The CDC has reinforced warnings about the herbal supplement kratom after dozens of deaths over the past few years have concerned healthcare officials.
The herbal supplement kratom is derived from the Southeast Asian kratom tree. People can purchase it over the counter throughout the US in powder-capsule form, as a tea and as a mixed capsule with caffeine. It is a popular drug for its pain relief properties and is often sold as a supposedly safer and “natural” alternative to opioids.
While this ”atypical opioid” certainly does have pain relief applications, it also carries substantial risks.
In a report published Friday, April 12, the Centers for Disease Control updates figures on kratom-linked fatalities in the United States for the years 2016 to 2017, putting the number of overdose deaths at 91. Previous figures indicated around 44 deaths since 2011, so this is a significant uptick.
Out of some 27,338 overdose cases, 152 people tested positive for kratom—even when it was not the direct cause of death. Health experts say that even where kratom is not the actual cause of death it may still be a contributing factor because, when taken with other medications, it can lead to overdoses which are more complex to treat.
the report reads. “Kratom was determined to be a cause of death by a medical examiner or coroner for 91 of the 152 kratom-positive decedents, including seven for whom kratom was the only substance to test positive on postmortem toxicology, although the presence of additional substances cannot be ruled out.”
“In approximately 80 percent of kratom-positive and kratom-involved deaths in this analysis,” the report adds, “the decedents had a history of substance misuse, and approximately 90 percent had no evidence that they were currently receiving medically supervised treatment for pain.
As a national drug problem, the wider opioid overdose issue still massively dwarfs kratom. Opioids were responsible for 47,600 fatalities in 2017 alone. While it is important not to overstate the current role kratom plays in drug deaths, health experts are concerned because kratom’s popularity seems to be growing.
Kratom is particularly popular among people with a history of substance abuse, not just pain medication addiction. This may indicate that its opioid-like effects are something that people may seek out if they have prior drug dependence.
There is also some misinformation regarding kratom as a means of ending opioid addiction “naturally”. For this purpose it is often sold in tea form and is said to ease withdrawal-related symptoms like cramps and nausea. However, kratom is not a scheduled or restricted drug. It is not regulated, and research hasn’t fully verified its effects or explored it in the same way as regulated pharmaceuticals.
As an herbal supplement, its dosage and the exact makeup of the product may differ between brands. Even giving the benefit of the doubt that most brands are trying to deliver top quality for consumers, this gap in regulation can lead to serious issues.
Kratom has also been linked to heavy metal exposure. A recent FDA report evaluated 30 different kratom products available to the public and found that the majority had ”significant levels of lead and nickel” that were past the safety levels set for oral drug ingestion. Heavy metal exposure over a long period of time can lead to nervous system damage and increased cancer risk, among other health issues.
Previously, FDA Commissioner Scott Gottlieb has warned that the use of kratom appears to be gaining popularity as a means of treating opioid problems, but that this is risky.
“At a time when we have hit a critical point in the opioid epidemic, the increasing use of kratom as an alternative or adjunct to opioid use is extremely concerning,” Gottlieb explained in a press release. “It’s very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms. …. There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder.”
The main thrust of the CDC and FDA warnings is that beneath the idea of kratom as a “natural” pain relief supplement hides a darker reality: it is an unregulated and potentially lethal substance which, because it is not carefully monitored poses a real risk to users, particularly if they take opioids.
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