Published: Thu, February 08, 2018
Medicine | By Douglas Stevenson

Opioid Alternative Kratom Is Actually an Opioid Itself, FDA Warns

Opioid Alternative Kratom Is Actually an Opioid Itself, FDA Warns

In a statement, FDA Commissioner Scott Gottlieb, MD warned that kratom should not be used to treat medical conditions or be used as an alternative to prescription opioids.

The Food and Drug Administration analysis, published Tuesday, makes it more likely that the supplement, kratom (KRAY-tom), could be banned by the federal government. All of those compounds, they discovered, shared structural similarities with opioids like derivatives of morphine.

Still, concern about kratom is mounting, especially because some people appear to be using the supplement as a way to step down from opioid painkillers like heroin and morphine.

Many point to instances where kratom was mixed with other substances.

He said that as of November 2017, the FDA had reports of 36 deaths caused by products containing kratom. Gottlieb said, "The model shows us that kratom compounds are predicted to affect the body just like opioids".

Additionally, the researchers found that 22 of the 25 compounds in kratom bind to mu-opioid receptors, and that some of the compounds may bind to receptors in the brain that may contribute to stress responses that impact neurologic and cardiovascular function.

Between 2010 and 2015, calls about kratom to poison control centers rose 10-fold from 26 to 263, according to the Centers for Disease Control and Prevention.

The FDA previously placed kratom products on import alert to prevent them from entering the country illegally and has seized several batches.

In many of those cases, kratom was used along with other drugs, making it hard for authorities to determine the actual cause of death.

However, as an unregulated and unapproved psychoactive substance being used without supervision, kratom poses unknown risks.

Based on the new FDA new research, along with information from previous studies and reports of harmful effects tied to kratom, "we feel confident in calling compounds found in kratom, opioids", Gottlieb said in a statement.

Kratom is banned in Australia, Malaysia, Myanmar, and Thailand and in several USA states: Alabama, Arkansas, Indiana, Tennessee, and Wisconsin.

They say kratom is not habit forming but the FDA's scientific reports say the brain responds to kratom the same way it does with opiates.

"We recognize that many people have unmet needs when it comes to treating pain or addiction disorders", he said. The Drug Enforcement Administration announced its plans to temporarily list kratom as a Schedule I controlled substance in 2016, but withdrew after a public outcry.

The FDA does not now approve kratom for any therapeutic uses.

Last November, researchers at Harvard Medical School and independent product testing company NSF International identified four unapproved, unlisted stimulants in six supplements now marketed for weight loss and fitness.

It wasn't the first time. On the bright side, most of the calls reported minimal to moderate side effects, though there was one death recorded.

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