Kratom Has ‘Deadly Risks,’ FDA Warns

There is considerable debate around the classification of kratom. Historically, it has been used to treat an assortment of illnesses, for instance, to ease symptoms of opioid addiction and withdrawal or decrease dependency.

Kratom was also used for pain relief, producing euphoria, and fighting off fatigue, particularly among rural areas of Thailand and Malaysia. Nevertheless, both countries recognized its potential for addiction and banned the substance for recreational use.

According to the American Kratom Association, there are currently an estimated 3 to 5 million kratom users in the United States. As health care professionals are pressured to reduce prescribing opioids, individuals struggling with addiction and dependence often seek out alternatives like kratom. It has been proclaimed to be a legal, inexpensive substitute to opioid medication. However, the Food and Drug Administration (FDA) warns of kratom-drug interactions resulting in permanent liver damage and death.

FDA Warns of Risks Associated with Kratom

In the United States, kratom is marketed as plant-based dietary supplements to treat various illnesses and experience a “legal” and “natural” high. Though, the standing of it being a dietary supplement remains unclear.

The FDA does not deem kratom a recognized supplement with bulk dietary ingredients. Alternatively, the FDA classified kratom’s psychoactive compounds mitragynine and 7-hydroxymitragynine as opioids and advocated for them to be placed into the Controlled Substances Act Schedule I by the Drug Enforcement Agency (DEA).

The FDA continues to warn consumers that kratom “should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids” and that there is no scientific evidence for its safe use.

In addition to the FDA’s warnings of kratom’s potential for abuse and addiction, a statement from FDA Commissioner Scott Gottlieb M.D., on FDA advisory about deadly risks associated with kratom highlights the data on the increasing dangers for its users.

The Poison Control Center’s National Data System identified 1,174 calls related to kratom use alone from 2011 to 2017, with symptoms ranging from vomiting and confusion to seizures and cardiac arrest. In addition, kratom was identified as the cause of death in 91 of 152 kratom-related deaths, though only seven cases had kratom as the single identified substance.

This information spotlights that kratom is commonly used alongside other drugs presenting a greater risk for overdose. The Center for Disease Control and Prevention (CDC) reports that drugs interact with the substances in kratom, suggesting a significant potential for harm.

Although kratom or its psychoactive compounds are not a scheduled drug under the U.S. Controlled Substance Act, the DEA does not acknowledge any legitimate medical or approved uses. Furthermore, it has not been evaluated or tested in clinical trials by any regulatory authorities or healthcare professionals to determine its safety and effectiveness.

What Is Kratom?

Native to Southeast Asia, kratom (mitragyna speciosa) is an evergreen tree-like plant mainly cultivated in Indonesia, Malaysia, and Thailand for recreational and medicinal use. The kratom leaves are dried and then processed into powders, capsules, pills, and extracts.

Forms

Kratom products are sold on the internet, in herbal stores, and tobacco or smoke shops, known as head shops. And in the U.S., the most common use is in liquid form, but powders added to food and beverages and capsules are growing in popularity.

Another form to ingest kratom is brewing it like tea or coffee, where the leaf or powder steeps in hot water or cold extracted. The resulting product is bitter, so various sweeteners are typically added.

Uses

In addition to the perception of reduced harm when people use kratom, instead of taking another opioid, it is used for a wide range of health reasons, including:

• Alleviating intense or chronic pain
• Increasing energy and alertness
• Lessening a depressed mood
• Lowering levels of anxiety
• Reducing or stopping the use of painkillers
• Reducing PTSD symptoms
• Elevating mood

It is also used as pain medication because it appears to block pain signals in more than one way. It impairs neurons that transmit pain in specific brain channels and introduces a numbing effect to pain pathways.

However, the DEA and CDC do not recognize any legitimate medical use for kratom in addition to the FDA. CDC reports have published cases that indicate kratom can cause death when interacting with other drugs.

Effects

The effects of kratom can cause symptoms similar to stimulants and opioids because of the drug’s ability to interact with opioid receptors in the brain. It produces pleasure and decreased pain at moderate amounts, but it causes a stimulating effect in smaller doses, increasing sociability and energy.

At doses of 5 grams or less, the potential for adverse effects is mild, but at higher doses, such as 8 grams or more, the side effects include:

• Nausea and vomiting
• Confusion
• Constipation
• Dizziness
• Drowsiness
• Itching
• Sweating
• Dry mouth
• Loss of appetite
• Seizures
• Hallucinations

Risks

The profound danger of kratom use is the lack of understanding of all the chemical compounds in its leaves and how they may interact with prescription medications, recreational drugs, and even herbal supplements.

Also, the labels on kratom products should be warning consumers of its unregulated manufacturing standards and ensuring the product is not contaminated or tainted.

In 2018, kratom was identified as the source of a multistate outbreak of salmonella infections. The FDA investigated outbreaks in 20 states after consumption and identified salmonella infections linked to three kratom brands. Out of the 16 products tested, 6 had entirely unknown manufacturers.

Furthermore, kratom can have severely dangerous interactions with antipsychotic medication, specifically one called quetiapine. A 27-year-old male with a history of mental health issues died due to mixing kratom with his quetiapine pills. This case brings further attention to the need for more studies into kratom drug interactions.

Kratom Withdrawal

Kratom is supposed to help with withdrawal symptoms from traditional opioids. Still, like all drugs with opioid-like effects, it can cause dependence, which results in withdrawal when you stop using. Withdrawal symptoms include:

• Diarrhea
• Fever and chills
• Aggression
• Hostility
• Muscle aches
• Loss of appetite
• Irritability
• Runny eyes and nose
• Jerky movements
• Emotional changes

Getting Help

Although kratom is legal in most states, consistent use, especially at high doses, can cause tolerance, dependence, and addiction. If you or someone you love is suffering from substance abuse, Northridge Addiction Treatment Center can help.

We offer medically supervised detox and a comprehensive residential treatment program for drug and alcohol addiction. Located in Northridge, California, NATC can be your ideal sanctuary to reach peace of mind.

Reach out today. We can help.