A prominent drug policy organization, the Foundation for Drug Policy Solutions, has issued a stark warning regarding Kratom, labeling it an "addictive opioid-like drug" that is contributing to a rise in emergency room visits and fatalities. The Foundation, through its social media channels, emphasized the public health threat posed by the substance, which remains legal in most U.S. states.
"Kratom is no harmless supplement. It’s an addictive opioid-like drug that’s fueling a surge in ER visits and deaths—yet it’s still legal in most states. This a danger to public health. It’s time to sound the alarm," stated the Foundation for Drug Policy Solutions in a recent tweet.
Kratom, derived from the leaves of the Mitragyna speciosa tree native to Southeast Asia, contains alkaloids like mitragynine and 7-hydroxymitragynine. These compounds interact with opioid receptors in the brain, similar to traditional opioids, leading to effects such as pain relief and euphoria. However, unlike conventional opioids, kratom's primary alkaloids exhibit G-protein biased agonism, which may result in less respiratory depression, a common cause of overdose death with other opioids.
The U.S. Food and Drug Administration (FDA) has consistently warned against Kratom use, citing concerns about its potential for addiction, liver toxicity, seizures, and other serious adverse events. In 2021, the FDA's adverse event reporting system received 75 reports involving Kratom products, including 20 deaths and 20 hospitalizations. A CDC study from 2019 noted 152 kratom-positive decedents in drug overdose deaths between July 2016 and December 2017, with kratom determined as a cause of death in 91 of those cases, though often in combination with other substances.
Despite these warnings, Kratom is not federally regulated as a controlled substance, leading to a patchwork of state-level laws. While some states and municipalities have banned it, many others have either kept it legal or introduced regulations like the Kratom Consumer Protection Act (KCPA). Proponents, including the American Kratom Association, advocate for regulation rather than prohibition, arguing that unadulterated Kratom can be used safely for pain management and as an aid for opioid withdrawal, and that many adverse events are linked to contaminated products or use in combination with other drugs.
The Foundation for Drug Policy Solutions, co-founded by former White House drug policy advisor Kevin Sabet, aims to promote policies that prevent drug use and combat the addiction crisis. Their stance on Kratom aligns with their broader mission to advocate for stricter drug controls and public awareness campaigns. The ongoing debate underscores the complex challenges in balancing public health concerns with individual access to unregulated substances.