Kratom could make opioid crisis even worse, FDA warns

CINCINNATI -- The federal government issued a warning Tuesday for an unregulated herbal extract some people use to curb opioid withdrawal symptoms. 

In fact, the U.S. Food and Drug Administration warned the extract could make the opioid epidemic even worse.

Mitragyna speciosa, or kratom, is plant that grows naturally in Thailand, Malaysia, Indonesia and Papua New Guinea. Energy drinks and supplements containing kratom are sold at certain gas stations, mini-marts and herbal remedy stores in Greater Cincinnati.

The I-Team first reported on kratom more than a year ago. At that time, we found the National Institute on Drug Abuse considered it an addictive drug.

On Tuesday, the FDA agreed.

"Importantly, evidence shows that kratom has similar effects to narcotics like opioids, and carries similar risks of abuse, addiction and in some cases, death," FDA Commissioner Scott Gottlieb said.

Calls to U.S. poison control centers about kratom increased 10-fold from 2010 to 2015, according to the FDA. Gottlieb said the agency also is aware of 36 deaths associated with kratom products.

Tami George, of Crescent Springs, Kentucky, blames kratom for her son's death. Zach Ziehm had been sober for three years, had a job he loved and was father to a newborn son. George told us she believes kratom energy drinks triggered a craving for opiates that led Ziehm to relapse, and ultimately, die of an overdose.

 

Ziehm's mood started to change with the drinks, George said: he was edgy, restless, discontent, "like he was coming out of his skin."

"I don't think he realized that these drinks were going to trigger that kind of response," George said.

George said her son first found out about kratom from a friend who'd relapsed and was using kratom to curb withdrawal symptoms. It was the same friend Ziehm called to get his final dose of heroin, George said.

Some drug treatment centers screen for kratom, but hospitals don't always test for it. 

Ashel Kreutzkamp, Nurse Manager at St. Elizabeth Health Care, compared a recovering addict using kratom to a game of Russian roulette.

"You can say that, once addicted, always addicted. And you always have to live your life like that because something is going to spark and get those (opioid) receptors to start firing again," she told us last August.

Although the FDA doesn't regulate or approve kratom sales, the agency does warn it's risky because of serious side effects: hallucinations, severe withdrawal and delusions.

The agency does, however, regulate what sellers can say about it: that means no medical advice.

Kratom is already banned in several states, including Indiana, while several others have pending legislation to ban it. Gottlieb also said FDA has detained hundreds of shipments of kratom and was working to prevent more shipments from entering the U.S.

The Drug Enforcement Administration had planned to ban the plant by adding it to a list of illegal drugs that includes marijuana, heroin and LSD. But the agency backed away from that plan last October after a flood of public complaints including a letter signed by 62 members of Congress and a protest at the White House organized by the American Kratom Association.

The group has said categorizing kratom as an illegal substance would stymie medical research into its potential therapeutic uses. The DEA said last October it would delay a decision until the FDA issued a recommendation.

There's no scientific evidence that kratom can help with opioid addiction, Gottlieb said. The agency's review process is ongoing.

"We’ve learned a tragic lesson from the opioid crisis: that we must pay early attention to the potential for new products to cause addiction and we must take strong, decisive measures to intervene," Gottlieb said. "From the outset, the FDA must use its authority to protect the public from addictive substances like kratom, both as part of our commitment to stemming the opioid epidemic and preventing another from taking hold."

Kratom's other names:

  • Herbal Speedball
  • Biak-biak
  • Ketum
  • Kahuam
  • Ithang
  • Thom

Reported health effects include:

  • sensitivity to sunburn
  • nausea
  • itching
  • sweating
  • dry mouth
  • constipation
  • increased urination
  • loss of appetite
  • psychotic symptoms in some users

Source: National Institute on Drug Abuse

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Matthew Perrone of the Associated Press contributed to this report.

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