Poison control got 682 calls for kratom exposures in 2017 – 52 times more than the US centers received about the supplement in 2011, a new study reveals.
Kratom has been falsely advertised as everything from mood stabilizing to relieving opioid withdrawals, but it isn’t approved by the Food and Drug Administration (FDA) for anything.
The FDA warned last year that certain substances found in kratom act on the same receptors as opioid drugs, and yet the substance is being distributed without the oversight and safety testing the US government requires of drugs.
Yet the substance has sickened hundreds of people, including several children and even newborns going through withdrawal, according to a new study from Nationwide Children’s Hospital.
Between 2011 and 2017, calls to US poison control centers for exposures to kratom (pictured) increased from 31 to 286, resulting in hospitalizations and even 11 deaths, a new study found
Kratom powder is derived from a tropical tree native to Southeast Asia (though it is now banned in several countries in the region) and its natural roots may deceive consumers into thinking the substance is far safer than it really is.
‘The idea that this is a natural alternative to other pain medications and that it’s a plant and is natural equals safe – that is not something we want people to think,’ says Central Ohio Poison Control Center director Henry Spiller.
‘Just because it’s a plant doesn’t mean a large amount isn’t going to put you in danger.’
Kratom isn’t particularly well understood or closely studied, and this, says Spiller, is much of the problem.
‘There’s not a whole lot of information or real evidence on kratom,’ he says.
‘It’s more just anecdotal Reddits and various things from people trying it, but there’s not a lot of evidence of its risks and toxicity.’
Trusting Redditors have sought supplements websites and smoke shops selling kratom and even advertising it as an alternative to medications to help ease the harrowing symptoms of opioid withdrawals.
And despite the FDA’s stern warning that kratom is not tested, regulated or safe, it seems to have grown increasingly popular among Americans.
In 2011, US Poison Control Centers got only 31 calls related to kratom.
By 2017, the agencies got 286 calls in a single year.
‘We went from tens to hundreds. If we get to the thousands, I’m pretty sure someone will have to step in, like the Drug Enforcement Agency,’ says Spiller.
Though the substance’s opioid-like components have gotten significant attention from the FDA and other health experts, its other mechanisms are more often the cause of poisonings from kratom.
Kratom is ‘what we call a “dirty drug,”‘ Spiller says, meaning ‘it does more than one thing.’
He says that its primary action is more similar to that of Tramadol, a very different pain reliever from opioids like OxyContin.
Both kratom and Tramadol change the way the brain processes serotonin and norepinephrine.
‘It causes tachycardia, agitation and seizures and that’s a whole different picture than what [people] think they’re getting,’ says Spiller.
‘It’s pain relief but it’s very different.’
These are the main types of symptoms poison control centers saw from kratom exposures.
But when people took kratom in very large doses, the substance’s effects on the mu opioid receptor became the dominant feature of their reactions.
This caused some people to slip into comas or slowed or stopped their breathing.
‘It really goes in two different directions,’ says Spiller.
He was also taken aback by the number of children and even infants exposed to kratom.
Between 2011 and 2017, there were 48 calls to poison control centers for children 12 or younger that had come into contact with kratom.
Nearly 70 percent were under two, seven were newborns and five of those had withdrawal syndrome.
Their withdrawals were linked to the opoioid-like alkaloids in kratom that their mothers had used.
‘It was a surprising feature [of the study results] that I wasn’t anticipating,’ Spiller says.
The babies ‘come out with a startle reflex’ meaning they respond as if alarmed when there is no trigger, ‘and diarrhea.’
‘They’re just newborns, they’re not really working yet, but they’re getting into neonatal ICUs instead of going home with mom the next day.’
None of the babies seemed permanently impacted by kratom, and they all survived, but it is too soon to tell if they could suffer consequences later in life.
For adults, many kratom exposures ended badly.
Over 30 percent ended up being admitted to a hospital or other healthcare facility, more than half had serious medical issues and 11 people died.
‘If [kratom use] continues rising as it looks like it is, we’ll start to see more and more people in the ER and something has to be done,’ says Spiller.
‘It’s early on, this is just sort of the beginning and I’m hoping it will just sort of go away.
‘But people need to know that just because it’s a plant and it’s natural doesn’t mean it’s safe.’