Kratom, an herbal supplement made of mashed leaves from a tropical tree, was linked to 91 deaths over the 18-month period from July 2016 to December 2017. This claim was made in a report released by the United States Centers for Disease Control and Prevention (CDC) on April 12, 2019.
In the report, the CDC analyzed 27,338 overdose deaths for the stated period. Of these deaths, the deaths linked to Kratom was less than one percent. While the percentage may be small, these deaths highlight a possibly troublesome issue – an increasing number of individuals are using kratom to fight pain and depression, even opioid addiction.
Of the 91 kratom-linked deaths, only seven individuals tested positive for exclusively using kratom. The other 84 fatalities tested positive for both kratom and at least one other substance, thus, it was difficult to make conclusions about the drug – or the combination of drugs – that resulted in the overdose.
This presents a few issues about the report’s reliability. Oliver Grundmann, a pharmacologist and toxicologist Oliver Grundmann of the University of Florida in Gainesville, said that the numbers “are a little bit murky”. As such, it’s difficult to make definitive conclusions about the 91 fatalities’ cause of death.
But just because kratom is linked to such a small percentage of overdose deaths doesn’t make it any less risky. For one thing, kratom supplements are largely unregulated even in the United States where recreational drugs, herbal supplements, and medicines are strictly regulated.
The CDC report will likely fuel the debate about putting kratom on the permanent Schedule I list of controlled substances of the Drug Enforcement Administration (DEA). The for-and-against factions are equally passionate about their causes, and the debate will heat up in the coming days.
Some scientists and politicians have expressed their concerns about putting kratom on the DEA’s Schedule 1 list. Their assertion is that doing so will put legitimate research into opioids alternatives and opioids withdrawal treatments will be at a standstill.
Kratom, after all, has been widely used in many Southeast Asian countries for several years yet there are no reported overdose fatalities. There have been, however, reports of users becoming more tolerant of higher doses and eventually of becoming dependent on it, according to Grundmann,
He has also said that while he fully supports the concerns of the Food and Drug Administration (FDA) about keeping unsafe products off the shelves, the actual cause of death in the kratom-related fatalities isn’t clear yet. He added that, “If somebody had a preexisting condition or had been taking prescription drugs or illicit drugs, it is exponentially difficult to pull apart all of the substances and compounds they had been exposed to and determine what is actually responsible for that person’s death.”
Along with a dozen researchers, Grundmann has warned the DEA and the Department of Health and Human Services (DHHS) that banning kratom may cause larger issues in the long-term period. The consumers, for example, will seek and buy kratom from black market sources or use opioids again resulting in more serious risk of death.
For another thing, many kratom products are adulterated in the sense that these contain other dangerous substances, even drugs. In 2018, the FDA found salmonella bacteria in kratom shipments with 50 individuals reported hospitalized; no deaths were reported.
Kratom advocates are then pushing for stricter manufacturing and labelling regulations to prevent these instances. Many kratom products are sold online and in storefronts without proper labelling including the name of the manufacturer.
Kratom critics point to the case of Caleb Sturgis who died last summer from “acute mitragynine intoxication” according to the coroner’s office. His family has filed a lawsuit of wrongful death against SoCal Herbal Remedies, a distributor of kratom products, alleging that kratom isn’t safe.
Mitragynine is one of the chemicals in kratom. It works in a similar manner as opioid drugs, such as morphine and codeine, in pain relief. It apparently also boosts the mood and energy, thus, kratom is popular as a mood booster and an energy supplement.
Kratom is even used in the treatment of opioid addiction and in the management of post-traumatic stress disorder symptoms in some veterans. Indeed, these benefits make it an increasingly popular herbal supplement with several million Americans believed to use it on a regular basis.
Many people consider kratom as a safe herbal supplement because it comes from a plant. But emphasis must be made that it doesn’t necessarily make it safe.
The reported side effects for kratom use include seizures and hallucinations, even symptoms of psychosis. For this reason, there have been strong calls from the Trump administration to ban it on the national level. According to Scott Gottlieb, a former FDA commissioner, “There is no evidence to indicate that kratom is safe or effective for any medical use.”
For people who have concerns about the use of kratom or who have underlying medical conditions, the use of kratom isn’t advised. Keep in mind, too, that kratom is banned in several states and local jurisdictions including Alabama, Arkansas, and Vermont as well as in the District of Columbia.
