Substance abuse researchers have long looked for a magic pill that can easily cure people’s addictions to alcohol and/or drugs, but finding such an elixir has proven elusive at best. This now appears to be the case with the herbal supplement kratom, as research released this month further suggests that possible negative impacts—including its own addictive properties—overshadow its potential benefit as an addiction cure.

Derived from a southeast Asian evergreen tree, and used as a traditional medicine in that region since the 1800s, kratom’s popularity in North America has grown considerably over the past decade. Currently treated as a “supplement” by the FDA, kratom supporters claim that it helps manage chronic pain, boosts energy levels, and eases opioid and alcohol withdrawal symptoms. Perhaps due to its opioid properties, kratom is also gaining popularity for recreational purposes, and an estimated three million Americans use the supplement, which can be purchased online, and in health food stores, smoke shops, and some convenience stores.

The FDA has been investigating kratom as “a drug of concern,” while the U.S. Drug Enforcement Administration (DEA) cited it for having a “high potential for abuse,” with no accepted medical use. In 2016 the DEA announced plans to include kratom as a controlled substance, putting it in the same Schedule I category as heroin. However, the administration backed down in the face of opposition from more than 60 members of Congress, and perhaps a nudge from the White House. Five states, though, have passed legislation prohibiting the use and sale of kratom.

Kratom medical research is limited, and kratom supporters dispute existing research findings on kratom overdose death numbers, liver toxicity, addictive properties, and possible respiratory suppression. And now the supplement’s supporters and opponents will have two more research findings to consider.

A study conducted by Purdue University, Washington University, and Memorial Sloan-Kettering determined that kratom could be an effective treatment to reduce alcohol consumption in those with alcohol use disorder (AUD). However, the researchers determined that side effects, including kratom addiction, rendered the treatment unsafe. In conclusion the researchers determined that support for further medicinal AUD therapies should be given to substances that do not “produce such obvious side effects.”

A federally funded study into drug-induced liver injury by the Albert Einstein Healthcare Network determined that of 404 cases of liver damage linked to dietary supplements, seven of them could conclusively be connected to kratom. Lead researcher Dr. Victor Navarro called the results a “bellwether,” when he released the findings November 10, during the annual meeting of the American Association for the Study of Liver Diseases. “Not only are we seeing increased use of kratom and adverse events associated with it, but liver injury,” he said.

While more research is needed to better determine the risk-benefit profile of using Kratom as an addiction therapy, regulators may weigh in first, as there are indications that DEA may again try to add kratom to its list of Schedule I Controlled Substances.

Sources:

1. Chris Adam. “Opioid-based plant might not be best solution to curb habitual alcohol use.” November 13, 2019. Medical Press. Retrieved from: https://medicalxpress.com/news/2019-11-opioid-based-solution-curb-habitual-alcohol.html
   
2. Marie McCullough. “Kratom products may cause liver injury, new analysis finds.” November 12, 2019. The Philadelphia Inquirer. Retrieved from: https://www.msn.com/en-us/health/other/kratom-products-may-cause-liver-injury-new-analysis-finds/ar-BBWBRkU
   
3. Molly Walker. “Kratom-Linked Hepatoxicity on the Rise in the U.S.” November 10, 2019. MedPage Today. Retrieved at: https://www.medpagetoday.com/meetingcoverage/aasld/83244
   
4. American Kratom Association. Multiple Pages. No Date. Retrieved from: http://www.americankratom.org/