A herbal supplement is thought to have contributed the deaths of almost 100 people after accidental overdoses. The supplement in question is known as kratom (mitragyna speciosa), a plant is known for its psychoactive properties. It is believed to have therapeutic benefits, but from July 2016 to December 2017, according to the Centers for Disease Control and Prevention (CDC) it has caused 91 deaths. 

Kratom as a supplement is used to manage pain and boost energy. It naturally grows in Southeast Asia and has been used there as an opium substitute. In recent years its use has become more popular in the United States, however its use it potentially unsafe. 

Kratom as an Opioid Substitute

Kratom contains alkaloid mitragynine, a compound that affects the same brain receptors as opioids such as morphine. In low doses, alkaloid mitragynine causes stimulant reactions, but high doses create opioid-like effects. This exposes kratom users to the risk of addiction as well as substance abuse and dependence. 

Furthermore, studies have found that addicts substitute kratom in the place of opioids. Kratom can also cause withdrawal symptoms. It is commonly mixed with other substances like benzodiazepines and narcotics, which can be just as dangerous as mixing other opioids. [1]

In November 2017, the Drug Enforcement Administration identified kratom as a drug of concern.

The FDA’s Statement on Kratom

The US Food and Drug Administration (FDA) released a statement advising people not to use this supplement. 

“Taken in total, the scientific evidence we’ve evaluated about kratom provides a clear picture of the biologic effect of this substance. Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids. There is no evidence to indicate that kratom is safe or effective for any medical use.” 

“And claiming that kratom is benign because it’s ‘just a plant’ is shortsighted and dangerous. After all, heroin is an illegal, dangerous, and highly-addictive substance containing the opioid morphine, derived from the seed pod of the various opium poppy plants.” [4]

The Data: How Many Deaths Kratom Caused

The CDC analyzed data from the State Unintentional Drug Overdose Reporting System (SUDORS) in order to pinpoint the exact amount of deaths caused by this drug, whether the overdose was unintentional or the intent was unknown. 

Although kratom is not classified as an opioid, its history of overdose deaths is included in SUDORS. The CDC searched through death certificates, medical examiner and coroner reports, even postmortem toxicology results.

Their research discovered between 2011 to 2017, the poison control database reported 1,807 calls about kratom poisoning. In June 2016–17, kratom was determined to be a cause of death in 11 states. That number doubled to 27 affected states the following year.

During that time period, 152 out of 27,338 people who died from drug overdose (0.56%) tested positive for kratom. Many victims had traces of other drugs in their bodies, mostly fentanyl (65%) and heroin (33%). The aforementioned supplement was shown to be the main cause of death for 91 of these 152 people (almost 60%). In 7 of the 91 deaths, kratom was the only drug to test positive in the toxicology reports. 

The scary conclusions of these trials are that although many victims had a history of substance abuse, some innocently believed they were just taking a health supplement. 

Since the method of identifying kratom in a body varies from state to state, the known statistic might be underestimating the true number of kratom-responsible deaths. In order to clarify the full extent of kratom’s effects in fatal doses, further documentation of the testing process is needed. [2]

The Debate on Kratom

Due to its potential as a pain-reliever, treatment for post-traumatic stress disorder and opioid addiction, advocates for kratom oppose its boycott and claim there is not enough evidence of its harm.

FDA Commissioner Scott Gottlieb replied to these protests in a recent statement: “We have been especially concerned about the use of kratom to treat opioid withdrawal symptoms, as there is no reliable evidence to support the use of kratom as a treatment for opioid use disorder and significant safety issues exist.” 

He continues to implore individuals suffering from opioid addiction to seek help from a health care provider for safe and effective medical therapies.

“There are also safer, non-opioid options to treat pain. We recognize that some patients have tried available therapies, and still have unmet medical needs. We’re deeply committed to these patients, and to advancing new, safe and effective options for those suffering from these conditions.” [3]

Meanwhile, the FDA encourages research for the public to better understand kratom and its safety profile while advising people not to use products with kratom or its psychoactive compounds, mitragynine and 7-hydroxymitragynine.

As Gottlieb stated: “[The] FDA stands ready to evaluate evidence that could demonstrate a medicinal purpose for kratom; however, the agency has received no such submissions and is not aware of any evidence that would meet the agency’s standard for approval.” [4]

For an in-depth evidence-based look at the benefits and risks of kratom check out this article from Dr. Axe. 

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.

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