Health Effects & Risks of Kratom, Opioids & Other Natural Occurring Medicines | Dr. Chris McCurdy

Andrew Huberman talks with Dr. Chris McCurdy about kratom (Mitragyna speciosa), a plant compound now used by an estimated 20 million Americans daily. McCurdy explains kratom's complex, dose-dependent effects, ranging from a caffeine-like stimulant at low doses to a sedative, opioid-like effect at higher doses, and stresses that US products (concentrates, extracts, and synthetic 7-hydroxymitragynine isolates) are far more potent and risky than the traditional fresh-leaf use in Southeast Asia. They discuss kratom's potential to help people transition off opioids, its addiction and respiratory-depression risks, and how all products get lumped under one name like undifferentiated 'alcohol.' The conversation broadens into how most modern medicines derive from plant alkaloids, and ends with the surprising pharmacologic history of soft drinks like Coca-Cola, 7Up, and Dr. Pepper.

• McCurdy estimates over 20 million Americans use kratom every single day, far above the often-cited 2 million.
  00:25:50
• Surprisingly, the largest survey of users found most take kratom responsibly for energy and mood, not to get high.
  00:24:50
• A soon-to-publish paper finds synthetic 7-hydroxymitragynine isolates cause respiratory depression equivalent to opioids in animals.
  01:17:46
• The dangerous compound 7-hydroxymitragynine may not even occur naturally in the plant and is now chemically manufactured and sold.
  01:05:52
• Huberman admits drinking 600 to 900 mg of caffeine daily, while McCurdy reframes sodas as originally pharmacologic 'soft drinks.'
  02:10:34
• Coca-Cola is still the largest importer of coca leaves into the US, processed in New Jersey, with cocaine extracted for pharmaceutical use.
  02:12:12
• A 2007 case report: a man had a seizure mixing kratom leaf and modafinil, then quit kratom cold turkey with only a runny nose.
  01:59:09

• Morphine was the very first alkaloid ever isolated; cocaine was the second.
  01:00:09
• Kratom acts on three systems at once, opioid, serotonin, and adrenergic, like a 'pharmaceutical shotgun' or symphony orchestra.
  01:31:24
• About 75% of FDA-approved drugs were discovered from or modified from natural products.
  00:53:54
• GLP-1 weight-loss drugs originated from peptides in the saliva of the Gila monster lizard.
  00:54:58
• Kratom's alkaloids likely evolved as antifungal defenses for a tree growing in hot, humid, fungus-prone swamps.
  01:40:47
• White, red, and green 'vein' kratom labels are mostly marketing; alkaloid content is nearly identical across colors.
  01:45:31
• Cocaine is still the best local anesthetic ever discovered and is used for nasal and eye surgeries.
  02:12:43
• 7Up once contained lithium for mood, and Coke syrup was sold in pharmacies to settle nausea, including in pregnant women.
  02:19:31
• Smith Kline & French studied mitragynine in the 1960s but shelved it because it was no better than codeine.
  02:35:08

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