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Herbal Supplement Kratom Contains Opioid, FDA Issues Public Warning

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The Food and Drug Administration has issued a public warning on the supplement kratom. Kratom contains opioid and should not be used to treat pain.

Kratom, an unregulated herbal supplement used as an alternative drug to pain relievers, contains opioid properties triggering concerns for its potential for abuse, addiction and, serious health consequences, according to a new research by the FDA.

The substance that originated from Southeast Asia has become popular with consumers since it can provide relief from pain, anxiety, depression, and drug withdrawal symptoms.

Kratom is available in capsule and powder form, and it has gained popularity in the U.S. as an alternative treatment for pain, anxiety and drug dependence. Proponents say that is safer than other opioid painkillers such as OxyContin and Vicodin, but the FDA research says otherwise.

FDA Methodology And Findings

The FDA had been studying kratom for years, and recently, it used computational modeling and referred to reports on the adverse effects of the supplement to analyze its chemical properties.

The agency analyzed the 25 most prevalent chemical compounds found in kratom using a tool that can simulate how chemical constituents of a substance are structured at a molecular level, how they may behave inside the body, and how they can potentially affect the brain.

The tool called Public Health Assessment via Structural Evaluation or PHASE, showed that kratom compounds affect the body in the same way that opioids do.

Based on FDA's scientific evaluation, kratom isn't just a plant, but an opioid.

"It's an opioid that's associated with novel risks because of the variability in how it's being formulated, sold and used recreationally and by those who are seeking to self-medicate for pain or who use kratom to treat opioid withdrawal symptoms," says Scott Gottlieb, commissioner of the FDA.

The FDA said it is concerned about the growing use of kratom to treat opioid withdrawal symptoms since they found no reliable proof that using kratom can treat opioid use disorder and other medical conditions.

What Is Kratom?

Kratom or Mitragyna speciosa is a tropical tree indigenous to Thailand, Malaysia, Indonesia, Papua New Guinea and Myanmar. It is used as a medicinal plant for its opioid and stimulant properties. It is related to the coffee plant, and the leaves can be brewed as a tea.

Low doses of kratom have stimulating properties while high doses can result in sedative and narcotic effects. It contains mitragynine and 7-hydroxymitragynine - known compounds that engages opioid receptors, thus, mimicking the effects of opioids.

Excessive use of kratom can be addictive. It causes withdrawal, muscle spasms, mood swings, muscle aches, depression, insomnia, agitation, anxiety, nausea, and constipation. Kratom overdose may cause psychosis and seizures.

The FDA has also linked the substance to 44 reported deaths since 2011.

Opioid Use Disorder

According to the National Instituted of Drug Abuse, 115 Americans die every day due to opioid and prescription drugs overdose. The most commonly abused drugs are prescription pain relievers, heroin, and synthetic pain reliever fentanyl.

Every year, the economic burden of opioid abuse amounts to $78.5 billion according to the Centers for Disease Control and Prevention. The said amount includes the costs of healthcare, lost productivity, addiction treatment, and crimes.

In November 2017, the FDA issued an advisory against kratom. It is likely that the federal government will ban the substance.

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