What’s the REAL Story About Kratom?

It seems that the sale of Kratom is becoming more and more commonplace. There are many outlets that advertise and sell Kratom products such as gas stations, health and nutrition stores, and online outlets to name a few. It is touted by these places that Kratom is beneficial for improved concentration and mood, increased energy, pain relief, relaxation, improved sleep and even treatment of opioid withdrawal.

What is Kratom Made of?

Mitragyna Speciosa (commonly known as Kratom) is a tropical evergreen tree that is primarily found in areas of Southeast Asia. The plant is technically a member of the coffee family. It has origins dating back to at least the 1800's in Africa and Southeast Asia where it was used historically in religious ceremonies and for medicinal purposes. In those cases, someone would either chew on the bark of the tree, consume the leaves in pure form, or brew a tea from the dried leaves. From a medicinal standpoint, the substance was used to help increase stamina for manual labor such as farmers, field workers and seafarers.

What are the Side Effects of Kratom Use?

Like virtually all prescription and over the counter medications, Kratom has known side effects and drug-to-drug interactions.  Some reported side effects of Kratom include:

• Decreased appetite and weight loss
• Dry mouth
• Nausea and vomiting
• Muscle aches
• Drowsiness
• Depression
• Anxiety
• Seizures
• Difficulty breathing

Can Kratom be Used to Treat Opioid Addiction?

It had been thought that Kratom may be a safer alternative therapy to treat opioid addiction, however studies have shown no clear benefit along with many side effects. Additionally, patients have exhibited significant opioid-like withdrawal symptoms when discontinuing use of Kratom. This has sometimes resulted in utilizing other medicines to in turn treat Kratom withdrawal.

Other Known Concerns of Kratom

From 2011 to 2017, Poison Control Centers have received about 1,800 reports of Kratom-related incidents, including reports of death¹. High blood pressure, seizures and withdrawal symptoms have been documented in about half of these Kratom incidents.

An additional concern has been that Kratom products may be contaminated with salmonella bacteria. In April 2018 more than 300 people in 38 states became ill with salmonella following Kratom use. Salmonella infections can be deadly and the FDA has reports of at least 35 deaths attributable to salmonella tainted Kratom products.¹  In many cases infection with salmonella has no obvious symptoms. The best way to prevent it is to avoid contamination.

Research has shown that Kratom use during pregnancy can have a negative effect on infant development and also lead to babies being born who exhibit symptoms of withdrawal that require treatment.

What Does the FDA Say About Kratom?

The United States Food and Drug Administration (FDA) identified Kratom as a compound of interest but had not regulated its use or distribution.  Recently, the FDA has issued warnings about making false claims about Kratom’s effectiveness and has changed the compound’s designation to a chemical of concern.  There is a movement within the agency to designate Kratom as a schedule I compound which would mean that, although the substance could still be used in research, there is not legitimate medicinal use and sales would be halted.

In summary, there is no controlled scientific studies that show a definitive benefit for Kratom use. Further, there are a number of side effects, risks and interactions that can occur with its use. The compound is considered “concerning” to the FDA and multiple warnings have been issued regarding the use of Kratom. Individuals who use Kratom should inform their doctor or pharmacist and discuss other options for treatment.

References:

1. “Kratom: Unsafe and Ineffective”, Healthy Lifestyle Consumer Health – Mayo Clinic, April 25, 2019.
2. Grinspoon MD, Peter, “Kratom: Fear-worthy foliage or beneficial botanical?”, Harvard Health Publishing, September 26, 2019.
3. Gianutsos, Gerald, “The DEA Changes Its Mind on Kratom”, U.S. Pharmacist, March 17, 2017
4. Tacket, Michael, “Kratom Strains: The Complete Guide in 2019”, Buds and Blossoms.com, August 9, 2019.
5. Cinosi, Eduardo, et.al. “Following ‘the roots of Kratom (Mitragyna speciose): the Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries”, BioMed Research International, October 15, 2015.