The Ultimate Scientific Verdict on Kratom: WebMD?

Publisher’s Note: One implication of this article is that kratom should be regulated as a dietary supplement. The resultant regulation would address labeling, adulteration, health claims and related issues of product integrity. If this end is pursued, the kratom industry should examine the use of voluntary-consenus-standards-kratom.

What Is Kratom? Why Does the DEA Want to Ban It?
By Jennifer Clopton
WebMD Health News
Sept. 19, 2016 — Advocates say the herb kratom offers relief from pain, depression, and anxiety. Scientists say it may hold the key to treating chronic pain and may even be a tool to combat addiction to opioid medications.

But the Drug Enforcement Administration (DEA) is moving to ban its sale as of Sept. 30, citing an “imminent hazard to public safety.” The DEA last month announced it would make kratom a Schedule 1 drug — the same as heroin, LSD, marijuana, and ecstasy.

The agency says kratom has a high potential for abuse and no current medical use. But its announcement has sparked outrage. Opponents have rallied in front of the White House against the ban, and more than 124,000 people signed a petition asking the federal government to reconsider.

Some research scientists are among those pushing to reverse the decision, arguing a ban will harm their ability to study whether kratom can help treat pain and addiction. In the meantime, users are rushing to buy the supplement before it becomes illegal.

Here’s what we know about kratom.

What Is Kratom?

Kratom is a tropical tree in Southeast Asia. Its leaves have been used for hundreds of years to relieve pain. They can be eaten raw, but more often they’re crushed and brewed as tea or turned into capsules, tablets, and liquids.

In low doses, kratom acts as a stimulant. In large amounts, it acts as a sedative, and the DEA says it can lead to psychotic symptoms and psychological addiction. According to the CDC, about 42% of cases of kratom use reported between 2010 and 2015 involved non-life-threatening symptoms that required some treatment. About 7% of exposures were classified as major and life-threatening. The DEA says it knows of 15 kratom-related deaths between 2014 and 2016.

Kratom has been on the DEA’s list of drugs and chemicals of concern for several years. But the DEA notes that its use appears to be going up. Law enforcement agencies across the country seized more kratom in the first half of 2016 than ever before. U.S. poison control centers received 263 calls about kratom in 2015, a tenfold increase from 2010, the CDC says.

In mice, kratom targets a part of the brain that responds to drugs like morphine, codeine, and fentanyl, according to a study published earlier this month by Susruta Majumdar, PhD, a researcher at Memorial Sloan Kettering Cancer Center in New York. These types of drugs are called opioids.

Majumdar’s study found that unlike morphine, kratom does not lead to harmful side effects like slowed breathing — called respiratory depression — constipation, and physical dependence. Since most deaths from opioid overdose are because of respiratory depression, he believes kratom merits further study.

Majumdar, who has studied kratom for 2 years, says he believes the herb has promise because it’s not addictive.

“I’m not a kratom advocate,” Majumdar says. “I’m not going to say it is a solution for everything, but there is early promise and scheduling is premature in my humble opinion.”

Kratom remains poorly understood, says Edward W. Boyer, MD, PhD, a professor of emergency medicine at the University of Massachusetts Medical School. He knows of a case where a man successfully treated his opioid withdrawal with kratom.

“Most people with opioid withdrawal have abdominal pain, diarrhea, dysphoria.

This guy really only had a runny nose, and that is pretty remarkable,” Boyer says. “I’m not willing to say [kratom] is great for everyone. I’m just ready to say that is pretty interesting and it should probably be studied more in a controlled way.”

Walter C. Prozialeck, PhD, chair of the department of pharmacology at Midwestern University in Illinois, analyzed about 100 studies on kratom. He says one major question remains: How addictive is kratom?

Anecdotal reports suggest it is less addictive than opioids, but he says many companies in the U.S. advertise it as a legal high. Several Southeast Asian countries have outlawed it because of addiction concerns.

Prozialeck’s review also found that in almost every case of reported kratom side effects, there were other things involved, like other drugs or health conditions. And since it’s been sold as an herbal supplement, kratom hasn’t received the same amount of governmental oversight as an approved drug.

“So we go from no regulation at all to a total ban. It seems like there could be some middle ground somewhere,” Prozialeck says.

Given all these questions, Prozialeck says doctors aren’t likely to recommend kratom to patients. But he says many in the scientific community do support more research on the drug, especially given the nation’s opioid epidemic.

