Study: Kratom May Have Therapeutic Effects and Low Potential for Abuse

Baltimore, MD—Kratom"may have therapeutic effects and relatively low potential for abuse or harm." That's the word from Johns Hopkins Medicine in a

press releaseannouncing new findings published inDrug and Alcohol Dependence. Using the results of a survey of more than 2,700 self-reported kratom users, the researchers concluded that the herbal supplement "likely has a lower rate of harm than prescription opioids for treating pain, anxiety, depression and addiction" and is a possible alternative to opioid use. They added that there is a need for research and regulation, but not an outright ban on sales of the herbal supplement.

Discussing the findings, the researchers caution that self-reporting surveys aren’t always entirely reliable, and also note that kratom is not approved by the U.S.Food and Drug Administration(FDA), and that research to formally establish safety and benefits of the herb is lacking. The release add: reports — although sparse — have linked [kratom] use to hallucinations, seizures and liver damage, when combined with alcohol or other drugs.

Albert Garcia-Romeu, Ph.D., instructor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, said in the release that the new survey findings “suggest that kratom doesn’t belong in the category of a Schedule I drug, because there seems to be relatively low rate of abuse potential, and there may be medical applications to explore, including as a possible treatment for pain and opioid use disorder.” He added, “There has been a bit of fearmongering, because kratom is opioidlike, and because of the toll of our current opioid epidemic.”

Related: Debates: Kratom for Chronic Pain?

A look at the study: Garcia-Romeu and his team enrolled 2,798 people to complete an online survey on their use of kratom. Participants were recruited online and through social media, as well as through the American Kratom Association (AKA). Nine in 10 (91%) of participants reported taking kratom to alleviate pain on average a couple times a day for back, shoulder and knee pain; 67% reported taking the herb for anxiety; 65% said they took it for depression; and 41% said they took kratom to treat opioid withdrawal. Of those taking it to help with withdrawal, the release says, 35% reported going more than a year without taking prescription opioids or heroin.

Regarding the potential for abuse, according to the release: Fewer than 3% of responses met the criteria for moderate or severe substance use disorder for abusing kratom, and 13% met some criteria for kratom-related substance use disorder. "This is comparable to about 8%–12% of people prescribed opioid medications who became dependent, according to statistics from the U.S. National Institute for Drug Abuse (NIDA)."

Garcia-Romeu put this in perspective: “Both prescription and illicit opioids carry the risk of lethal overdose as evidenced by the more than 47,000 opioid overdose deaths in the U.S. in 2017. Notably there’s been fewer than 100 kratom-related deaths reported in a comparable period, and most of these involved mixing with other drugs or in combination with preexisting health conditions.”

A note of caution from Garcia-Romeu: “Although our findings show kratom to be relatively safe according to these self-reports, unregulated medicinal supplements raise concerns with respect to contamination or higher doses of the active chemicals, which could increase negative side effects and harmful responses. This is why we advocate for the FDA to regulate kratom, which would require testing for impurities and maintaining safe levels of the active chemicals. Otherwise, unregulated products run the risk of unsafe additives and dosing problems, which could be like getting a shot of grain alcohol when you were trying to order a beer.”