Tox Tuesday: Kratom linked to opioids, Salmonella poisoning

March 06, 2018

[caption id="attachment_10223" align="alignleft" width="150"] Photo by Ahman Fuad Morad[/caption]

Kratom, a plant-based drug commonly taken in an attempt to treat pain and addiction withdrawal, has been in the news a lot lately as authorities try to outline the health risks of the loosely regulated substance.

The U.S. Food and Drug Administration (FDA) has issued two separate warnings about kratom in recent weeks. First, the FDA published a statement describing evidence that certain chemical compounds in kratom bind to the same brain receptors that highly addictive opioids (like oxycodone and hydrocodone) affect, suggesting that kratom could be abused in the same way opioids are.

"The model shows us that kratom compounds are predicted to affect the body just like opioids," the FDA said. "Based on the scientific information in the literature and further supported by our computational modeling and the reports of its adverse effects in humans, we feel confident in calling compounds found in kratom, opioids."

Secondly, the FDA urged consumers to avoid kratom products after a multistate Salmonella outbreak was linked to products that may contain kratom. The U.S. Centers for Disease Control and Prevention (CDC) reported that 28 people in 20 U.S. states were affected by the outbreak, with 11 of those people requiring hospitalization. Of people interviewed by health officials, 73% had recently taken kratom.

Through whole genome sequencing, a process that looks at the genome of Salmonella samples from the outbreak, investigators have linked all of reported cases to a single rare strain of Salmonella, suggesting that everybody who got sick shares one source of infection.

What is kratom?

Kratom products come from a tree of the same name (scientific name: Mitragyna speciosa) that grows in Thailand, Malaysia, Indonesia and Papua New Guinea. Its leaves have a long history of being used to relieve pain when brewed into tea. To consumers today, kratom is typically sold in a few forms: leaves, pills, capsules, powders and teas.

Kratom is a stimulant in low doses, meaning it causes increased alertness and energy. But in larger amounts, it becomes a sedative. Some experts say it can cause psychotic symptoms such as hallucinations and delusion, as well as a psychological and physiological addiction.

Though not illegal in most of the country, kratom is considered a “drug of concern” to the U.S. Drug Enforcement Administration, and it is not approved for any medical use by the FDA.

Category: Toxicology