Recently, the Southeast Asian tree, Kratom, has been under scrutiny by the government and the media. The leaves can be brewed into a tea, chewed, smoked or ingested in capsule. At low doses, it is a stimulant, and higher doses, it becomes a sedative. It has been cited as helping with pain management, but also for its potential as a substitute for opioids, such as pain medications and heroin. Kratom is also legal in the United States and much cheaper than the previously-mentioned drugs. There are some side effects associated with its use, like nausea, itching, loss of appetite, seizures and hallucinations.
The reason that the plant has come under fire recently for its alleged lethality is due to the significant increase in calls to poison control centers concerning Kratom between 2010 and 2015. The CDC cites that out of 660 calls during the study period, 24.5 percent had minimal signs and symptoms and 47.7 percent were moderate non-life threatening, but required some kind of treatment. 7.4 percent were major, life threatening exposures. Single exposure, meaning only Kratom was used, was reported in 64.8 percent cases.
During that time, there was one death related to Kratom. However, the person had two medications in their system: paroxetine, an antidepressant, and lamotrigine, an anticonvulsant and mood stabilizer. This combination may have caused a reaction that contributed to their death. While Kratom may interact with other substances negatively, it is relatively inconclusive whether it is the sole reason for adverse reactions that were cited.
As of right now, there is not much research around the plant. However, Dr. Christopher McCurdy believes the plant may have some potential. Dr. McCurdy is a medicinal chemist and professor out of the University of Florida, who specializes in design, synthesis and development of pharmacotherapy for drug abuse/addiction and pain. He also says that pharmaceutical companies are not putting money into Kratom research because it cannot be patented, due to it being a plant. In essence, these companies do not see guaranteed profit coming from it, so they are not investing in it.
With government skepticism, it makes rationalizing research even more difficult. FDA Commissioner Dr. Scott Gottlieb recently stated, “There is no evidence to indicate that Kratom is safe or effective for any medical use,” and likened the compounds within Kratom to opioids. Dr. Gottlieb fears that the substance may have potential for abuse. In 2016, Kratom was temporarily listed by the DEA as a Schedule 1 substance, to be on the same level as heroin and LSD. After outrage by the public and by some members of Congress, it was removed.
Dr. Scott Hemby, who chairs the Department of Basic Pharmaceutical Sciences at High Point University, disagrees. Dr. Hemby has done research around the addictiveness and impacts of Kratom and has found that while it has some chemical similarities to opioids, it is not the same. He found that two chemicals in Kratom, mitragynine and 7-hydroxymitragynine, bind to opioid receptors, but in a more toned down and less addictive way. He stated, “Just because it binds, it doesn’t mean it has the same efficacy.” For these reasons, he found the statements by the FDA to be misleading.
What we can learn from this is that there is still much more to be discovered about Kratom. For now, the government should certainly keep a watch on it and explore its potential legitimate medicinal uses. It is an option that can and should be explored further before we take drastic measures like banning it. It may actually have the potential to quell the tide of the opioid epidemic that we are facing now. From what I have seen, it does not appear to be used as a recreational party drug. It seems that people are using it as a healthier alternative to prescription painkillers and as a way to curb off of much more dangerous opiates. With this in mind, there should be more funding for research and potential regulation for the substance in the future. We should do this for the betterment of our citizens who are in pain and who are suffering from addiction.