Many
71 drug tests do not test for kratom or the active alkaloids mitragynine or 7-hydroxymitragynine present in kratom. This is also part of the reason why many people are attracted to using kratom.
I asked my participants-whether their friends, family or coworkers know about their kratom use. Pearl shared “they don't know I know yeah nobody knows and I don’t tell anybody.
It's such a new thing and it may not be new, but yeah I don't need any judgment from them at all”. For Pearl, discussing her kratom use can lead to opening up about her personal health which would put her in a vulnerable position. Pearl chooses to not share her kratom use with coworkers or anyone outside her immediate social circle. This is a tactic used to protect herself from judgment or discrimination. Pearl’s use of kratom can expose her as being a “drug user”, and in the U.S., that label, because of the drug war, can result in not only judgement, but incarceration.
The discreetness prevents non-kratom users from making assumptions about a kratom user’s motives for using.
My participant Lauren uses kratom to relax at the end of her days. When I asked her whether her friends, family or coworkers know about her kratom use she shared, “you know the moral panic around it it's something that not a lot of people would necessarily walk around and say ‘hey I take this’ just because there's been like the bad press and stuff so I can see it's not really something that I don't bring it up like what I'm like hanging out of out of the party and I would assume a lot of people wouldn't either.” Lauren’s assumption is right, kratom users do not disclose their kratom use with just anybody. This comment captures the sentiments of many kratom users in this study. They have an awareness or expectation of how their kratom use will be stigmatized and discriminated against them. This experience colors their everyday experience in countless ways. This also goes for kratom users who are also people of color. People of color
72 kratom users have to navigate how they can avoid discrimination for using a new substance while also having a darker complexion.
THE CRIMINALIZATION OF KRATOM
The last theme of study on kratom users is around the criminalization of kratom. During interviews I asked my participants “What are your thoughts on the criminalization of kratom?”.
Many of their answers varied, but they all had similar viewpoints. Since kratom has been helpful to them they do not feel that it should be criminalized. Kratom is still federally legal for now, but kratom’s legal status varies by state and county. We have seen this pattern with a great many other things that are criminalized such as drugs, guns, and other contraband. Just because something is made illegal does not mean the demand for it goes away. In this section, I will discuss how my participants have been affected by the criminalization of kratom.
One of my participants Lauren shared, “I'm living in San Diego which I didn't realize when
I moved here it’s one of the only places, you're not allowed to like have it shipped to you like it's not legal within the city limits”. Lauren cannot have kratom shipped to her home because of the
San Diego kratom ban. This results in people like Lauren having to go out of the way to pick up their kratom. Lauren also shared:
Pretty much everything I've seen where there's been like adverse reactions has been like somebody mixing it with something else, or a bunch of other stuff, and so I feel like it's stigmatized and the way that it shouldn't be like unfortunately I'm in San Diego which is like the only place in most of California that you actually can't get it legally, I have to drive like just outside the city limits to like where the shop is because it's for some reason, when I moved here, I tried to just order online, like I used to, and it was like oh no we can't ship to San Diego and I feel like those kind of bans are based on not evidence just on people kind of getting hysterical about it, so I think it's important that people kind of understand what it is better.
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Lauren quickly realized when she moved to San Diego that she could not order kratom online. We
need to acknowledge that even though kratom is banned in San Diego people will still go to great
lengths to get their product. The ban did not stop kratom from entering San Diego county, but it
did stop the selling of kratom within San Diego city limits. Even though kratom is banned in San
Diego city, I have seen kratom suppliers stretched out of the margins of San Diego county such as
La Mesa, Carlsbad, Vista and San Marcos. I asked Lauren her thoughts on the criminalization of
kratom and she told me:
I think it’s a terrible idea, well, I mean I think criminalizing drugs in general is a pretty terrible option as far as societal attitudes toward that I just don't think it's beneficial, even for things that are like a lot more destructive than kratom is, I mean for kratom I think it's just a ridiculous idea I mean if you're not going to put caffeine on there if you're not going to put you know coffee and all these things that are available, it seems crazy to me to do kratom it's just like a moral panic I think that's going on right now. The same way there was around bath salts or salvia or whatever.
Lauren believes there is a moral panic around the dangers of kratom. This moral panic is
insinuated by the moral entrepreneurs who benefit from having kratom out of the market and out
of people’s hands. Overall, kratom is a pretty mild substance. The danger with kratom is when
polydrug use occurs. Combining kratom with other substances such as alcohol, opioids,
stimulants, or depressants can have severe reactions in people. It is not recommended that
kratom be involved in polydrug use. Because kratom is a natural alternative to opioids,
corporations such as the pharmaceutical industry, do not want people to learn about kratom. The
pharmaceutical industry wants people to continue using opioids to manage their pain, but we all
know just how addictive those very opioids can be. There is a for-profit system that the pharmaceutical industry has invested millions of dollars into.
