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As of early 2018, 44 reported deaths in the U.S. were linked to the use of kratom — an opioid-like plant substance that is available as a dietary supplement.[1] A new analysis by researchers at the Centers for Disease Control and Prevention (CDC) linked the substance to a higher number of overdose deaths.[2] The analysis was published on Apr. 12 in Morbidity and Mortality Weekly Report.
The Food and Drug Administration (FDA) has not approved kratom for any therapeutic uses, and there...
As of early 2018, 44 reported deaths in the U.S. were linked to the use of kratom — an opioid-like plant substance that is available as a dietary supplement.[1] A new analysis by researchers at the Centers for Disease Control and Prevention (CDC) linked the substance to a higher number of overdose deaths.[2] The analysis was published on Apr. 12 in Morbidity and Mortality Weekly Report.
The Food and Drug Administration (FDA) has not approved kratom for any therapeutic uses, and there is no reliable evidence supporting its effectiveness or safety.[3] Yet the substance has been used increasingly without medical supervision for treating a variety of conditions, including anxiety, depression, opioid use disorder and pain.[4]
Using a database for unintentional overdose deaths, the CDC researchers identified 152 deaths that involved kratom from July 2016 to December 2017.[5] Specifically, kratom was determined to be a cause of death in 91 (60%) of these cases according to information recorded in death certificates or reported by medical examiners and coroners.
In 89% of these 91 cases, the patient did not have previously reported overdoses, and 88% of them did not receive medically supervised treatment for pain. A caveat for the analysis is that, in addition to kratom, other opioids also were identified as causes of death in most of these cases.
Kratom has been linked to abuse, addiction and withdrawal symptoms: aggression, emotional changes, hostility, insomnia, irritability, jerky movements, muscle aches and runny nose.[6] Last year, FDA scientists showed that multiple kratom compounds bind strongly to opioid receptors, supporting the classification of these compounds as opioids.[7]
The FDA has issued a public health advisory regarding the risks of kratom, and the Drug Enforcement Administration has classified the substance as a “drug and chemical of concern.”[8],[9]
Other serious adverse events associated with use of kratom include seizures and liver damage.[10] Cases of psychosis — hallucinations, delusion and confusion — also have been reported in association with use of kratom.[11] Additionally, kratom is sometimes laced with other opioids, such as hydrocodone.[12]
Do not use kratom for any reason. Instead, seek medical care from a licensed health care professional for pain or other health problems.
References
[1] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. February 6, 2018. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-agencys-scientific-evidence-presence-opioid-compounds. Accessed August 12, 2019.
[2] Olsen EO, O’Donnell J, Mattson CL, et al. Notes from the field: Unintentional drug overdose deaths with kratom detected — 27 states, July 2016 — December 2017. MMWR Morb Mortal Wkly Rep. 2019;68(14):326-327.
[3] Food and Drug Administration. Warning letter to KratomNC. May 16, 2019. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/kratomnc-576964-05162019. Accessed August 12, 2019.
[4] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. November 14, 2017. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-fda-advisory-about-deadly-risks-associated-kratom. Accessed August 12, 2019.
[5] Olsen EO, O’Donnell J, Mattson CL, et al. Notes from the field: Unintentional drug overdose deaths with kratom detected — 27 states, July 2016 — December 2017. MMWR Morb Mortal Wkly Rep. 2019;68(14):326-327.
[6] National Institute on Drug Abuse. Drug facts: Kratom. April 2019. https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/drugfacts-kratom.pdf. Accessed August 12, 2019.
[7] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. February 6, 2018. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-agencys-scientific-evidence-presence-opioid-compounds. Accessed August 12, 2019.
[8] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. November 14, 2017. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm. Accessed August 12, 2019.
[9] Drug Enforcement Administration. Drugs of abuse. 2017. https://www.dea.gov/sites/default/files/2018-06/drug_of_abuse.pdf. Accessed August 12, 2019.
[10] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. November 14, 2017. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm. Accessed August 12, 2019.
[11] Drug Enforcement Administration. Kratom (mitragyna speciosa korth) – (Street names: thang, kakuam, thom, ketum, biak). January 2013. https://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdfh. Accessed August 12, 2019.
[12] Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. November 14, 2017. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm. Accessed July 26, 2019.
