Kratom: Could it help or hurt the opioid addiction crisis?

NEW ORLEANS (WVUE) – Many people who suffer pain hate the side effects of opioid painkillers, and some even fear becoming addicted to the potent prescription drugs.

So some are turning to a botanical substance that is now on the radar of federal health officials.

“It’s a very severe pain that’s deep. It’s everywhere from the neck down,” said Andrew Troenkrasnow.

He likes to be called “AZ,” and some might say that’s a small request given all that he has faced.

“It’s testicular cancer, but only in my chest right there. It’s a pretty rare type of cancer. I found out about it Mardi Gras weekend last year,” he said.

While working in Uptown New Orleans at Mushroom Records, the 21-year old shared his diagnosis and what he said helps with the lingering effects.

“You know, a good day I might take six pills at a time, so three grams,” Troenkrasnow, aka AZ, stated.

He takes Kratom, the Mitragyna speciosa plant native to Southeast Asia.

“So I use it mostly for chronic pain related from Lyme disease and cancer,” added Troenkrasnow.

“This is one brand right here, and then this is our house stuff that we do, so white, green, red. Those packs indicate the different strains,” said Christopher Hummel as he showed us some kratom products.

Hummel owns Mushroom Records, which now offers a menu of kratom products for sale.

“You know, it can be prepared as a tea, but it’s not particularly great tasting, so people who take it as capsules. They’ll buy a pack, 15 pills to, you know, a pack, $10, then people buy the powder, which is a cheaper way to go,” Hummel stated.

Taste aside, debate is growing over kratom’s safety and whether it can help or hurt the opioid painkiller epidemic.

“Kratom is a very benign plant that doesn’t harm you,” said Mac Haddow, Senior Fellow on Policy for the American Kratom Association.

Haddow described it as a dietary type supplement that helps with pain.

“I’ve on occasion had to use an opioid. I’ve never been addicted to them, but they gave me a temporary relief. Kratom is just as effective for me, personally, in terms of my back pain,” Haddow stated.

The AKA estimates about 5 million people in the U.S. consume the Asian foliage.

“Because of the cancer treatment, I was on a lot of opioids, on very heavy doses, so when I was trying to get myself off of that, I was having a lot of trouble, and increasing my kratom dose helped a lot with the aches and the pains and the nausea. Made it a much easier process,” said Troenkrasnow.

Hummel said an injury led him to try kratom.

“I took kratom because I was worried about sitting there for six weeks taking painkillers and having to stop. Other consumers buy it for recreational purposes. It’s a stimulant, it gives you good energy. And then you get people who buy it for withdrawal symptoms,” Hummel stated.

But the Food and Drug Administration said there are no FDA-approved uses for kratom, and it urges consumers not to take it.

In a September press release, the FDA said, “To date, there have been no adequate and well-controlled scientific studies involving the use of kratom as a treatment for opioid use withdrawal, or other diseases in humans.”

Further the FDA has said kratom affects the same opioid brain receptors as morphine, and it appears to have properties that expose users to the risks of addiction, abuse and dependence.

“There is some science to show that certain compounds in kratom, there are two primary ones, one is a stimulant like cocaine in small doses, while if you increase the dose it becomes an opioid in nature,” said Dr. William Rout, an addiction specialist and Director of the Addiction Medicine Fellowship Program at Tulane University’s School of Medicine.

Rout weighed in on questions about whether kratom can aid or hinder opioid withdrawal.

“At the present time I think that’s an unknown because there are no scientific studies that have been done to validate that. It does have opioid properties, and if you’re in opioid withdrawal and you take some of this leaf, it will relieve some of the symptoms of the withdrawal,” Rout stated.

For its part, the National Institute on Drug Abuse describes kratom’s leaves as having compounds that can have psychotropic, or mind-altering effects.

Troenkrasnow said he has not experienced any of that.

“Not at all. I mean, sometimes I’ll get a little bit more energy or a little bit more relaxed from it depending on my dosage. Depending on the strain, there might be a little bit of mild euphoria but nothing too big, and definitely no negative psychological side effects,” he said.

“If you find a product that gives you a high in some way, that’s not kratom, that’s kratom that has bad products mixed in with it,” added Haddow.

At the end of October, the Louisiana Poison Control Center reported receiving 19 calls so far this year, with 10 coming from people who reported experiencing “moderate effects” from kratom.

State lawmakers are concerned.

The Louisiana Department of Health is working on a study on scheduling kratom as a controlled dangerous substance. State legislators called for the study in a resolution passed earlier in the year.

Some medical examiners have reported deaths associated with kratom.

In New Orleans, the coroner’s office said there have been two deaths since early 2018 when the office started screening for mitragynine levels where kratom would be considered a contributor to death, along with other drugs. The agency added that there are currently no cases classified as a drug-related death where kratom was the only drug found in the decedent’s system.

In neighboring Jefferson Parish, the coroner’s office said so far this year there have been two kratom-related deaths and two for all of 2017. St. Tammany Parish reports no kratom deaths, but adds that the substance has turned up in some toxicology tests. When contacted, the offices of the coroners for St. Bernard and St. John parishes said they had no kratom-related deaths.

So far the FDA has linked at least 44 deaths to kratom. But advocates of kratom said the agency’s interpretation of data is flawed.

“We did an exhaustive analysis of those deaths. Every one was from poly-drug use, or from the utilization of adulterated kratom products that had fentanyl, Pink, other kinds of very potent substances which are manufactured by unscrupulous vendors trying to sell their products …We think that people, consumers need to very carefully vet the manufacturers,” said Haddow.

“Most of our other product we import directly from Indonesia, package it ourselves. That way we know no one’s added anything to the product, changed it in any way,” Hummel stated.

Troenkrasnow said he’s not concerned about possibly consuming kratom that has been mixed with something that could harm his health.

“No, because I trust where I’m buying it from, you know? I know the sources where it’s coming from,” he said.

Would Dr. Rout advise patients or anyone else to consider kratom at this point?

“I would tell them until there’s a lot of good scientific evidence, not to use the drug, or use the leaves,” Rout said.

And Dr. Rout says when it comes to battling opioid addiction, there is really no overnight remedy.

“Opioid withdrawal is not taking a pill. You know this idea that we have in this country that you go into a program and you get detoxed in three to five days and you’re cured is malarkey. Opioid dependence or addiction is a disease. It is a chronic disease,” said Dr. Rout.

“I think it’s important that we don’t just say no to it, or the FDA doesn’t just shut it down. I think we should actually do research, find out what the benefits are and also if you take too much of it, like, what it could do to you over time,” said Hummel.

As for Troenkrasnow, he said he did not mix kratom with his chemo regimen, but adds that the substance has been very helpful to him.

“Without kratom, I probably wouldn’t be here right now, like, I would not have made it through the withdrawals,” he said.

At the federal level, the Drug Enforcement Administration said there has been no final determination on making kratom a Schedule 1 drug and that the issue remains under review.

Hummel added that he does not see many young people buying kratom.

“Most people that buy it, our average consumer is going to be probably in their 30s, if not older. I very seldom ever see anybody under the age of 25 buying kratom products.