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As Lauren and I were discussing the criminalization around kratom, she shared, “I think it should be kind of a non-issue honestly like I think that it's nonsense people are trying to criminalize it and that it's just a perfectly as far as pretty mild substances go like something that shouldn't be like regulated, any more than something like coffee or Kava.” Lauren thinks that kratom should be a non-issue. As discussed previously, people use kratom for all kinds of reasons that are quite personal. Criminalizing kratom will further push kratom consumers into the margins of society and put strain on this community.
Booker is the co-owner of a kratom shop that I became familiar with while conducting this research. Booker has extensive knowledge of the kratom world and was willing to share his insight with me. When I asked Booker, his thoughts about the criminalization of kratom he shared:
Without sounding like a conspiracy theorist over here, I think big pharma does have a lot to do with it. You know because I mean daily, I get I get customers who are transitioning off of pharmaceuticals into and more to kratom, you know the herbal supplement. And I think once more and more people try it and the science and the actual the true facts get out there, and not the made up facts that you see online are brought to the public, I think it's going to be a saint of a product, I think it's going to be really good for the community, I think it could help a lot of people, especially with the opiate crisis going on right now.
Booker’s experience owning and working at a kratom shop gives him the opportunity to meet all kinds of customers. These customers come in looking for other alternatives to alleviate their current situation. Booker said himself that he gets customers looking to get off pharmaceuticals and willing to try kratom. I am grateful I was able to connect with Booker because of his insight and position at the kratom shop.
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Earlier I mentioned I asked all of my participants how they feel about the criminalization
of kratom as well as what they would do about accessing kratom if it were criminalized. I found
that everybody who participated in my study would not be deterred from accessing kratom if
kratom was criminalized. Criminalizing something does not completely prevent it from entering
the United States. In fact, criminalizing would increase the demand for said product. Since there
is a high demand for kratom in the U.S. this means there has to be a sufficient supply of kratom.
One participant Childan said, “It’s banned in San Diego, but it doesn't let people in [North
County], doesn't stop people in [North County] from taking it.” What Childan says has some truth to it. As we learned with Lauren, banning kratom in San Diego has done very little to keep it from coming into the city. Kratom needs to be recognized as a natural substance that can help people recover from drug addictions, mental health problems and chronic pain.
There is something to note about the fact that most of my participants are willing to go out of their way to access kratom. Many people use kratom to help kick start and maintain a stable mindset throughout their day. Criminalizing or banning kratom is not necessary. This study has demonstrated that people use kratom only to better themselves and improve their living
conditions. Towards the end of my interviews, I would ask participants, “What would you do
about accessing kratom if it was criminalized?” To my surprise my participants shared that they
would try to access it through the internet or friends that they knew of. Many of my participants
like Sean shared that having clear regulations and guidelines for kratom product would be the
next step. Sean shared with me:
I just think that it's in this weird gray zone where it should be legal, but it probably wouldn't be such a bad idea if, if there was some kind of regulation around the industry. I think that just banning it outright would be a huge mistake and I think that the impact on society would actually be measurably worse, I think that you can see, you know I think there'd be measurable increases in opiate abuse
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and stuff like that, without it, and a lot of people like really rely on it to stay off opiates right?
Sean’s quote discusses the semi-legality of kratom and how banning it would have a big impact on the kratom community. There are many people living in the U.S. that rely on kratom to manage pain, opioid use as well as other various reasons. Having regulatory standards when it comes to kratom product in regard to growing, harvesting, processing, grinding and shipping would be a step in the right direction. Regulation around the kratom industry would require for testing of kratom product before it hit the shelves and into customer’s hands. This would reduce the risk of consumers becoming sick from kratom product.
In an interview with Sunali Wadehra, Dr. Oliver Grundmann said, “Within the regulatory framework that the FDA has oversight, it can be assured that we have unadulterated, non- contaminated kratom products on the market that are well-labeled, that adhere to good manufacturing practices, and that consumers as well as patients with healthcare providers can rely on. These are essential points that will help us ensure that accessibility can be possible and those that are currently using kratom are needing that access” (Wadehra, 2020). There are businesses like Space Kratom and Aroma Kratoms who ethically source their kratom as well as completely test their product before it gets in customer’s hands.
