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Kratom — the little herbal supplement with big concerns

August 09, 2019 by Kimberly Drake

Someone has released the Kraken. No, not the legendary monster of ancient Scandinavian folklore, or the colossal creature of doom in the 1981 film, “Clash of the Titans,” but something potentially just as dangerous in a much less threatening form. This “Kraken” of epic destruction is called kratom, and it’s an unassuming extract from a tropical tree related to the coffee plant that is sold in some stores and online as a “natural” herbal supplement.

It’s a bit of a mystery herb, with a sketchy legal status currently under heavy debate. As I began digging for more information, even my “voodoo consultants,” a term lovingly exchanged amongst my circle of alternative medicine experts, question its value and safety. What is this herbal “Kraken,” and why on earth would someone release it?

Although it has been used for centuries in Southeast Asia for its stimulant and painkilling effects, this green powder, capsule or tablet is marketed in the United States as a mood enhancer or pain reliever. Because it acts on the opioid receptors in the brain, it is also gaining popularity among those who suffer from opioid use disorder as an alternative to treatment with medication such as buprenorphine or methadone. Those with chronic pain from conditions like lupus, fibromyalgia or osteoarthritis are also touting kratom as a “miracle drug” for symptom relief.

Many believe, because it’s natural, there should be no issues with its use. However, according to the study, “Kratom Use and Toxicities in the United States,” by the University of New York at Binghamton, this train of thought is proving to have deadly consequences. Using data reports from 2011 to 2018, the researchers identified 935 cases where the use of kratom caused adverse reactions and medical events. Side effects noted were agitation, tachycardia, drowsiness, vomiting, confusion, seizures, hallucinations, respiratory depression, coma and cardiac or respiratory arrest, and two of the individuals who had taken kratom died as a result. The scientists discovered a concerning increase in kratom use, with 18 reports of adverse reactions in 2011, and a total of 357 just in the first half of 2018. 

Researchers concluded, “kratom use is increasing and is associated with significant toxicities. Findings suggest kratom is not reasonably expected to be safe and poses a public health threat due to its availability as a herbal supplement.”

The Food and Drug Administration (FDA) has sent up the red flag on kratom as well and issued FDA Import Alert 54-15, dated June 11, 2019. In the alert, the administration says it has seen an “increase in the number of shipments of dietary supplements and bulk dietary ingredients that are or contain kratom, and these shipments have come in a variety of forms, including capsules, whole leaves, leaf resins and bulk liquids made of leaf extracts.” The agency also says this compound goes under pseudonyms such as Mitragyna speciosa, mitragynine extract, biak-biak, cratom, gratom, ithang, kakuam, katawn, kedemba, ketum, krathom, krton, mambog, madat, Maeng da leaf, nauclea, Nauclea speciosa, and thang, making it difficult to identify in products. 

Although kratom is a botanical qualifying as a dietary ingredient under section 201(ff)(1) of the Federal Food, Drug and Cosmetic Act, the FDA says there does not appear to be a history of evidence establishing that kratom is safe as a dietary ingredient. They go on to remark that current scientific studies show serious concerns over the toxicity of kratom in multiple organ systems. The herbal supplement was also implicated in a 2018 salmonella outbreak that affected nearly 200 people in 41 states, which further supports the FDA’s safety concerns.

The United States Drug Enforcement Administration (DEA) is also alarmed and is currently weighing evidence to identify if kratom should be labeled a Schedule 1 Controlled Substance and join other drugs on that list like heroin and LSD. The agency already moved to ban kratom in 2016 but was met with protest from the American Kratom Association and those with chronic pain, depression or anxiety that say this herbal preparation has improved their quality of life. 

Whoever released this herbal “Kraken” into the world of natural supplements has undoubtedly unleashed a monster and opened the flood gates of debate. Substances that occur in nature have incredible powers. Powers to heal, and, as in the case of kratom, the potential ability to destroy anyone in its path. Vigilance in doing your research and consulting your health care provider before diving into supplements, herbal remedies, or even prescription drugs are ways to prevent becoming the victim of unfounded claims or experiencing dangerous monster-like side effects. This vigilance also goes a long way in keeping this, and any future “Krakens” safely locked up where they belong.

Kimberly Drake can be reached at [email protected]

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