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FDA Warns Public of Dangerous Health Risks from Kratom Herb Use


Photo by: Sanit Fuangnakhon via Shutterstock

The herb kratom, used a supplement to treat anxiety, depression, and pain, has been associated by the Food and Drug Administration to deadly health risks.According to the agency, kratom has similar effects to narcotic drugs like opioids that any abuse may lead to death.

“It’s very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms.There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder,” stated FDA Commissioner Scott Gottlieb.

Mitragyna speciosa or kratom is a tropical evergreen tree in the Rubiaceae coffee family.It is a native plant in Southeast Asia, particularly Indonesia, Malaysia, Myanmar, Papua New Guinea, and Thailand, and has been used as an herbal medicine since the 19th century.Since 2013, no clinical trials had been performed to understand the benefits and risks of the plant.But it has been marketed in powder and pill forms, and some people buy them to manage their chronic pain, anxiety and depression, and as a treatment for withdrawal symptoms from opioid use.

A professor of emergency medicine at the University of Massachusetts, Dr.Ed Boyer, studied the plant and found its narcotic effect.Two active ingredients found in the plant, mitragynine and 7-hydroxymitragynine, bind to the opioid receptors in our body that indicate an opioid-like effect.However, kratom does not seem to cause slow breathing, unlike hydrocodone or heroin.The active ingredient 7-hydroxymitragynine can be more potent than morphine, according to Dr.Boyer.

Dr.Chris McCurdy, a medical chemist, professor at the University of Florida, and one of the authors of a study to be presented to the Society of Neuroscience, described that the active ingredient mitragynine is not addictive and may have medicinal properties.

“I share the public health concerns.I'm not beating a drum to keep it legal and keep it the wild wild West.But I truly believe that it has medical potential,” said McCurdy who studied the plant for more than a decade.

Kratom has been criticized by government agencies in the US.In 2014, the FDA issued an alert that allowed the plant to be detained by US officials without a physical examination.In August 2016, the Drug Enforcement Agency planned to make kratom as a Schedule I drug, a chemical or substance defined as a drug without currently accepted medical use and a high potential for abuse.But public outcry and letters from the Senate and House of Representatives pushed it back.

“I realize there hasn't been a huge amount of science, but that's where we are now at: getting some of this science to the forefront.Obviously, I agree with the need to regulate the marketplace, but I don't want it to impede the research and potential for a treatment,” said Dr.McCurdy.

Kratom Used As A Drug

In addition to being used as a medical drug by some people, kratom also became popular as a recreational drug.Across Southeast Asian territories, a tea-based cocktail called “4x100” became a hit among younger people.It is composed of kratom leaves, cough syrup, Coca-Cola, and ice.

Since 1836, kratom was used as an opioid substitute in Malaysia.The plant became an opioid substitute as well in Thailand by the 19th century.But there are no formal trials performed to study and analyze the efficacy and safety of kratom as an opioid substitute since 2011.

As an herbal medicine, kratom leaves relieve pain in the musculoskeletal system.Chewing the leaves also gives an increase in energy, appetite, and sexual potency.The leaves and its extracts may be used to heal wounds, applied as local anesthesia, treat coughs, and treat diarrhea and intestinal infections.It is commonly used by people who work in laborious occupations to relief exhaustion and enhance mood.

Adverse Effects of Kratom

Outside Southeast Asia, kratom has been reported available for purchase in head shops, convenience stores, and gas stations.Similar to other substances, kratom can cause undesirable effects from prolonged use or abuse.

- Nervousness

- Nausea and vomiting

- Sweating

- Itching

- Constipation

- Delusions and hallucinations

- Paranoia and psychotic episodes

Kratom produces an opioid-like effect and prolonged use or abuse of the substance can lead to addiction.Withdrawal symptoms from kratom-dependence include depression, panic, mood swings, anxiety and irritability, and muscle pain.According to an online user’s guide, the effects of kratom use primarily depends on how many leaves were used by the person.

- 2 to 6 grams of leaves: mostly stimulant.

- 7 to 15 grams of leaves: stimulant to some people, euphoric or sedative to others.

- 16 to 25 grams of leaves: strong sedating effects to most people.

- 26 to 50 grams: very strong euphoric or sedating effects to people with possible delusions and hallucinations.

Additional Information

- Respiratory depression is a major health risk of opioid use.But such risk is not confirmed with kratom.

- Alkaloid extractions from the plant are composed of 60 percent mitragynine and two percent 7-hydroxymitragynine.

- Kratom’s active ingredients and compounds are undetected by standard screening tests.Only specialized testing can reveal its compounds in a person’s bodily fluids.


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