Kratom overdose deaths rising in US: health officials
NEW YORK: Overdose deaths in the United States involving herbal supplements made with kratom, a mild narcotic popular in Thailand, are more common than previously reported, health officials say.
A government report released this week said kratom was a cause in 91 overdose deaths in 27 US states. Officials had said previously that they knew of 44 nationally.
Most who died had also taken heroin, fentanyl or other drugs. But kratom was the only substance detected in seven of the deaths.
The Centers for Disease Control and Prevention (CDC) reported the numbers after combing through death certificates and toxicology reports from an 18-month period.
Kratom comes from a plant native to Southeast Asia but it has been illegal in Thailand for decades. It is especially popular among young men in the southern provinces, where the leaves are often mixed into “cocktails” containing cola and cough syrup.
The local status of kratom could be about to change, however. While the government’s recent legalisation of the controlled production, import and use of cannabis for medical and research purposes made headlines, kratom is also covered under the new law.
In the United States, kratom is sold over the counter in capsules and powders with claims that it helps ease pain, anxiety and drug dependence.
Officials say it causes euphoric effects like the opioid drugs behind the current overdose epidemic in the US.
Poisonings reported from taking kratom have soared as the substance has become an increasingly popular treatment for opioid withdrawal and addiction.
Phone calls about kratom exposures to poison control centres skyrocketed by more than 50-fold from 13 in 2011 to 682 in 2017, according to a new study published in the journal Clinical Toxicology.
Over that period, 11 people died following kratom exposure, the study said, including two people who had exposure to only kratom as opposed to a combination of substances.
“There is a significant increase in the number of cases,” said Henry Spiller, director of the Central Ohio Poison Center, which led the study with the Center for Injury Research and Policy, the Research Institute at Nationwide Children’s Hospital and others.
He said the spike was probably the result of greater use, and perhaps larger doses, of a substance that has only recently turned more mainstream.
“There’s a general feeling, I think, that this is a natural substance, so it’s safe. But we need to get across there are risks with this,” he said. “If use continues to grow, we’re going to see these problems because it is a real potent substance.”
The US Food and Drug Administration has said that, like opioids, kratom carries similar risks of abuse, addiction and in some cases, deaths.
Supporters of kratom, led by the American Kratom Association, have disputed the danger, citing past reports suggesting it has low toxicity and has a milder withdrawal than opiates. They compare the addiction characteristics of kratom to caffeine in coffee.
“Follow the science. Kratom itself is safe,” Charles Haddow, the group’s senior fellow of public policy, said last month.
Between 3 million and 5 million people use kratom in the United States, according to the association.
The study published in Clinical Toxicology says that small doses of kratom produce mild stimulant effects, while opioid-like effects occur after moderate to high amounts and sedative effects are associated with very high doses.
Of 1,174 single substance kratom exposures reviewed in the study, the most common clinical effects were agitation and irritability, tachycardia, nausea, drowsiness and lethargy, vomiting, confusion and hypertension.
The Department of Health and Human Services in late 2017 recommended that kratom be listed as a Schedule 1 drug, which would ban the substance and put it in the same classification as heroin and LSD.
But such a move would have to come from the Drug Enforcement Administration, and no action has been taken. The proposal is currently in a public comment period.
For now, the FDA has not approved kratom for any medical use and the DEA has listed kratom as a “Drug and Chemical of Concern”.
The American Kratom Association is fighting the move to ban the substance, arguing that the FDA has failed to show kratom is dangerously addictive and that it presents a risk to public safety.
The group has said a ban on katrom would potentially increase deaths because many users would turn to dangerous and addictive drugs.