“If it lived up to its billing, some of the compounds in kratom could be useful at least as the basis for the development of better drugs that would treat pain without the addictive benefit of opioids. That would be an amazing advance in pain management,” Prozialeck says. “But nobody knows how research will turn out. It could be a dead end. The biggest negative of the DEA ban is it will stifle any research in this area.”

What’s Next?

DEA spokesman Russ Baer says there is no discussion within the agency to reverse the scheduling decision. But the decision is temporary, and the agency has up to 3 years to convince the FDA to make kratom a Schedule I drug permanently. During that time, if research warrants, the decision could be reconsidered.

Baer says the DEA has reversed a scheduling decision once in 2004, on a drug called TFMPP, which is used as a legal alternative to ecstasy.

Scientific references available at:

16 comments. Leave a Reply

  1. J

    I understand the topic, but first I’d like to point out where the problem lies in this whole mess:

    “‘If it lived up to its billing, some of the compounds in kratom could be useful at least as the basis for the development of better drugs that would treat pain without the addictive benefit of opioids. That would be an amazing advance in pain management,’ Prozialeck says.”

    Synthetic counterparts have never been better than naturally occurring alkaloids in their natural profile, so the thinking that this plant needs to be refined down to one or two compounds out of the MANY alkaloids we appreciate in kratom needs to stop.

    That same mentality has caused scrutiny to all other natural creations.

    To answer the topic regarding regulation as a dietary supplement, that would be a step backwards since the market already does just well without FDCA guidelines. In this industry, the vendors have gained the loyal trust of their customers. The problem that has caused amateur/young kratom vendors to step inside FDA jurisdiction is the use of structure/function claims. Some of these vendors don’t understand the FDCA policies, as you’ll see a structure/function claim disclaimer on a website where there is no need for such footnote because no claims are being made. The only nitpicky issue we see is the occasional inexperienced business that assumes if something is legal, they can make any claim they want and even instruct users how to use the material. That’s not the fault of the product though. It’s a problem with the individual running the business who are ignorant on policies that govern commerce.

    Regulation has not been needed when the plant material is sold for no purpose, and with no structure/function claims.

    Unfortunately, the vendors who break these policies by selling it as a dietary supplement have attracted negative attention and are to blame. Those who make claims simply make more sales, and these vendors care only about money. That’s not the fault of an innocent tree leafor.

    If there is to be any regulation, simply require someone like the American Kratom Association to evaluate all business models. They can ensure that no claims are being made, thus negating the need for FDCA compliance or disclaimer footnotes. Vendors should not be allowed to give medical advice. Again, this industry has been smooth sailing for over 20 years without problems. The only issues that arose were the recent instances where a company blatantly broke FDCA policy. An example is when an energy shot manufacturer created VicoZen/VivaZen. First such product was severely shunned by the real, natural kratom community. Second, the manufacturer labeled their product as a dietary supplement on the bottle and made claims on the same label WITHOUT approval. See, to market a dietary supplement, one must submit a New Dietary Ingredient (NDI) application for the ingredients listed within (unless grandfathered pre-1995, difficult to prove when Internet was barely taking off at that time!). The manufacturer then muse wait for an approval from the FDA and prove with substantial proof/data that such NDI’s do not pose a health risk to the public. The company of those “shots” never submitted an NDI for the botanical specimen. Worse, they used an EXTRACT of the botanical specimen, so it can’t be considered plain leaf anymore. Extracts are modified and aren’t “natural” leaf profiles. If anything must be regulated, it should be extracts and products marketed as dietary supplements. Therefore, if no structure/function claims are being made, and if the plain leaf material isn’t sold for any purpose (i.e., for ingestion), then it should be exempt from FDCA regulation.

    • J

      Further… when such energy shot manufacturer combines kratom with substances that raise blood pressure and heart rate (like yohimbine HCL, extremely powerful stuff that is somehow approved as a supplement), it causes kratom to be blamed simply because it’s considered “too new” despite its existence on Earth covering the whole timeline compared to an extract of yohimbe. The AKA can be a great regulator of “standards” and ensure that merchants aren’t bringing herbal mixes to the marketplace. The problem has always been dangerous substances mixed with safe substances. Retail smokeshops/headshops have generally been the offenders. Remember, they were coming from the business of selling Mephedrone (“bath salts”), so they’re used to selling synthetic laced herbs.

