Published: Thu, February 08, 2018
Health | By Jay Jacobs

FDA Says Kratom Is An Opioid, Damaging Hopes for Addiction Treatment

FDA Says Kratom Is An Opioid, Damaging Hopes for Addiction Treatment

Kratom is imported from Southeast Asia and has become increasingly popular for relief from pain, anxiety and depression as well as opioid-withdrawal symptoms.

The US Food and Drug Administration warned the public once again on the use of the herbal supplement kratom in a statement on Tuesday. Gottlieb said the FDA is concerned about the substance's "potential for abuse, addiction, and serious health consequences; including death". He noted that, "Given all these considerations, we must ask ourselves whether the use of kratom-for recreation, pain, or other reasons-could expand the opioid epidemic". But other researchers warn that the herb, taken in capsules or by drinking tea, is too risky to use. That's because "the activity of kratom at opioid receptors indicates there may be similar risks of combining kratom with certain drugs, just as there are with FDA-approved opioids", Gottlieb said. That makes definitively labeling kratom as the cause of death impossible.

"Claiming that kratom is benign because it's "just a plant" is shortsighted and risky", Gottlieb said in a statement.

Still, there is limited available research on kratom, and the FDA's research is largely based on case reports that involved multiple drugs, not just kratom. But officials backtracked after a public outcry and pressure from some members of Congress. "And yet the medicine is in the dose, so I think kratom might have a really good place in skilled practitioner medical hands".

The FDA provided that evaluation late a year ago. "In addition, a few assessable cases with fatal outcomes raise concern that kratom is being used in combination with other drugs that affect the brain.", the agency stated.

For their latest report, scientists at the FDA looked at the chemical structures of the 25 most prevalent compounds in kratom. The model also showed that 22 of the compounds bind strongly to opioid receptors in the brain and to receptors "that may contribute to stress responses that impact neurological and cardiovascular function". "The use of kratom is also associated with serious side effects like seizures, liver damage and withdrawal symptoms".

After the FDA's November announcement, Jack Henningfield, an addiction specialist who works at the drug policy consulting group Pinney Associates, said that surveys of kratom users suggest that many are taking the supplement to help stop using opioids.

Although a number of deaths have been linked to use of kratom, it's unclear if the deaths are a direct result of using the drug, Marc Swogger, an associate professor of psychiatry at the University of Rochester Medical Center in NY, told Live Science in a 2016 interview.

However, as an unregulated and unapproved psychoactive substance being used without supervision, kratom poses unknown risks.

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