By Jana Wu, LCSW, LADC, ICAADC, CASAC
I have worked in mental health and substance use treatment for more than 15 years. As I approach 50, I keep returning to a question that feels both personal and professional: Why are we so quick to relieve women’s distress before we fully understand it?
Kratom is part of what brought this question into sharper focus for me.
I have met and worked with many women from their late 30s into their 60s who stumbled onto kratom while searching for relief from anxiety or pain. Many describe another benefit as well: energy. They often describe it not simply as a way to feel better, but as a way to keep functioning in lives that already feel stretched to their limits.
They tell me kratom helped them work, exercise, keep up with their children, care for aging parents, and continue meeting the demands of daily life.
Listening to these women has made me think about the much longer history of women, anxiety, and substances that promise relief.
A Long History of Treating Women’s Distress
The medical response to women’s anxiety did not begin with benzodiazepines. In the 19th century, diagnoses such as hysteria and neurasthenia were used to explain symptoms including anxiety, fatigue, insomnia, irritability, and pain. By the mid-20th century, sedatives were followed by tranquilizers, such as Miltown, and eventually benzodiazepines.
Valium, introduced in 1963, became the top-selling prescription medication in the United States for years. Its association with women’s distress became prominent enough to enter popular culture. In 1966, the Rolling Stones released “Mother’s Little Helper,” a song about a woman relying on prescribed tranquilizers to cope with the pressures of family life, domestic responsibilities, and aging.
Nearly 60 years later, the reference is striking. The medications have changed, but the question remains: What happens when the distress does not?
When Relief Is Not Enough
Benzodiazepines can provide essential relief and have a legitimate place in medicine. But relief is not the same as a long-term treatment plan. Benzodiazepines carry risks including physical dependence and potentially dangerous withdrawal.
For women in midlife, this becomes particularly important. Perimenopause can bring or intensify anxiety, sleep disruption, and changes in mood while many women are simultaneously managing careers, children, aging parents, relationships, and enormous expectations of themselves.
Yet, our health care system is often better equipped to quiet a symptom than to understand the life surrounding it.
Understanding why a woman suddenly cannot sleep, why panic has appeared for the first time, or why she no longer feels at home in her own body requires curiosity and patience. It means considering what may be hormonal, psychological, medical, or situational before simply trying to make the symptom disappear.
Why Kratom Deserves Our Attention
I am not suggesting that benzodiazepines cause women to use kratom. These pathways are far more complicated than that.
But I hear enough stories of women searching for relief from anxiety, pain, insomnia, fatigue, and other symptoms to believe we should pay much closer attention to how they arrived there.
For some, kratom may represent another chapter in a long history of medicating women’s distress. For others, it may feel like an attempt to reclaim control by choosing something perceived as natural, traditional, and outside the pharmaceutical system.
But “natural” should not be confused with predictable or risk-free. Kratom products in the United States are not regulated like FDA-approved medications and can vary substantially in potency.
From a substance use treatment perspective, another concern is what people may be using alongside kratom. I see individuals who use kratom while also drinking alcohol, taking prescribed benzodiazepines, or using opioids. Combining substances with sedating or opioid effects can increase the risk of dangerous interactions, including excessive sedation and respiratory depression. This is a risk I do not think we talk about enough.
The point is not that benzodiazepines lead women to kratom, nor that kratom is the answer. It is that women continue searching for relief.
Whose Discomfort Are We Treating?
We need to offer women more than a choice between enduring severe anxiety and relying indefinitely on a substance to make it disappear.
Providers should also ask themselves a difficult question: Whose discomfort are we treating?
Women’s anxiety should not be minimized. But neither should every manifestation of it be treated as something that must disappear immediately.
As clinicians and researchers learn more about kratom and kratom use disorder, we should listen carefully to how women arrived there. Sometimes that story began years earlier, with a woman who was anxious, a provider who wanted to help, and a prescription that offered relief.
The harder question is what happens when relief becomes the treatment plan.
Contributor Bio
Jana Wu, LCSW, LADC, ICAADC, CASAC, is a clinician at Mountainside Treatment Center specializing in PTSD, anxiety, depression, and co-occurring disorders. A nationally recognized expert on kratom, she founded the country’s first clinician-led kratom support group and has presented on kratom and emerging substances to professional audiences nationwide. Her expertise has been featured in The Wall Street Journal, Rolling Stone, and on NBC News and iHeartRadio. She was a founder of the Addictions Committee of the Connecticut chapter of the National Association of Social Workers.
