If you don’t know what Kratom is, you’re not alone. With a name that sounds like something out of Shazam, it is in fact a highly addictive, unregulated drug. It has been brought into the US by importers, often via illegal routes, for the last decade and is frequently seized by the FDA and destroyed. It causes death, dependency, and is, to all intents and purpose, an unregulated type of opioid sold across the counter to anyone. In fact, if you’re waiting in the car at your local gas station and you fancy a fix, just pop into the shop. It’s probably on the shelf.

If you would like your local retailers to stop selling this drug to your children and other vulnerable members of the community, there is a link at the end of this article to report the drug and actions you can take to have the product removed from shelves.

What is Kratom?

According to a very detailed analysis of the plant on Wikipedia, Mitragyna speciosa (commonly known as kratom) is a tropical evergreen tree in the coffee family native to Southeast Asia. It is indigenous to Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where it has been used in herbal medicine since at least the nineteenth century. Kratom has opioid properties and some stimulant-like effects.

As of 2018, the efficacy and safety of kratom are unclear, and the drug was unapproved as a therapeutic agent due to the poor quality of the research. FDA and other investigations suggest that any applications for licensing would fail, based on the drug’s current safety profile and reported interactions with other medications and substances, reactions that are often fatal.

In 2019, the Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition. Some people take it for managing chronic pain, for treating opioid withdrawal symptoms (no shred of clinical evidence exists to support this), as a herbal cure-all sold on various websites as a treatment for pretty much everything, from the common cold to cancers, or for recreational purposes.

The onset of effects typically begins within five to ten minutes and lasts for two to five hours. It’s worth noting that most opioid users end up taking both opioids and Kratom (or cycling), clear evidence that Kratom is useless as a treatment against opioid addiction.

Common and more serious side effects include;

• nausea
• itching
• sweating
• dry mouth
• constipation
• increased urination
• loss of appetite
• seizures
• hallucinations
• respiratory depression (decreased breathing),
• seizure
• addiction
• psychosis

Other serious side effects may include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity. When use is stopped, withdrawal symptoms often occur. Deaths have occurred with kratom both by itself and mixed with other substances. Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.

Kratom is a controlled substance in 16 countries and, in 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use. In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts.

The real danger posed by Kratom

Availability is a key problem. Your child can stop in to shop at a gas station and buy the product off the shelf. A fact verified today by my colleague in Texas. It also doesn’t show up on regular drug tests, so many deaths associated with Kratom go unlisted.

If in some weird alternate universe Kratom is shown to possess any real medical benefits (none have been discovered or scientifically validated as yet) it would still require a lengthy regulation process for certification by the FDA. This process exists to protect consumers against products exactly like Kratom. In 2013, the US Drug Enforcement Agency (DEA) issued a warning about Kratom, stating that there was no proven medical use for the drug.

To be 100% clear on this. Kratom is considered highly dangerous by the FDA and many other countries’ drug licensing authorities. It can lead to death, dependency, and a host of other nasty conditions. It is a psychedelic, so please don’t feed me bullshit about pain management. Get stoned enough and your pain tends to magically evaporate for the duration of the high. The effects reduce with each usage, leading to increased dosages and almost guaranteed addition.

Kratom also won’t cure any diseases or conditions, no matter what the quacks and con-artists selling Kratom promise you.

New drugs often enjoy a honeymoon period with the public, a window where they can be freely distributed simply because legislation has not yet been enforced to protect the public. Cocaine was legally sold across the counter not so many years ago. The system isn’t perfect and it is slow to react. Sadly, death and addition are an all too common byproduct of this window.

There is a reason doctors don’t (or shouldn’t) keep their patients permanently stoned up the yazoo and there is a reason America has a MASSIVE problem with opioid addiction. Psychotropic and psychedelic drugs aren’t the answer for management of chronic pain. In fact, they aren’t a medical solution for just about anything.

If you’re a late-stage cancer patient or other, bedridden and on death’s door, that is a different issue. Don’t confuse chronic pain with end of life scenarios.

