FDA: Herbal supplement may have opioid effect

FDA: Herbal supplement may have opioid effect

A new warning from the FDA says the popular herbal supplement, kratom, may affect the body the same way opioids do.

"The scientific evidence we've evaluated about kratom provides a clear picture of the biologic effect of this substance", said Dr. Gottlieb in the statement.

"Importantly, as commonly used in raw plant form, it does not appear to produce the highly addictive euphoria or lethal respiratory depressing effects of classical opioids", the group, including scientists from Johns Hopkins University, Columbia University and the University of Rochester, wrote.

"Cases of mixing kratom, other opioids, and other types of medication is extremely troubling because the activity of kratom at opioid receptors indicates there may be similar risks of combining kratom with certain drugs, just as there are with FDA-approved opioids", according to the agency. But other researchers warn that the herb, taken in capsules or by drinking tea, is too risky to use.

The FDA also said it has identified 44 reports of death involving kratom since 2011, up from 36 reported in November. In 2016, opioids were responsible for more than 42,000 deaths. Kratom proponents have said the government sometimes blames kratom for deaths caused by other substances, but the new fatality cited by the FDA, given the absence of other substances, "reinforces our concerns", Gottlieb said.

The FDA has submitted its review to the Drug Enforcement Administration, which is considering whether to place kratom in the same category of illegal drugs as heroin and LSD. "We affirm our belief that the existing science on kratom does not justify its placement into Schedule I of the CSA, nor for kratom to be added to any local or state Controlled Substances list that would effectively remove it from consumer access". But officials backtracked after a public outcry and pressure from some members of Congress. FDA has stepped in, concerned over the product's lack of scientific evidence to support medical claims. Further analysis confirmed that two of the most prevalent compounds in kratom are known to activate opioid receptors, and that kratom has a strong bind to mu opioid receptors, comparable to those of scheduled opioid drugs.

Warning Over Kratom: What's the Real Impact for Pain Practitioners?

Kratom has been used around the world for centuries to help people manage pain and opium withdrawal.

Henningfield, who has done work for the nonprofit American Kratom Association, argued late previous year that the substance's "overall abuse potential and risk of death isn't anything close to narcotics like opioids", and warned that restricting or banning it could drive some people onto the black market to buy it or push them back to opioids.

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