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Is Kratom Safe? Is It Legal?
Question: Is kratom too dangerous to use?
Answer: Kratom is promoted for many uses. These include increasing energy, helping with anxiety and depression, providing pain relief, and easing symptoms of opioid withdrawal. However, any potential benefit of kratom appears to be outweighed by its risks.
A native herb of Southeast Asia, kratom is typically sold in the U.S. as a leaf powder or leaf extract and may come as a powder, liquid, capsule, or tea. The active compounds in kratom can have opioidlike effects similar to morphine and heroin. Known side effects include agitation and insomnia, nausea, vomiting, drowsiness, rapid heartbeat, and hypertension. Weight loss, liver toxicity, seizures, psychosis and hallucinations have also been reported. Consuming kratom tea during pregnancy was reported to cause withdrawal symptoms in an infant -- requiring treatment with morphine (Murthy, Paediatr Child Health 2019). Use of kratom has been linked to at least 44 deaths.
Calls to National Poison Control centers in the U.S. regarding kratom have risen dramatically, according to a recent study (Post, Clin Tox 2019). Sixty-five percent of calls received about kratom between 2011 and 2017, came in just the last two of that seven-year period. Over half (51.9%) of the incidents resulted in serious medical outcomes, including seizures, kidney failure, cardiac arrest, coma and 11 deaths. Serious adverse events and death were more likely to occur in people using kratom in addition to other substances, such as alcohol, benzodiazepines (such as Valium and Xanax), caffeine, or fentanyl (a prescription opioid drug), but at least two deaths were associated with the use of kratom alone.
The FDA has urged consumers not to use any products labeled as containing kratom, or its psychoactive compounds, mitragynine and 7-hydroxymitragynine.
Although not currently federally classified as a controlled substance, kratom has been classified as a Schedule 1 substance or as otherwise legally restricted in Alabama, Arkansas, Indiana, Rhode Island, Tennessee, Vermont and Wisconsin. In other states, however, there are currently no legal restrictions on the use kratom. The FDA is currently evaluating the available scientific information on kratom, after which it will make its recommendation to the U.S. Drug Enforcement Agency (DEA) on how it should be classified. The DEA announced its intent to classify the active compounds in kratom as Schedule I controlled substances, but is awaiting the FDA's recommendation after receiving "numerous comments from members of the public challenging" this proposed classification.