Popular pain relief kratom supplement may pose a health risk

10 Jul 2019 --- The kratom herb, widely used in pain management and in treating opioid addiction, may not be safe to use as an herbal supplement. This is according to a new research from The State University of New York at Binghamton, US. Kratom is an herbal supplement derived from a plant that grows throughout South-East Asia and its active chemicals act on opioid receptors in the body. The study found that it presents side-effects including agitation, increased heart rate and vomiting. In light of the findings, the scientist suggest halting kratom’s use as an herbal supplement, but more research is warranted.

Reportedly, patients used the supplement to treat or prevent drug withdrawal, treat opioid use disorder or treat pain. In low doses, the supplement can cause stimulant-like effects such as increased alertness. In higher doses, kratom users can experience opiate-like effects. William Eggleston, a Clinical Assistant Professor of Pharmacy Practice at Binghamton University, increasingly noticed patients presenting with toxicity or withdrawal from kratom use. This led him to examine what types of toxicities were being reported to Poison Centers in the US to better assess whether or not kratom is safe enough to be used as an herbal supplement. 

Eggleston and 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.

William Eggleston, Clinical Assistant Professor of Pharmacy Practice at Binghamton University, State University of New York.The findings showed that 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 seizures (6.1 percent), withdrawals (6.1 percent), hallucinations (4.8 percent), respiratory depression (2.8 percent), comas (2.3 percent) and cardiac or respiratory arrests (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 research concluded that kratom is not reasonably safe and poses a public health threat due to its availability as an herbal supplement.

“Although it is not as strong as some other prescription opioids, kratom does still act as an opioid in the body,” says 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.”

Eggleston and his team are currently working with colleagues at SUNY Upstate Medical University to better assess how many patients are actually using kratom and if the risk for toxicity changes depending on the dose of kratom taken.

This past June, a new Harvard T.H. Chan School of Public Health research found that dietary supplement use may result in severe medical events, experienced by young people at a threefold higher rate than vitamin use. Although the study did not identify particular “risky” ingredients in the supplements, previous research has found that undeclared prescription pharmaceuticals, steroids, kava and germander are likely culprits, as they can lead to liver damage and other concerning health consequences. The team asserted that proactive enforcement of regulations is needed to reduce access and consumption among adolescents and young adults – the key demographic attracted to these kinds of supplements.

Edited by Kristiana Lalou