The Food and Drug Administration (FDA) warns the public about the risks associated with kratom. The herbal supplement used as an alternative to opioid painkillers caused 36 deaths to date.
Last year, the U.S. Drug Enforcement Administration withdrew the notice of intent for two active ingredients of kratom as Schedule 1 substances. The withdrawal came two months after they labeled the Southeast Asian drug as an imminent hazard to public safety.
A Medicinal Plant With Opioid-Like Effect
Also known as Mitragyna speciosa, kratom is an herbal supplement taken in dried powder form as a painkiller or as an adjunct therapy for patients recovering from opium addiction. Many consumers, particularly those from the Southeast Asia, also use the herb as a treatment for anxiety and depression since it can produce euphoria.
Despite its opioid-like activity, many proponents claim that kratom is a relatively safe substance to use since it is plant-based. However, the government regulatory department found evidence that the herbal supplement can cause addiction and death.
"It's very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms. The FDA is devoted to expanding the development and use of medical therapy to assist in the treatment of opioid use disorder," said FDA Commissioner Dr. Scott Gottlieb in a statement. "However, an important part of our commitment to this effort means making sure patients have access to treatments that are proven to be safe and effective."
Gottlieb acknowledged that some kratom users are after its euphoric effects, adding that allowing the legal use of the herb can only worsen the growing opioid crisis. FDA also mentioned about the 36 kratom-related deaths, as some manufacturers can lace the drug with opioids such as hydrocodone.
A report from the Centers for Disease Control and Prevention showed that from 2010 to 2015, the U.S. poison centers received 660 calls of kratom exposure, a tenfold increase from 26 to 263 in 2015. This data support that there is indeed an increase in the use of kratom in the United States.
Regulating Use Of Kratom
Aside from issuing a warning, experts believe that the government should work on regulating and standardizing the product.
"The compounds in kratom aren't particularly potent opioids like prescription opioids, morphine or fentanyl," said Dr. Christopher R. McCurdy, professor of Medicinal Chemistry and Director, University of Florida Translational Drug Development Core. "Is it addictive? It may be, slightly. But without any control or standardization of products that are out there, it's hard to say what people are using."
Jack Henningfield, an addiction specialist from Pinney Associates who worked with the American Kratom Association, counter-warned the FDA that banning the substance could potentially lead users to purchase from the black market or just simply return to using opioid.