Kratom Plant Acts Like A Prescription Opioid, Warns FDA, Others Not So Sure
According to a recent release by the Food and Drug Administration (FDA), after a close examination by researchers, the agency believes that compounds in the kratom plant act similar to prescription opioids. The FDA also stated that kratom had been associated with at least 44 deaths.Authors Note: This article is for informational only. Views expressed here are not necessarily the opinions of either the author or Just Believe Recovery.
FDA Commissioner Scott Gottlieb said in a statement that scientific studies have demonstrably shown that kratom is:
“…an opioid that’s associated with novel risks because of the variability in how it’s being formulated, sold, and used recreationally and by those who are seeking to self-medicate for pain or who use kratom to treat opioid withdrawal symptoms.”
During the research, scientists at the FDA examined the chemical components more than two dozen compounds in the kratom plant and found that all of them shared structural traits with opioid analgesics, such as morphine derivatives. They also discovered that the compounds in the plant bind fiercely to specific opioid receptors.
In total, the FDA has received 44 reports of fatalities linked to kratom use, and say they are particularly concerned about several deaths involving kratom in which it was used in conjunction with other substances that affect the brain, such as illicit drugs, opioids, and benzodiazepines.
The FDA also said, however, that many of the reports they’ve received could not be fully evaluated, given limited information. Moreover, “reports not always contain sufficient information for FDA to determine whether there is a correlation between the reported event and use of the product.”
“Cases of mixing kratom, other opioids, and other types of medication are extremely troubling because the activity of kratom at opioid receptors indicates there may be similar risks of combining kratom with certain drugs…”
Gottlieb warned that “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.”
The Other Side
Some researchers are critical of the FDA’s computer model and approach.
Andrew Kruegel, Columbia University pharmacologist, who has studied kratom, per Tonic:
“I don’t really see what this adds to this field or adds to the body of knowledge around kratom. “It’s very strange to me.”
According to the interview with Tonic, Kruegel is “perplexed” as to the reason the FDA released this statement about kratom. The approach they used is known as molecular modeling, a method employed in the initial stages of drug development.
Moreover, by targeting a specific receptor, scientists could “cycle through tens of thousands of compound models, looking for one that might activate the receptor.”
“But that’s a very early step in drug development. You would not be very confident in the results of that assay. It’s all done virtually in a computer.”
But researchers should be “producing the compound and testing it in actual living things—with no guarantee it’ll have the expected effect.” In fact, scientists have already shown since the 1990s that kratom compounds bind to mu opioid receptors.
His point is this: opioids are compounds that interact with opioid receptors, but not every opioid will have the same effect. For example, naloxone attaches to opioid receptors, and yet is a drug used to reverse overdoses related to opioids. This is why scientists carefully analyze precisely how each opioid works.
“The problem with saying it’s ‘an opioid’ without qualification is that it just paints everything with this broad brush, and obviously carries a negative connotation given what’s going on in the country right now.”
More About Kratom
The scientific name for kratom is mitragyna speciosa. It is found in South East Asia in rainforests and some swampy areas in Africa.
The kratom plant has yellow flowers and dark green leaves. The earliest mention of kratom in the western world came from Dutch botanist Pieter Korthals in 1839.
Advocates for kratom use and many medical professionals around the world consider the substance to be beneficial due to its medicinal properties, but some countries have banned the consumption of the plant, in an attempt to ensure that people are not put at risk for health-threatening side effects.
Ten other countries have enacted strict regulations, criminalizing kratom and labeling it as a scheduled drug. The drug remains legal in most states throughout the U.S., despite attempts by the FDA and Drug Enforcement Agency to make it illegal.
States that have declared kratom an illicit substance include Alabama, Arkansas, Indiana, Rhode Island, Tennessee, Vermont, Washington D.C., and Wisconsin.
At the time of this writing, there was pending legislation in Illinois, Kansas, New Jersey, New York, Missouri, and West Virginia.
Legislation to ban the drug has failed in Florida, Georgia, Iowa, Kentucky, Michigan, and Oregon.
~ G. Nathalee Serrels, M.A., Psychology