The Food and Drug Administration (FDA) issued a public advisory Tuesday about the herbal supplement kratom.
Kratom is a common name for a plant that grows in several countries in Southeast Asia including Thailand, Malaysia, Indonesia and Papua New Guinea. He said that calls to US poison control centers involving kratom increased 10-fold between 2010 and 2015, and that the herb is associated with side effects including seizures, liver damage and withdrawal symptoms. The plant's euphoric affect, which is similar to narcotics such as opioids, has led to recreational use as an alternative to opioids. Jessica Bardoulas of the American Osteopathic Association tells USA Today there's "anecdotal and scientific evidence indicating kratom could be an effective opioid alternative". "It's probably easier to "do it yourself" with kratom ordered over the internet than find - if it's available - and pay for FDA approved, doctor supervised treatment". Gottlieb said the FDA is treating kratom as an unapproved drug and also has taken action against kratom-containing dietary supplements.
"Given all these considerations, we must ask ourselves whether the use of kratom - for recreation, pain or other reasons - could expand the opioid epidemic", he said.
So far, no marketer has tried "to properly develop a drug that includes kratom", Gottlieb said.
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"The FDA knows people are using kratom to treat conditions like pain, anxiety and depression, which are serious medical conditions that require proper diagnosis and oversight from a licensed health care provider", Gottlieb said.
But the FDA said Tuesday that kratom carries similar risks, including addiction and death, and the agency is working to block shipments. The FDA says that review is underway. The agency states, however, that there is no reliable evidence that kratom can be used to treat opioid use disorder. Hundreds of shipments have already been detained and many are seized.
The DEA almost made it a Schedule 1 drug in 2016, which would have put it in the same category as heroin, marijuana and LSD, but ultimately scrapped the plan. "We've used our authority to conduct seizures and to oversee the voluntary destruction of kratom products". "To those who believe in the proposed medicinal uses of kratom, I encourage you to conduct the research that will help us better understand kratom's risk and benefit profile, so that well studied and potentially beneficial products can be considered". And in the United States, Alabama, Arkansas, Indiana, Tennessee and Wisconsin have banned kratom.