Kratom has attracted quite a lot of attention in the media. Some praise it for its healing properties and call it a miracle herb. Others label it as a life-threatening drug and advocate for its ban. Each of the sides claims that the other spreads false claims.
These contractions can easily cause confusion. Especially because kratom is illegal in several countries as well as in specific locations within the USA. Both the FDA and DEA warn against using kratom claiming that it’s an opiate and can cause death.
So, whom should you side with on this debate?
Is kratom an opiate or not?
Is kratom safe? Or should it be banned.
Is it truly a dangerous and fatal drug, or simply a helpful yet misunderstood herb?
Let’s dive deeper and find out.
What Is Kratom?
Kratom, or Mitragyna Speciosa, is a plant from the coffee plant family that’s native to Southeast Asia. It’s rich in alkaloids and has numerous health benefits. Some of the most popular ones include relaxation, increased energy, pain relief, and reduced anxiety and stress. But the nature of the effects differs depending on the dosage and the type of kratom taken.
There are generally four types of kratom:
- Red Vein
- Green Vein
- White Vein
- Yellow Vein
Each of the types have their own unique set of benefits. Kratom comes in the form of powder, capsules, tea, and extracts.
Popular Arguments Against Kratom (and What’s Wrong About Them)
1. Kratom is Causing and Increasing Number of Deaths
Some of the FDA’s most arduous arguments against the use of kratom are that it causes addiction, seizures, kidney failure, liver damage, and even death.
In 2016, the FDA wanted to ban kratom and include it in the Schedule I list of controlled substances. The same list where you can find the most dangerous drugs such as heroin, LSD, and cannabis. This would have not only made kratom illegal but also would have drastically limited the possibility to perform studies on it.
In a press release in early 2018, an FDA representative stated that kratom had claimed 44 lives at that point.
However, the cases presented were rater inconclusive. In most of them, kratom wasn’t the only substance present in the blood of the deceased.
The same occurred in 2019 when the CDC released a report on nearly 100 deaths by kratom. According to postmortem toxicology results, just 7 of the victims had only kratom present in their blood and, even in those cases, the CDC admitted the possible presence of other drugs.
When it comes to drug tests, such as those needed for employment, most standard tests do not test for kratom.
Incomplete and Inaccurate Interpretation of Kratom Death Reports
Instead, these people combined kratom with drugs, alcohol, and prescription medications with clearly stated fatal risks.
Some of the deaths also included homicide victims, suicide, and falling out of a window after which the person refused medical treatment. Neither one of which had been directly caused by kratom itself. One death was even counted twice because the death had been reported twice.
Yet, since kratom was in their blood, the FDA stated kratom was the main cause of death. (A more detailed report on these deaths and their cause can be found here).
The FDA also refers to and sometimes includes in the number of kratom fatalities nine deaths that occurred in Sweden in 2010. Interestingly though, these deaths weren’t the result of pure kratom. Instead, the deceased took pills that contained kratom laced opioids.
So, was kratom the actual cause of these deaths? Or was it something else? Or perhaps kratom was simply a supplement that these people were taking to deal with something very serious and potentially life threatening, such as depression.
Also, compared to the death toll caused by alcohol and opioids (both heroin and painkiller) overdose every year, which is 88,000 and 28,000 respectively, the danger of kratom seems rather…
…exaggerated.
2. Kratom is an Opiod that Must Be Scheduled
Is kratom an opioid or not is a question that puzzles many. Both kratom and opioids bind with opioid receptors. But the way each of them interacts with these receptors is different.
When opioids bind with the receptors, they recruit certain proteins in the process. These proteins then regulate signal transduction in the body. Because of this, they are the ones causing respiratory depression and death, the most dangerous opioid side effect.
Is kratom an opioid then?
In 2018, the FDA made a bold statement that kratom was indeed an opioid posting deadly health risks. They said that after investigations they had concluded that, if kratom acted like an opioid, that it was indeed an opioid. Moreover, their statements were partially based on a computational model called PHASE that the FDA had developed in-house to simulate the interaction of kratom alkaloids with the human brain (more on that below).
Much controversy arose due to that, and the FDA later changed its statements. Since then, it no longer refers to kratom as an opioid but rather a herbal product with “opioid-like effects.”
So, is kratom an opioid?
The answer is no. Kratom does not belong to the opioid plant family, nor does it engage the proteins mentioned above in the same way that opioids do.