      Did you know that damiana and lotus flower is illegal in Louisiana? Guilt by association! Headshops were selling smoking blends which contained JWH-018 and many other Chinese synthetics onto these herbs, and the state decided to ban the medium which delivered the chemicals! This is a significant fact to consider when researching what led up to kratom being demonized. When the “bath salts” bans were going on, all nearby products on shelves were assumed to be the same thing with a different name. It is worth pointing out that many lawmakers think “Kratom” is a branding. It’s simply a slang name for a botanical name, but such a trendy name got more attention. Regulate the retail headshops – they can’t be trusted as history is shown. They could also care less about this tree, as they’re in the business of selling products in gray area territory, then move to the next hot product after they run it into the ground. All of the negativity surrounding this tree resulted from headshops. The online market does not need regulation when the natural, plain leaf material is sold without claims. WebMD is not an expert on this industry. The customers and vendors of the industry know the truth.

  2. Shannon

    WELL SAID J!!

  3. Paul P

    So here we have, in one article, two scientists whose research supports the potential of kratom:

    1) Susruta Majumdar, PhD, a researcher at Memorial Sloan Kettering Cancer Center in New York.

    2) Walter C. Prozialeck, PhD, chair of the department of pharmacology at Midwestern University in Illinois.

    Whose science and research and peer-reviewed observations must be ignored because, on the other side, we have:

    DEA spokesman Russ Baer.

    Please explain to me: What exactly are Mr. Baer’s credentials? Where did he earn his PhD? In what area of science has he conducted his research? Because his words are powerful, and could destroy the lives of hundreds of thousands of people in about nine days. I want to know what his expertise is. Or is he just a bureaucrat?

    This more or less summarizes how outrageous this entire ordeal has been. It is not about science, or reasonable policy. It is, plainly and simply, about power.

    • Paul P

      I’ll answer my own question.

      Russ Baer’s credentials for making scientific decisions about the health and behavior of Americans, and research-based observations regarding the biochemistry of fauna and its effects on human biology?

      Bachelor’s degree in Criminal Justice. Florida State University.

      The word of two PhD research scientists, superceded by a cop.

      This, again, is precisely what is wrong with this kratom discussion. The wrong voices are the loudest voices.

      • Sad Citizen

        Thus we are the laughing stock of other countries.

  4. John D.

    Easily the most troubling element of this whole fiasco is the DEA’s assertion that they DO NOT have to consider the comments, the perspectives, and the will of the American people. Of course, who wants to listen to Scientists who are experts in their fields when you can just make up your own “Science”. This ‘turning a deaf ear’ to all commentary belies the claim that the DEA is acting in the public interest. They seem to believe that they have the power to create reality itself. “All use of kratom is misuse because we said so” (I am, of course, paraphrasing here) is just one example. This is, whatever the motivation, a case of powerful people in a powerful agency exercising that power simply because they can. It is a mockery of the American system of government and should send shivers down the spines of freedom loving citizens across the nation.

  5. Anonymous

    Thank you. Very informative and well written. There has to be a dark motive behind the DEA’s decision on this ban.

  6. J

    It’s as if the DEA pretends to not consider all previous research as substantial, even when patents were created as a result.. for exact purpose of treating addiction and pain symptoms.

    So what will the DEA do come Sept 30th? Place it on temporary Schedule I and then require NIH, NIDA, USDA, universities, etc to RESUBMIT studies that prove it has already been documented to be effective, safe, and an accepted treatment method in the USA? All the DEA needs to be shown is the federally funded studies that would disqualify Mitragyna speciosa for even a proposed ruling to be Scheduled!

    It is obvious something is entirely wrong when the data is right there in their face, yet they ignore it and portray this old tree as some new imminent threat!

    I don’t know about you all, but this move is the beginning of one huge revolt. This issue has pissed off even non-users of this plant. Our Congress allowed this group of anti-American mercenaries to have extraordinary, unjust power. I don’t know ANYBODY who sides with the DEA nor anything having to do with regulating this tree. These fools pretend the research isn’t there, but it is. They are blatantly disregarding our government’s own funded studies, evidencing that this avaricious club clearly has an agenda that violates federal law.