On overdose and related interactions

There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A 2019 paper analyzing data from the National Poison Data System found that between 2011–2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances.

In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances, including illicit drugs, opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications, such as cough syrup.

Also, there have been some reports of kratom packaged as dietary supplements or dietary ingredients that were laced with other compounds that caused deaths. The FDA also seized various Kratom products that were contaminated with Salmonella. Still think your local retailer should be selling this?

Figures above provided by the National Institute on Drug Abuse

The FDA and Kratom in the US

According to a 2019 statement on the FDA website the FDA stated the following regarding Kratom.

The U.S. Food and Drug Administration is warning consumers not to use Mitragyna speciosa, commonly known as kratom, a plant which grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea. FDA is concerned that kratom, which affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.

There are no FDA-approved uses for kratom, and the agency has received concerning reports about the safety of kratom. FDA is actively evaluating all available scientific information on this issue and continues to warn consumers not to use any products labeled as containing the botanical substance kratom or its psychoactive compounds, mitragynine and 7-hydroxymitragynine. FDA encourages more research to better understand kratom’s safety profile, including the use of kratom combined with other drugs.

To date, they have taken the following actions against the product’s import into the US.

• In September 2014, U.S. Marshals, at the FDA’s request, seized more than 25,000 pounds of raw kratom material worth more than $5 million from Rosefield Management, Inc. in Van Nuys, California.
• In January 2016, U.S. Marshals, at the FDA’s request, seized nearly 90,000 bottles of dietary supplements labeled as containing kratom and worth more than $400,000. The product, manufactured for and held by Dordoniz Natural Products LLC, located in South Beloit, Illinois, is marketed under the brand name RelaKzpro.
• In August 2016, U.S. Marshals, at the FDA’s request, seized more than 100 cases of products labeled as containing kratom and worth more than $150,000. The products are distributed by Nature Therapeutics LLC, which does business as Kratom Therapy and is located in Grover Beach, California. The seized products are marketed under the brand name Kratom Therapy.

The FDA has issued warnings to companies. The companies receiving warning letters use websites and social media to illegally market kratom products, making unproven claims about the ability of the kratom drug products they distribute to cure, treat, or prevent disease. Examples of claims being made by these companies include:

• “Kratom acts as a μ-opioid receptor-like morphine.”
• “In fact many people use kratom to overcome opiate addiction.”
• “Of course, people who are using kratom to overcome a preexisting opiate addiction may need to use kratom daily to avoid opiate withdrawal.”
• “Usage: It is for the management of chronic pain, as well as recreationally.”
• “Kratom is frequently used as a natural alternative to treat depression, anxiety, addiction, diabetes, chronic pain and fatigue…Kratom has been reported to have taken the place of brand name drugs like Hydrocodone or Oxycodone for individuals, all the way to weaning people off of Heroin.”
• “Some researchers have even claimed that kratom can protect you against cancer!”
• “Kratom is used for energy, to increase attention/focus, to relax, and also to treat pain and addiction. Here is just some of what our customers have used kratom to treat . . . Chronic Pain, Migraines, Opiate Addiction, ADHD/ADD, Anxiety, Depression, Arthritis, Insomnia, and much more!”

Health fraud scams like these can pose serious health risks. These products have not been demonstrated to be safe or effective for any use and may keep some patients from seeking appropriate, FDA-approved therapies. Selling these unapproved products with claims that they can treat opioid addiction and withdrawal and other serious medical conditions is a violation of the Federal Food, Drug, and Cosmetic Act.

There are a lot of advisories issued by the FDA on this drug, you can find an extensive list in the footer of the article linked to above.

Reporting This Drug

You can use this link provided by Medwatch to report the drug and any adverse interactions you, or someone you know, may experience.

MedWatch Online Voluntary Reporting Form

What can you do about retailers making these products freely available in your town or city? If they are large chains, reach out with a formal letter to their head office, notifying them of the dangers of Kratom, and copy in your local government and press. For smaller private retailers, try dropping off or sharing information on the dangers of the product and if they show disregard for your children’s safety and others within their community, consider boycotting the stores.