The American Kratom Association (AKA) is a non-profit organization formed by kratom consumers to protect the rights of Americans who use kratom for their own purposes. Through organizing and lobbying the AKA has promoted scientific research, education and clarifying the misinformation surrounding kratom at federal, state and local governments. The AKA has worked on the Kratom Consumer Protection Act (KCPA) which is a piece of legislation that allows consumers access to legal kratom and reducing the sale of unregulated or harmful kratom products. The KCPA’s intention is to ensure that only approved kratom is sold and distributed
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amongst the American market. The aim is to protect kratom consumers, disprove myths, rumors,
and misconception surrounding kratom by providing clear regulatory standards.
If kratom was criminalized it would increase the demand and supply of kratom in the
U.S. This could lead to potentially contaminated product into the market, which puts consumers at risk. This is why legislation or acts like the KCPA are important for the kratom community.
Kratom is not dangerous when it is grown, distributed, sold and consumed correctly. It would be best to offer kratom consumers a safer solution than criminalizing kratom.
After asking my participant’s their thoughts on the criminalization of kratom, I asked;
“Would you still try to access kratom if it was criminalized?”. Off the bat, I got answers saying yes and they would try to access it online. When I asked Sean this question he told me; “I would probably still take it yeah I think again the risk would go up, but the rewards from are so high, having it has kind of an ally my life and part of my lifestyle, now that I figured out I think how to take it to think I probably would still take it yeah.” Sean uses kratom for a variety of reasons which include helping with anxiety and depression, cup of coffee in the morning and a workout enhancer. Sean believes that kratom is “in this weird gray zone where should be legal but it probably wouldn't be such a bad idea if, if there was some kind of regulation around the industry.” Considering that there is no federal or state regulatory action surrounding kratom proceeding with some rules and regulation would not be a bad idea.
One of my participants, Anthony, shared his thoughts about the criminalization of kratom. Anthony used kratom to help him get through his work week and manage his ADHD. In our interview, Anthony shared, “I mean just like weed is illegal it's like it's very it's ridiculous, it's outdated and it makes absolutely zero sense like so what them banning kratom that’s just infringing on the rights of people to do as they please.” Anthony was willing to share his ideas
78 on the criminalization of kratom. He even compared it to how the U.S. federal government has scheduled marijuana as a Schedule 1 Controlled Substance. By scheduling and banning kratom, it is infringing on the rights of kratom consumers. As mentioned before, there are many people, like Childan and Pearl, who rely on kratom to kick start and get through their days. Anthony went on to share, “I am going to do as I please anyways and if I if I find a benefit in it, if it's going to benefit me I don't care if I'm breaking the law if I'm helping myself like if it's a healthy choice you know what I mean like it was a bad and yeah, but I see is beneficial, at least in moderation. So, I feel like yeah I felt the government shouldn't infringe on that.” For someone like Anthony, there is no stopping him from doing what he wants. It would seem that Anthony does not care about breaking the law when it comes to using kratom. He would rather use kratom to help him be more productive throughout his days than wait around for the government to figure out how to proceed with kratom legislation.
When interviewing Booker, he said, “And I feel like that's kind of on a not as intense scale as the you know the reefer madness, but I feel like that's kind of what kratom is going through right now. I think, over time, people are going to understand and more of the science is going to come out and kratom is going to be a much larger entity than it is now.” Booker referenced “reefer madness” as the demonization of cannabis and criminalization of its consumers, mainly Black and brown men. Both cannabis and kratom have similar experiences in that they have both been targeted for being natural plants with medicinal benefits. Over time, kratom will become more mainstream and widely known. With more research on kratom it is only a matter of time before there is federal or state regulation. I saw this because the U.S. government has already tried to schedule kratom within the Schedule I Controlled Substances.
With more awareness and research on kratom we can see it go in a different direction.
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SIGNIFICANCE AND RECOMMENDATIONS
This research highlights the experiences of people who use kratom in the San Diego
region. The participants of this study were chosen specifically because they use kratom daily.
Through interviews, my participants displayed how kratom has a social significance in their life.
The findings of this study suggest that people learn how to use kratom and learn how to think
about kratom through their social circles. Through this interaction, people learn that kratom is a
useful substance that can help them, despite the warnings and semi-legality of kratom. In general, therefore, it seems that people who are curious about trying kratom, need to be aware of how kratom can be habit forming. Overall, this study strengthens the idea that kratom is significant in the lives of people who are trying to better themselves. The key takeaway from this research project is that people use kratom for a variety of different reasons. Sometimes these reasons are multi-dimensional and intersect with one another. This research extends our knowledge of kratom use in the San Diego region.
Kratom is important to study because it is a relatively new substance to the United States and offers us the ability to learn more about substance use and the way we respond to it.
