Researchers find kratom unsafe for addiction and pain treatment
The popular herbal supplement kratom is increasingly being used to manage pain and treat opioid addiction, but it is not safe to use as an herbal supplement, according to new research by faculty at Binghamton University in New York, and published in the journal Pharmacotherapy.
William Eggleston, PhD, clinical assistant professor of pharmacy practice, said he had been seeing more and more patients presenting with toxicity or withdrawal from kratom use. Kratom is an herbal supplement derived from a plant that grows throughout southeast Asia. It is well-reported that the active chemicals in the plant act on opioid receptors in the body. Patients report using the supplement to treat or prevent withdrawal, treat opioid use disorder, or treat pain.
Eggleston was curious to see what types of toxicities were being reported to Poison Centers nationally in order to better assess whether kratom is safe enough to be used as an herbal supplement. His team conducted a retrospective review of kratom exposures reported to the National Poison Data System to determine the toxicities associated with kratom use. They also reviewed records from a County Medical Examiner's Office in New York State to identify kratom-associated fatalities, according to the study abstract.
A total of 2,312 kratom exposures were reported, with 935 cases involving kratom as the only substance. Kratom most commonly caused agitation (18.6 percent), tachycardia (16.9 percent), drowsiness (13.6 percent), vomiting (11.2 percent), and confusion (8.1 percent). Serious effects of seizure (6.1 percent), withdrawal (6.1 percent), hallucinations (4.8 percent), respiratory depression (2.8 percent), coma (2.3 percent), and cardiac or respiratory arrest (0.6 percent) were also reported. Kratom was listed as a cause or contributing factor in the death of four decedents identified by the County Medical Examiner's Office.
The findings suggest kratom is not reasonably safe and poses a public health threat due to its availability as an herbal supplement, researchers said.
The U.S. Food and Drug Administration issued several warnings last month to companies selling unapproved kratom products for opioid cessation, pain, and other medical uses.
Eggleston and his team are working with colleagues at SUNY Upstate Medical University to better assess how many patients are using kratom and if the risk for toxicity changes depending on the dose of kratom taken.
"Although it is not as strong as some other prescription opioids, kratom does still act as an opioid in the body," said Eggleston. "In larger doses, it can cause slowed breathing and sedation, meaning that patients can develop the same toxicity they would if using another opioid product. It is also reported to cause seizures and liver toxicity. Kratom may have a role in treating pain and opioid use disorder, but more research is needed on its safety and efficacy. Our results suggest it should not be available as an herbal supplement."