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Kratom: A “Natural Solution” or New Danger?


Increasingly, we are hearing people refer to a plant called Kratom as a “safe” or “natural” product for treating pain or even assisting people who are experiencing an opioid use disorder. While we recognize that there are a number of plants that are dangerous for humans to consume, many people continue to falsely assume that products derived from plants are inherently safe.

Over the past year we have seen an increase in mentions both online and from our community. As the death toll associated with Kratom continues to rise (44 at the time of publishing), we have been anxious to hear from experts. This week they gave us a response. The FDA Press Announcement provided us with valuable information about this plant and the current research available. We hope that you will find this brief summary helpful and we encourage you to read the full press announcement: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm595622.htm



Bottom Line According to the FDA


According to the FDA: “Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids. There is no evidence to indicate that kratom is safe or effective for any medical use [emphasis added]. And claiming that kratom is benign because it’s “just a plant” is shortsighted and dangerous. After all, heroin is an illegal, dangerous, and highly-addictive substance containing the opioid morphine, derived from the seed pod of the various opium poppy plants.”

“The extensive scientific data we’ve evaluated about kratom provides conclusive evidence that compounds contained in kratom are opioids and are expected to have similar addictive effects as well as risks of abuse, overdose and, in some cases, death. At the same time, there’s no evidence to indicate that kratom is safe or effective for any medical use,” said FDA Commissioner Scott Gottlieb, M.D.



Evidence for this Conclusion


The FDA uses a model called the Public Health Assessment via Structural Evaluation (PHASE) to simulate how the chemical structure of a substance can affect the brain. This allows the FDA to predict the outcomes of a substance quickly to prioritize public health and safety. Kratom has a number of compounds but they analyzed the 25 most common compounds. Takeaway: “Based on the scientific information in the literature and further supported by our computational modeling and the reports of its adverse effects in humans, we feel confident in calling compounds found in kratom, opioids.”

Reasons for this conclusion:

  1. All 25 of the studied compounds are structurally similar to controlled opioid analgestics
  2. Of the 25 compounds, 22 may bind to mu-opioid receptors
  3. Of the 5 most common compounds, 2 are already known to activate opioid receptors. In other words they are “opioid agonists”
  4. As a result of the way that some of these compounds may bind to the brain, they can impact brain and heart function


Blog Post by Taylor Dockter

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