The Food and Drug Administration released a report on Feb. 6 warning people against using the herbal pain reliever kratom, saying it could pose the same addictive qualities as morphine.
Kratom is the common name for the plant Mitragyna speciosa, which grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea.
According to the FDA, kratom affects the same brain receptors as morphine, and thus poses a risk for abuse and addiction.
The FDA report advises all people to avoid kratom or any pain-relieving products using kratom’s active ingredients, mitragynine and 7-hydroxymitragynine.
In a statement released on Nov. 14., 2017, FDA Commissioner Scott Gottlieb, M.D., said “kratom has raised significant concerns given its increasing prevalence and potential safety risks.
“Today, the agency issued a public health advisory related to the FDA’s mounting concerns regarding risks associated with the use of kratom.”
Gottlieb said that kratom was used to treat pain, anxiety, and depression—and was also being taken recreationally because its effects somewhat mimicked that of more powerful processed opiates.
He noted that some people were using kratom for opiate-withdrawal symptoms—essentially switching from one opiate-receptor-triggering drug to another.
The FDA statements both emphasized that the FDA encourages controlled, scientific research to fully investigate the properties and possible therapeutic uses of kratom.
However, as an unregulated and unapproved psychoactive substance being used without supervision, kratom poses unknown risks.
One of the worst, Gottlieb said, was that people who had serious mental or physical health issues might be treating symptoms with kratom but not addressing the root causes.
Gottlieb noted that poison-control centers had seen a tenfold increase in cases involving kratom between 2010 and 2015. He also pointed out that while kratom is often marketed as being natural and safe, as it is a plant, plants can be poisonous.
He said that as of November 2017, the FDA had reports of 36 deaths caused by products containing kratom.
“There have been reports of kratom being laced with other opioids like hydrocodone,” he wrote. “The use of kratom is also associated with serious side effects like seizures, liver damage and withdrawal symptoms.”
The FDA does not currently approve kratom for any therapeutic uses.
The FDA has been treating kratom as an unapproved drug since 2012, and has been seizing it significant quantities when possible.
In September 2014, U.S. Marshals, at the FDA’s request, seized more than 25,000 pounds of raw kratom material worth more than $5 million from Rosefield Management, Inc. in Van Nuys, California. In January 2016, U.S. Marshals, at the FDA’s request, seized nearly 90,000 bottles of dietary supplements labeled as containing kratom and worth more than $400,000, and in August 2016, they seized more than 100 cases of products labeled as containing kratom and worth more than $150,000.