Herbal drug kratom poisonings soar
Poisonings reported from taking kratom, a herbal drug sold over the counter, have soared as the substance has become an increasingly popular treatment for opioid withdrawal and addiction.
Phone calls about kratom exposures to poison control centers nationwide skyrocketed by more than 50-fold from 13 in 2011 to 682 in 2017, according to a study released Thursday and published in Clinical Toxicology.
Over that period, 11 people died following kratom exposure, 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 is 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. If use continues to grow, we’re going to see these problems because it is a real potent substance.”
Kratom is a plant grown naturally in Southeast Asian countries, including Thailand and Malaysia, where it’s been widely used for centuries. It’s sold as a powder, typically in capsules, that can be used in tea to ease opioid withdrawals, as well as fatigue, pain, cough and diarrhea. In the U.S., the herbal supplement is typically purchased at smoke shops, gas stations or online.
But kratom has garnered scrutiny by the Food and Drug Administration, which has said that, like opioids, it carries similar risks of abuse, addiction and in some cases, deaths.
Between 3 million and 5 million people use kratom nationwide, according to the American Kratom Association.
The average age of kratom users was 31 years old in the study. But of the 1,807 kratom exposures from 2011 to 2017, 137 were among teens between 13 and 19 years old and 48 were among children 12 years old or younger. The study found seven cases resulting from neonatal exposures, a finding that Spiller said was unexpected.
The study said that small doses of kratom produce mild stimulant effects, and opioid-like effects occur after moderate-to-high amounts, and sedative effects are associated with very high doses. The majority of cases, 86 percent, occurred at a residence. States with the highest exposure rates are Idaho, Oregon, Minnesota, New Hampshire and Maine. The lowest exposure rates were found in Wisconsin and Delaware.
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 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.”