DEA Raises the Alarm on Kratom and the Rise of Risky Exposure

UNITED STATES—A recent study published in Clinical Toxicology revealed that exposure to and use of kratom has dramatically increased over the past 7 years.

The herbal supplement often used to overcome opioid pain and withdrawal has now become a drug of concern according to the DEA. It has been a part of the DEA’s list of drugs and chemicals of concern despite it being an herbal supplement.

One of the major concerns about kratom is that it has never been approved for medical use by the FDA. But the danger lies in the fact that many believe it is safe because it is made of herbs.

But Henry A. Spiller, MS, DABAT, co-author, and director, Central Ohio Poison Center at Nationwide Children’s Hospital strongly advise against such misperception.

“Individuals who choose to use kratom need to be aware of the potential risks. Just because it is currently classified as an herbal supplement does not mean it is regulated or that it is safe,” he explained.

Kratom exposure can cause agitation, coma, irritability, hypertension, increased bilirubin, renal failure, seizure, and death.

What is kratom exactly?

Native to Thailand, Indonesia, Papua New Guinea, and Malaysia, kratom is a tropical evergreen from Southeast Asia and belongs to the Rubiaceae family.

Natives who have used kratom for many years say that it is addictive. The FDA also confirmed that it has opioid properties. While the alkaloids it contain can relieve pain, one of them has a structure similar to yohimbine. It is believed that mitragynine may be the source of the opioid-like effects of kratom.

This is why the herbal supplement is classified as a kappa-opioid receptor agonist with a potency believed to be 13 times more than that of morphine.

The leaves of kratom can be chewed brewed into a tea, or smoked. In supplement form, it is taken in capsule, extract formulations, and tablet.

What brought about the cause of concern?

The US Poison Control Centers received between January 2011 and December 2017 over 1,800 calls about kratom exposure. This is according to a recent study conducted by the Center for Injury Research and Policy – Nationwide Children’s Hospital, and the Central Ohio Poison Center.

  • 65 percent of kratom exposure occurred between 2016 and 2017.
  • The annual number of calls from 2011 to 2017 significantly increased from 13 to 682.
  • A full 32 percent of these calls resulted in a patient being admitted to a healthcare facility.
  • 52 percent of these calls led to serious medical outcomes.
  • 71 percent of exposures occurred in men
  • 89 percent of exposure involved aged 20 years and older
  • 86 percent of exposure happened at residence
  • 69 percent of the 48 incidents involving children were younger than 2 years.

Given the variety of serious medical outcomes associated with kratom exposure, the FDA has raised serious concerns about the supplement’s toxicity. The agency has reported 44 associated deaths, resulting in a ban in several states.

Alabama, Tennessee, Wisconsin, Indiana, Arkansas, and the District of Columbia are just some of the states that classified kratom as a Schedule 1 Substance and banned it subsequently.

In November 2017, a public health advisory outlining the deadly risks associated with kratom use was first issued by the FDA. Another one was issued in February 2018.

There was also a statement published by the agency stating that there’s no supported scientific data regarding the use of kratom for medical purposes. This is why the herbal supplement should not be used for opioid withdrawal or as an alternative to prescription opioid.

Kratom has yet to be added to Schedule I of the Controlled Substances Act by the DEA. Currently, it is under review by the agency.

Kratom vs CBD

Both are often linked to each other, especially with some online shops selling both in one place. But while both are herbal, the debate on which is better continues.

In terms of pain relief and management, many claim that kratom does a better job than the therapeutic remedy that cannabidiol oil provides.

What many don’t know is that pain is either nociceptive or neuropathic. The former is a result of a physical damage to tissue systems, while the latter is chronic pain.

Kratom is considered better at treating nociceptive pain at severe levels. CBD, on the other hand, takes care of neurodegenerative and neuropathic conditions.

Both Kratom and CBD has their share or pros and cons and will show you the benefits of the latter and other information.

When it comes to side effects, Kratom poses more risk, particularly in terms of addiction and subsequent withdrawal. It may be an opiate-receptor agonist that is milder than other opioids, but they’re addictive just the same.

The FDA and DEA have good reasons to raise the alarm on kratom.