Is it Safe to Mix Kratom and Alcohol?

Alcohol and kratom are both legal and easily accessible drugs. However, that doesn’t mean that mixing kratom and alcohol is necessarily safe.

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The whole is not always equal to the sum of the parts, as Aristotle tells us. For example, if it takes one person an hour to build a chair, then theoretically two people should be able to do it in half that time. But in reality, their combined efforts might finish the job in ten minutes. Or maybe they spend so much time arguing that it ends up taking them three hours. 

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The point is, those two people are not working independently on the same task. They are interacting with each other, and operating on the same system (the chair).

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Drug-drug interactions are kind of like that, including kratom and alcohol. But instead of building a chair, they’re messing around in your brain and body. Sometimes they might bump into each other, collaborate, or try to sabotage each other. That is to say, sometimes drugs work synergistically, and sometimes they get in each other’s way. 

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Just because you can use kratom and alcohol safely and responsibly on their own, it doesn’t mean that it is safe to combine them.

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In this article, we’ll talk about what happens when you mix kratom and alcohol. Is there a way to do it safely?

What Happens When You Mix Alcohol and Kratom?

The combined effects of kratom and alcohol has yet to be specifically studied.

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That said, serious or fatal effects of kratom use almost always involve other drugs. Polysubstance abuse is currently perhaps the most dangerous aspect of kratom, an otherwise relatively safe drug.

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For example, a 2019 report on the characteristics of deaths associated with kratom use found that 23% of deaths involved mitragynine (the active compound in kratom) alone. The other 87% of deaths involved other drugs combined with kratom. Those drugs were “typically controlled/recreational drugs, therapeutic drugs, and alcohol.”

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The NIH advises that kratom alone is relatively safe, with nearly all serious cases involving the addition of some other drug or contaminant.

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The Interaction of Kratom and Alcohol

Even though we don’t have specific studies, we can still make reasonable predictions about how they might interact in the body. We can base this on what we know about other drug-drug interactions, as well as what happens when you take kratom or alcohol alone.

How Does Alcohol Interact With the Body?

When the rate of alcohol consumption is happening faster than the liver can make this conversion, we get the acute effects of alcohol intoxication. This can result in disinhibition, memory loss, nausea/vomiting, and physical/cognitive impairment. In extreme cases, alcohol toxicity eventually leads to respiratory depression and death.

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Alcohol is metabolized by the body first to acetaldehyde, with the help of alcohol dehydrogenases. Acetaldehyde has highly deleterious health effects, but it is relatively short-lived and probably can’t pass through the blood-brain barrier. It gets oxidized to acetate by acetaldehyde dehydrogenases.

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However, there are multiple pathways that contribute to alcohol metabolism. Some of those pathways overlap with the metabolism of other drugs.

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One of the most important enzymes for alcohol oxidation and metabolism is called CYP2E1. But this enzyme is not specific to alcohol. Other drugs also compete for the use of this same enzyme. This can result in two different scenarios, which can have serious implications for dosing.

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First, if there’s not enough of the enzyme to take care of both alcohol and the other drugs, then the drugs will linger in the body for longer before they can get broken down. This could result in an overdose of that drug.

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On the flip side, the opposite could also happen. Let’s say the subject is a chronic alcohol user, so they actually have higher activity of that enzyme. That would mean that drugs get metabolized and eliminated too quickly, and will not be as effective. This is dangerous if the drug in question is a necessary medication.

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Another important aspect of alcohol is its interaction with the Gabaergic system. GABA is an important inhibitory neurotransmitter. Other drugs that influence GABA and GABA receptors can “cross paths” or exacerbate the effects of alcohol.

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How Does Kratom Interact With the Body?

While kratom metabolism has not been studied as extensively as alcohol metabolism, we do know that the most potent bioactive compounds in kratom are alkaloids called mitragynine and 7-hydroxymitragynine. These compounds interact with opioid receptors in the body.

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At lower doses, kratom acts like a stimulant – similar to coffee. At higher doses, it has a sedative, depressive effect – more like opioids.

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Although we don’t have specific studies on the interaction of kratom and alcohol, we can make some conjectures based on the fact that it interacts with opioid receptors.

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Alcohol and Opioids

First of all, the NIH advises against mixing alcohol with opioids. One of the dangers is that alcohol and opioids are metabolized by the same system in the liver. As we discussed above, when this happens, the metabolism of the drugs gets slowed down, which can result in higher toxicity.

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Alcohol may interact with opiates in other ways as well. For example, it has been suggested that alcohol can modify some opiate receptors.

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Finally, one of the major risks of opiates is respiratory depression. Combining opiates with alcohol can result in slowed breathing, coma, or even death.

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Although kratom is not technically an opioid, it does have many features in common. Therefore, there is a strong case for caution when combining an opioid-like substance with alcohol.

Alcohol and Stimulants

As we mentioned, at lower doses kratom acts as a stimulant. The danger of consuming stimulants in combination with alcohol, a depressant, is that it can mask the level of intoxication and more easily lead to overdose.

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Kratom for Alcohol Withdrawal

Finally, let’s address how kratom use can be used separately from alcohol in a way that might be beneficial.

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In fact, kratom is best known for its potential to treat opioid withdrawal. Early pre-clinical and anecdotal evidence also suggests that kratom could be an effective way to treat alcohol withdrawal.

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More research is needed to know the actual affects of kratom for alcohol withdrawal.

The Take-Away

Attempting to draw conclusions, or make permanent legislation, without proper evidence is dangerous – whether you are for or against kratom-use. The fact is, we still need more research about the therapeutic benefits, and dangerous effects, of kratom use.

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On the one hand, kratom is a legal and accessible solution for people who are otherwise out of options – including people suffering from chronic pain or drug withdrawal.

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On the other hand, just because a drug is legal doesn’t mean that it is always safe. Like any drug, kratom must be used responsibly.

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What we do know is that the majority of cases of kratom-related deaths involve multiple substances. Using kratom in combination with any other drug, especially alcohol, is potentially dangerous.

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If you have any questions regarding kratom, or any of our products, please feel free to contact us for a free consultation.