    Let’s assume that the DEA is dumb (bless their heart?) and they only report “facts” as relayed by HHS. That does not waive the DEA of being held accountable. The unverifiable data within the proposed ruling along with the omission of SUBSTANTIAL, beneficial evidence makes this plan scream of fearmongering. Everyone sees it. An immediate restraining order is warranted to prevent the unnecessary loss of many jobs, tax revenue, economic growth, and the last bit of faith that citizens had for their government. A positive response to the demands of the people (based on science, research, and anecdotal reports) is required BEFORE September 30th arrives. This proposed ruling must not be considered based on violations CRE has pointed out in previous topics within the Kratom Policy Forum.

    CRE, keep up the good work. We owe you several dinners.

  7. Kratom Research Institute

    Canada currently regulates kratom as a legal Natural Health Product. Canada has seen no deaths or public health problems associated with having kratom legally available as a dietary supplement. Regulating kratom as a legal dietary supplement is the correct approach for the United States.

    • Anonymous

      Yes absolutely this! The DEA is basically calling Health Canada inept when the reality is the DEA is completely incapable of making rational decisions for the good of the CITIZENS of America instead of just for their corporate buddies. Canada classifies Mitragyna speciosa as a “natural health product”. The simple fact that Canada is not experiencing ANY negative effects by having Mitragyna speciosa legal and readily available to the public is seeing the natural herb in action. And that action is? No deaths. No overdoses. No complaints. The USA looks like a bunch of alarmist and backward thinking when faced with evidence kratom is not dangerous to call it an “imminent public health hazard”. Unbelievably ridiculous. I don’t even know how the DEA is proceeding forward with this proposed ban while still trying to spin the lies. The payoff must be huge from the Pharma companies and rehab centers for the DEA to take direct action to purposefully harm law abiding hard working American citizens.

  8. Brittany Jordan

    This is quite literally life and death for some people. The DEA needs to be held accountable for the lives they are ruining. Mothers and fathers that just want to be able to get out of bed with no pain and work a normal job to support their family. Grandparents who wish to play with their grandchildren. These people are not felons, they are real, beautiful human beings that have found an answer that the government could not provide for them.

  9. Heather G

    We don’t have time to let you ban it while you do studies and confirm that’s not dangerous. The people who have relied on this to help themselves for years without issues DESERVE to have the plant that helps with their ailments.

    You cannot rip that away from them. It would be a terrible cruelty to take away the plant that helps so many people with chronic pain, mental illness, and opiate addiction. These people do not have TIME to wait for you to figure out what they already have that kratom is safe and it is useful and legitimate people need this to help with their legitimate issues. You can’t just take something away like that and not even give anyone time to talk about how it affects us or even try to find alternatives (we don’t know of anything that helps us like kratom). The earth is our home and its plants are our food and sometimes they also offer us a respite from the things that cause us to suffer in this life. We have a right to plants for both purposes! And we need the WHOLE plant. There are many many different strains of kratom and each on presents a unique alkaloid profile. Many people depend on having the right strain for them. You can’t take all that out and isolate certain compounds into a pill. We want the plain kratom leaf for pain! We demand it because it is our human right! Please have compassion for those whose sufferings you may not be able to even understand. At least try. #SaveKratom

  10. Anonymous

    All is can say is sigh. At this point I have bled too much fighting this thing and tried to make my voice heard. I dont know what else I can do, I guess we will just have to pray for Obama to overturn it or a miracle.

    • Anonymous

      Please do not give up. Please do not give in. Fight. Call, email, post, share. Our rights are being stolen right out from under us. The ramifications of this current action will affect generations to come. The will of the people should prevail, not corporate cronyism. Of the people, for the people, by the people. Show future generations that they CAN fight and they can win. Truth is on the side of Mitragyna speciosa. There are no lies being told by the citizens. Only the government. If we lose this, future generations will assume fighting the government will never be successful and citizen rights will continue to erode until there is nothing left.

      Join. The. Fight.

  11. Sad Citizen

    I’d LOVE to see someone with the right power stand up and say enough. I would follow that person to the ends of the earth. Let us call it the way it is. FACT, kratom alone is not a threat to public health. FACT it has proven uses, proven by doctors that work or have worked for our OWN FDA, NIH ..hello. FACT kratom does not fit the requirements of a temporary or permanent schedule I. Those are facts. There is no excuse for allowing this ban to happen. None. People have power to stop it before it happens, but even those who have that power now will not all have the power to reverse it later. We have learned this lesson. Come on.

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