As a result, even though the alkaloids in kratom target the same receptors as opioids do, the alkaloids themselves are not opioids and do not produce the same dangerous effects. It can however provide relief from opioid withdrawal without the risks that opioids cause.
Therefore, referring to kratom as a plant with opioid-like properties as the FDA does now is a more accurate assessment.
Schedule I Requirements
Drugs or other substances be scheduled based on their risks and abuse potential. Schedule I substances have the highest abuse potential whereas Schedule V has the lowest. According to the Controlled Substances Act (CSA), for a substance to be listed in Schedule I, it needs to have the following:
- high abuse potential
- no accepted medical use within the United States
- a lack of accepted use or safety under medical supervision
When a proposal to add or remove a substance from the Controlled Substances List is made, the following factors must be considered:
- the substance’s actual or relative abuse potential
- scientific evidence of the substance’s pharmacologic effects
- current scientific knowledge such as research on the substances
- abuse history and current pattern
- the duration, scope, and severity of abuse
- risk to the public health
- psychological or psychic dependence liability
- relatability or connection to another scheduled substance
The CSA also requires a scientific and medical evaluation as well as a recommendation from the HHS on whether a substance should be added to or removed from the Controlled Substances List. Without this recommendation, changes cannot occur.
HHS’s Recommendations Were Rescinded, but that Fact Wasn’t Made Public
In 2017, nearly a year after the DEA announced its intent to schedule Mitragynine and 7-hydroxymitragnine, the person who at the time was the Acting Assistant Secretary of Health of the Department of Health and Human Services wrote to the DEA that the HHS recommends bot primary kratom alkaloids to be classified as Schedule I substances.
The recommendation was made based on the scientific and medical evaluation prepared by the FDA.
However, a year later, in August 2018, the new Acting Assistant Secretary reviewed the recommendation and the scientific evidence on kratom.
Citing animal studies, he concluded that despite having opioid-like properties, mitragynine does not have abuse potential and can reduce the intake of morphine. Due to this, it did not meet the requirements needed to be listed as a Schedule I substance.
While he had some concerns about 7-hydroxymitragynine, he indicated that neither the FDA’s data nor the research he came across were enough for the alkaloid to be classified as a Schedule I substance. He also pointed out that multiple reputable scientists were questioning the instances of fatal kratom overdoses.
To conclude, he stated that scheduling kratom alkaloids without further research would be premature and could potentially harm the public.
While this letter definitely speaks in favor of kratom, its content was never made publicly known thus keeping the public unaware of the misinformation on kratom.
In fact, this was only discovered in early 2021, two and a half years later, meaning that the FDA had chosen to not notify the public about it. The letter has since been archived by the American Kratom Association and can be found here.
3. Kratom Can Cause Salmonella
In April 2018, there was a kratom related salmonella outbreak in the United States. According to the FDA data, 199 people in 41 states fell ill with salmonella after consuming contaminated kratom.
There is no denial of the fact that salmonella can be present in kratom. But that’s not a strong enough reason for a complete kratom ban.
Salmonella can also be present in poultry, raw meats, eggs, as well as in unpasteurized mike and other products such as romaine lettuce. It causes regular outbreaks. Yet, none of the contaminated products are getting banned. Just the infected batches.
The bigger problem does not lie in the fact that kratom can contain contaminants. But rather in the fact that the US doesn’t properly regulate it. It’s up to each individual seller to ensure that they test their product properly. That they offer high quality, contaminant-free kratom to the buyers.
It’s easy for governing institutions to place blame on kratom. When, in actuality, there would be fewer instances of contaminated and otherwise unsafe kratom if it was regulated just like other herbal supplements available.
Due to instances like this, the American Kratom Association (AKA) has pushed the Kratom Consumer Protection Act, legislation that is being lobbied in individual states. It aims to regulate kratom sales, manufacturing, and processing as well as punishing incompliance with it with fines or jail time.
4. Kratom is Unsafe and Ineffective
The Mayo Clinic has an article that states just that. And there are many other sources in the media claiming the same. According to them, studies on kratom brought up many safety concerns and no clear benefits. Governmental agencies also warn about the dangers that kratom poses to mental health.
Nonetheless, in late 2017, the University of Rochester published a review on kratom studies. It compiled the data 57 years of international studies. The researchers focused on 13 different studies that collectively examined nearly 30,000 individuals.