Criminalization made no significant difference in whether people were deterred from using kratom. This research demonstrated how attempts to ban kratom, without medical research, will be met with resistance. This occurs because people learn about kratom from their social circles, which offer counter narratives for how to view kratom, not as a dangerous drug, but as something that is medically useful. This study displayed how people experience kratom in their everyday life and how kratom fits into our current society. Although people who use kratom may be of little concern to a small group of researchers, it should in fact concern anyone who cares
80 about substance abuse, managing chronic pain, mental health, and the way we react to these issues in the United States. More research using controlled trials is needed to examine the medical benefits of kratom. More broadly, research is also needed to determine the efficacy of kratom used to treat opioid abuse, alcoholism, manage chronic pain, and ADHD. Further research might explore the recreational use of kratom, the legalization versus criminalization of kratom, as well as kratom use in women.
CONCLUSION
The purpose of this current study was to determine the role of kratom in people’s everyday lives as well as how they navigate the semi-legality of kratom. Because kratom is a new substance in the U.S., there is little research on the people that use kratom. There is significantly more research on the toxicology, pharmacology, and history of kratom, but little has been known about the people who use kratom. Previous research including surveys have been useful in understanding the basics of kratom use, but it is important to hear from the users themselves in order to have a clear picture on how to address kratom. To understand the social world of kratom use, we need to examine the science, history and potential legalization or criminalization of kratom here in the United States. The people who use kratom are navigating a semi-legal drug that has a purpose in their life. We have the research on the pharmacology and historical aspect of kratom, but there is limited sociological literature on kratom use. There is a significant gap in the literature around the social world of kratom use and this research project attempted to fill that gap by using grounded qualitative research methods.
People from all walks of life use kratom for a variety of reasons. There is a movement to criminalize kratom, yet there is also a movement of resistance to legalize it. This research project demonstrates why it is important to explore the social world of kratom users and understand how
81 they navigate the semi-legality of kratom. The various reasons for kratom use are available through anecdotal evidence rather than medical research. This study has shown that people speak to the benefits they obtain from using kratom, while remaining vigilant that it is also a powerful substance. Through interaction people learn that kratom is not a dangerous drug, but one that is medically useful.
This research project explored the stigma surrounding kratom which could ultimately help thousands of people dealing with health issues. By stepping into the social world of kratom users, we can better understand issues like substance abuse and chronic pain. Banning or criminalizing kratom makes research more difficult, propagates misinformation, and never gets to the root of why people choose to use drugs in the first place. The findings of this study could be useful in helping those who are struggling with substance abuse, mental health issues, and chronic pain. To make a difference moving forward we have to expand the ways in which we treat addiction, pain and disorders like ADHD. This can be done by exploring more holistic options, providing the necessary research, and support for people struggling with these issues.
Part of this investigation was to showcase how kratom is not the demon drug that government officials make it out to seem. My participants have demonstrated that kratom is used as a tool to help them get through their days and better their overall quality of life.
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APPENDIX A: INTERVIEW QUESTIONS FOR KRATOM USERS
1. Can you tell me about the first time, you had heard or seen kratom? a. Did you try it? b. Were you with other people? c. What was going on in your life at the time you tried kratom? 2. Does kratom feel familiar or similar to other substances or is it different? 3. Can you explain why you choose to kratom? a. How is it helpful to you? 4. Can you take me through a typical day for you in your life? I am curious as to how kratom fits into your schedule. a. What are the ways you use kratom with other things like tea, coffee? b. Have you found the “sweet spot” for yourself? c. Is there any reason you would change or switch up your regular dosing amount?
5. Can you describe kratom in your own words to someone who had never heard of it? 6. Have you ever had a family member, friend or loved one wonder what is kratom? a. How have others reacted to you using kratom? 7. Can you describe for me a step-by-step of your routine when you use kratom? 8. Can you take me through where and how you buy kratom or how you access it? a. How do you know what type of kratom to buy? b. How has the pandemic shaped your kratom use? c. Has the pandemic affected the availability of kratom for you? 9. Can you tell me a bit about the work that you do? a. Can you tell me how kratom impacts your work? i. Do you use kratom to increase your work productivity? ii. How have your coworkers responded to your kratom use? 10. Have you ever tried quitting kratom? What was that like for you? 11. Recently, the DEA moved to criminalize kratom use, what are your thought on criminalizing kratom? a. If kratom was criminalized, would you still try and access it? b. If kratom was criminalized would you still use it? c. What would you do about accessing kratom? Online? 12. If you could say anything to a legislator about kratom what message would you want them to hear? 13. How do you think kratom fits into our society? 14. How much research have you done on kratom for yourself?
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