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Kratom, a controversial opiate-like plant, is quickly becoming a problem for poison control in the United States.
In recent years, poison control centers have experienced an explosion of phone calls regarding this herbal supplement, which is increasingly being used to relieve pain, depression, anxiety and even the opioid withdrawal.
Kratom (Mitragyna speciosa) is a plant species that grows in Thailand, Malaysia, Indonesia and Papua New Guinea. Recently, more and more of them have crossed the US border in the form of an innocent green powder.
In the United States, kratom is only classified as a herbal supplement and as a result, many Americans assume that it can be safely taken. In reality, scientists know very little about this substance, including what it can treat, whether it is addictive and what is a safe dosage.
Thus, while some claim that this drug saved their lives from opioids, without regulation, research and advice, the substance has also been fatal, with at least 44 deaths attributed to its use.
Analyzing information from the National Poison Data System, a new study now adds weight to the fear that one day, kratom could simply increase the opioid epidemic.
From 2011 to 2017, it appears that kratom has triggered more than 1,800 phone calls to the country's poison control centers, and 65% of these calls have been made in the past two years.
This represents an exponential increase in just seven years, the number of annual calls going from 13 to 682, a jump of 52.5 times, which equates to going from one call per month to two calls per day.
More than half of these cases had moderate to severe health consequences, including seizures, fast heartbeat, breathing difficulties, coma, and kidney failure.
In eleven of these cases, the symptoms were fatal, which was particularly common among those with multiple drugs in their system.
In fact, the study found that those taking another drug in addition to kratom – such as alcohol, cocaine, benzodiazepenes and fentanyl – were more than twice as likely to be exposed to alcohol. have serious health implications.
"The use of kratom has been associated with a variety of serious medical consequences, ranging from epileptic seizures to coma in adults, to severe withdrawal syndrome in newborns," he said. co-author Henry Spiller, director of the Central Ohio Poison Center at Nationwide Children's Hospital.
"People who choose to use kratom should be aware of the potential risks.The fact that it is currently classified as an herbal supplement does not mean that it is regulated or that it is not. he is safe. "
For several years, the Drug Enforcement Administration (DEA) has classified kratom as a "substance of concern" and the FDA has issued several warnings about its use for medical purposes.
From what we know so far, kratom binds to opioid receptors in the brain as well as to serotonin receptors, which many antidepressants target. However, while some studies suggest that kratom may be a better alternative to methadone, the FDA has not yet approved it for any medical use, let alone opioid dependence.
"There is no reliable evidence to support the use of kratom as a treatment for opioid consumption disorder," reads in a statement from FDA Commissioner Scott Gottlieb. written in 2017.
"Opioid-dependent patients use kratom without reliable instructions for use and, more importantly, without consulting an approved health care provider about the dangers of the product, its possible side effects or its interactions with patients." other medicines. "
To be fair, kratom rarely causes death by itself. In fact, there is only one case thought to be purely because of this exotic herb. But that does not mean that there is no reason to worry.
Despite warnings from the FDA, people continue to use this herbal supplement in a dangerous and unregulated way. The new study found that the majority of cases involved men and that almost all patients were adults over 20 years of age.
Yet the impact on children is perhaps even more disturbing. About 2.5% of the calls involved children under 12 and most of the children involved were under two years old.
Even more surprisingly, seven of the appeals involved newborns, five of whom were suffering from withdrawal symptoms due to exposure to kratom in the uterus and one of them. between them would have been exposed to kratom during breastfeeding.
The authors ask the FDA to no longer consider kratom as a "dietary supplement" and begin to regulate it as a drug, thus ensuring its quality and safety, as well as further research.
This study was published in Clinical Toxicology.
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