Kratom Draws Support And Controversy As Opioid Addiction Treatment

The Fix

By Beth Leipholtz 07/09/18

“It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” said one kratom user.

Close-up of hand holding herbal medicine capsules and tablets

A controversial supplement, kratom, could have benefits when it comes to treating opioid use disorder, according to a new study. However, there is still much controversy around it due to safety concerns.

Kratom is a psychoactive drug that comes from the leaves of Mitragyna speciosa, which is an Asian plant in the coffee family.

Some believe it is effective for treating substance use disorders, but organizations such as the Food and Drug Administration (FDA) and the Drug Enforcement Administration are wary of that. In fact, the DEA even attempted to ban the substance.

In February, FDA commissioner Scott Gottlieb spoke against kratom, saying “there is no evidence to indicate that kratom is safe or effective for any medical use.”

Scott Hemby, a professor of pharmaceutical science at High Point University in North Carolina, led a new study recently published in Addiction Biology, which found that kratom may in fact have some benefits.

Kratom has two main ingredients: mitragynine (MG) and 7‐hydroxymitragynine (7‐HMG). MG accounts for 60% of the compound in the plant while HMG is about 2%. Using rats, Hemby’s study examined how both these ingredients affect the brain.

Hemby and other researchers allowed rats to self-administer both components of kratom. They found that the rats quickly began self-administering HMG, but did not have interest in MG.

“In other words, while one of kratom’s main compounds appeared to be addictive, the other wasn’t at all—in fact, it appeared to have the opposite effect,” Business Insider reported.

Because kratom affects some of the same receptors in the brain as opioids, the FDA announced in February that it would be called an “opioid.” But others believe kratom could be beneficial and treat cravings while reducing symptoms of withdrawal and the likelihood of relapse.

The results of the study suggest that it could be beneficial to breed the plant to have higher concentrations of one compound versus the other. However, the results are preliminary because the study was not done on humans.

Some people, such as 26-year-old Bryce Avey, began using kratom because they could not get access to other opioid treatments like buprenorphine and naltrexone. “It’s like a cruel joke that I finally found something that works and the FDA and DEA want it banned,” Avey told Business Insider.

David Juurlink, professor of medicine at the University of Toronto, told Business Insider that the use of kratom makes sense, as it affects the same brain receptors as opioids. “It makes sense that this product would mitigate the symptoms of opioid withdrawal or allow someone to transition from a higher dose to lower dose, or help get them off of opioids altogether,” he said.

Business Insider notes that concern about the supplement arises because there is no “quality oversight of kratom,” meaning people don’t know what the pills actually contain.

“Personally, I would never take this stuff,” Juurlink told Business Insider. “When you go to a pharmacy, you know there’s quality control, you know precisely how much you’re getting, and you know exactly what you’re getting. With this, it’s impossible to know.”