Contrary to the claims of the FDA, DEA, and others, this review proves that kratom can indeed be a safer alternative to opioids. It also confirms that kratom can improve mood and help with anxiety and other issues.
Studies and research on kratom are limited at this time. Because of that, we are not yet fully aware of the full potential of kratom and the alkaloids present in it. Nor do we know the full scope of the potential risks to properly advise users.
Yet, this may change in the future. A team led by Dr. Christopher McCurdy at the University of Florida College of Pharmacy has been awarded two grants from NIDA to study kratom alkaloids. While the team has 7 years total to study the herb, they have already come forward with positive results that kratom could indeed be a viable alternative in managing opioid dependence.
The research also contradicts the claim that kratom is unsafe. Kratom has such minimal respiratory depression that it is unable to affect humans when taken in pure and raw form.
So, this research may completely void the claim that kratom is ineffective and has no medicinal uses.
5. Kratom is Addictive
Another popular statement about kratom is that it is addictive. More specifically, according to the statements by the FDA data keeps showing that kratom has a strong potential for abuse and attention. Instead of being a cure for opioids, kratom is a gateway to continue opioid addiction.
A solid reason to list it among the Schedule I drugs, isn’t it?
Yes, in 2016, a group of scientists and doctors conducted an 8-factor study according to the CSA (Controlled Substance Act). They concluded that kratom is not only safe, but also not nearly as potent in terms of abuse, tolerance, and dependence as claimed by the FDA.
As a matter of fact, it is even less addictive than many Schedule IV and V drugs and is also within the range of many non-scheduled substances. Such as coffee and nasal nicotine spray.
The group has submitted their study to the FDA but is yet to receive a response.
Are the FDA’s Studies on the Dangers of Kratom Reliable?
The FDA had conducted its own studies which lead to the conclusion that kratom was an opioid, a statement that since then has been reworded. Why such a stark difference? How can two sides come up with radically different results using studies.
The answer lies in the way the FDA conducted these studies. While the studies included real people, the FDA has developed a computer program, called PHASE, that predicts the effects of kratom based on an algorithm.
There is a lack of transparency around PHASE. It has been developed in-house and very few details have been released about how it works.
Is it a reliable program or simply a means to confirm a bias?
Andrew Kruegal, a Columbia University chemist who has authored several studies on kratom, points out that the studies conducted by this algorithm are a lot less rigorous that many other studies on kratom.
The FDA also seems to be lumping all substances with opioid properties under the same category. When that isn’t a reliable practice.
Algorithms can be used in medicine, yet they need to be used in combination with other methods to yield accurate results. Because the effects of a substance on the human body depend on many more factors than simply a prediction of patterns.
Ignoring that would mean that the FDA isn’t actually conducting valid studies, but instead finding a way of proving its bias.
What Causes This Debate?
We recently came upon this interesting article. It talks about how big pharma is trying to extract the alkaloids found in kratom for medicinal use.
While we can’t claim the validity of this source, this is definitely some food for thought. It is also absolutely plausible.
Think about it. Morphine and codeine are two common pain relief drugs in medicine. Both derive from raw opium and can be further processed into heroin. Which, by the way, is a Schedule I drug.
So, morphine is an actual opioid and so is codeine. Yet, we use them in medicine.
This leads us to think about one thing.
If kratom is truly effective in helping people to feel better yet easily available for purchase from individual vendors, then the pharmaceutical industry is losing out on lots and lots of money.
Wouldn’t it make sense if they’d like to take credit for the benefits of kratom and pocket all that income?
What’s Our Stance on All this?
As you already know, we are fully for people having easy and affordable access to kratom. No one should be denied the right to freely purchase an herbal supplement that is helping them.
Sadly though, we still do not know everything about kratom. There is a need for a greater number of controlled studies on the benefits and risks of kratom use.
That would provide users with the necessary information to make fully informed decisions.
Until then, it all comes down to personal responsibility. Buying kratom from a reputable and trustworthy source, taking adequate doses of kratom, and not mixing it with incompatible substances. Learning about different aspects of kratom, as well as purchasing it from trustworthy and credible vendors to avoid salmonella and other contaminants is also necessary.
Which is what our blog aims to help you with. Empower you with the knowledge you need to stay safe, get the most out of kratom, and make informed decisions.
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What is your stance on this topic? Is kratom dangerous? Are you for the kratom ban? Or should it be studied in greater detail and be easily accessible in natural form. Feel free to share your thoughts with us.
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