What is the popular herbal supplement related to fatal overdoses?

Kratom, an over-the-counter herbal drug, has been associated with an increasing number of overdose deaths, federal health officials said this week.

Kratom was the cause of death in at least 91 fatal overdoses in the United States from July 2016 to December 2017, and 152 were tested positive for the substance during a post mortem toxicology during this period, revealed health officials.

According to the Associated Press, only 44 deaths were known nationwide.

A study conducted in February also revealed that kratom-induced poisoning had increased 50-fold, from 13 in 2011 to 682 in 2017, following phone calls regarding kratom exposure to anti-cancer centers. poison.

While in many fatal overdoses, other drugs, such as fentanyl or cocaine, were also cited as cause of death, federal regulators cautioned against the use of kratom.

What is kratom?

Kratom is a naturally grown plant in the countries of Southeast Asia, especially Thailand and Malaysia, where it has been widely used for centuries. It is sold in powder form, usually in capsules, which can be used in tea to relieve opioid withdrawal as well as fatigue, pain, cough and diarrhea.

In the US, the herbal supplement is usually purchased at tobacco shops, gas stations or online.

And its use is gaining popularity, according to US Centers for Disease Control and Prevention.

& # 39; A significant increase & # 39 ;: Poison reports related to herbal kratom drug skyrocket, according to new study

However, the Food and Drug Administration has closely examined kratom, saying that, like opioids, it carries similar risks of abuse, dependence and, in some cases, death.

Proponents of kratom, led by the American Kratom Association, challenged the danger of the substance, citing earlier reports suggesting that its substance was weakly toxic and its weaning less severe than that of opiates. They compare the dependence characteristics of kratom to caffeine in coffee.

"Follow science. Kratom itself is safe, "said Charles Haddow, the group's public policy officer.

Why does kratom make one?

Kratom hit the headlines this week after the CDC published an increase in the number of overdose deaths related to the herbal supplement.

In a toxicology report, in seven of 91 overdoses in which kratom was a cause of death, the herbal supplement was the only one to give a positive result, although the CDC indicates that other substances could not not be excluded.

When looking at the figures from the state reporting databases, the CDC reported 27,338 overdose deaths over the period, meaning that overdoses related to kratom accounted for less than 1% of fatal overdoses.

CDC: Kratom, herbal drug, linked to nearly 100 overdose deaths

On the February study on increasing the number of calls to poison centers, Henry Spiller, director of the Ohio Center in central Ohio, said: "The number of cases has increased dramatically . "

He added that the rise is probably due to increased use, and perhaps even larger doses, of a substance that has recently taken a more dominant turn.

"There is a general feeling, I think, that it's a natural substance, so it's safe, but we have to make it clear that there are risks with that." use continues to grow, we will see these problems because it is a real powerful substance. "

Who uses kratrom?

According to the American Kratom Association, between 3 and 5 million people use kratom throughout the country.

Adult men are the most common consumers. The February study found that 89% of kratom-related intoxications involved people aged at least 20 years and 71%, men.

The average age of kratom users was 31 years in the study. However, of the 1,807 kratom exposures recorded between 2011 and 2017, 137 involved adolescents aged 13 to 19 and 48 children aged 12 and under.

The study revealed seven cases resulting from neonatal exposures, an unexpected finding according to Spiller.

Thirty-two percent of kratom exposure cases in adults resulted in admission to a health care facility, while 52% resulted in a serious medical outcome.

What are the possible effects?

According to the National Institute for Combating Drug Abuse, kratom interacts with opioid receptors in the brain to relieve pain and produce sedation and pleasure.

Small doses of kratom produce mild stimulant effects, while opioid-like effects occur after moderate to high doses and sedative effects are associated with very high doses.

Of the 1,174 single-substance exposures treated with kratom in the February study, the most common clinical effects were agitation and irritability, tachycardia, nausea, somnolence, and dizziness. lethargy, vomiting, confusion and hypertension.

According to the report, the serious clinical effects were seizures, respiratory depression, increased bilirubin, bradycardia, rhabdomyolysis, renal failure, respiratory arrest and cardiac arrest.

The report says more research is needed to "define the human response to kratom," but in February, FDA Commissioner Scott Gottlieb warned against using it.

"Nothing indicates that kratom is safe or effective for any medical use, and that kratom is benign because it is just a plant, it is a short-term and dangerous vision." ", did he declare.

How and where is the medicine used?

Three-quarters of kratrom exposure occurred after the drug was intentionally taken. But among children 12 years or younger, 81% of the calls on the show took place after unintended use, according to the February report.

Of the adults, 60% of the reported poisons occurred after the drug was intentionally abused. The percentage among adolescents was above 76%. About 1 in 10 cases, both adults and adolescents, were suicide attempts.

In 83% of exposures to kratom, the drug was taken by ingestion, then by ingestion by other routes and by nasal inhalation.

The majority of cases, 86%, occurred in a residence. The states with the highest exposure rates are Idaho, Oregon, Minnesota, New Hampshire and Maine. The lowest exposure rates were observed in Wisconsin and Delaware.

Is kratom regulated?

Kratom is not currently registered as a controlled substance in the United States.

The Drug Enforcement Administration had previously proposed to include it among Schedule 1 drugs, which would outlaw the substance and classify it in the same classification as heroin and LSD, but void the move after a backlash.

The Department of Health and Social Services also previously recommended that kratom be listed on Schedule 1 drug list.

Several States have examined state regulations on kratom.

For the time being, the FDA has approved the use of Kratom for no medical use and the DEA has classified kratom as a "drug and chemical of concern".

The American Kratom Association is fighting to ban the substance, claiming that the FDA has not shown that kratom creates a dangerous addiction and that it poses a risk to public safety.

The group said a ban on kratrom would potentially increase the number of deaths, as many users would turn to dangerous and addictive drugs.

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