Kratom May Have Less Abuse Potential Than Opioids

February 6, 2020

The herbal supplement kratom may be less addictive and more effective for the management of pain than opioids, according to new research, but caution is needed.

NEWS BRIEF

The herbal supplement kratom may be less addictive and more effective for the management of pain than opioids, according to new research from Johns Hopkins University School of Medicine.1 In a cross-sectional, self-report survey of 2798 participants, kratom was generally found to be highly effective, with 91% people taking it for pain, 67% for anxiety, and 65% for depression. Others take kratom to reduce opioid cravings and withdrawal.

Lead author Albert Garcia-Romeu, PhD, cautions more research is needed before endorsement of kratom, but a total ban with little data is not warranted: “There is a high likelihood that banning kratom or its constituents would compel individuals who are presently using kratom for pain relief or opioid use reduction to return to using prescription or illicit opioids with a known risk of dependence and possible lethal overdose.”

Kratom (Mitragyna speciose) is available online and comes in a variety of forms-pills, tea, powder, capsules, and dietary supplements and ingredients. Derived from a tree, it is grown mainly in the tropics in places like Malaysia and Thailand, as well as other areas in Southeast Asia, including Papua New Guinea and Indonesia. It has been used throughout history for stimulant-like effects and to reduce anxiety and other symptoms.

In September 2019, the FDA issued a warning cautioning the public and health professionals kratom has the same effects as opioids and might be harmful or addictive. Because not much is known about kratom, the FDA is looking into all scientific investigations concerning its use. However, Dr Garcia-Romeu says the findings “suggest that kratom doesn’t belong in the category of a Schedule I drug, because there seems to be relatively low rate of abuse potential, and there may be medical applications to explore, including as a possible treatment for pain and opioid use disorder."3

References:

1. Garcia-Romeua A, Cox DJ, Smith KE, et al. Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic. Drug Alcohol Depend. 3 Feb 2020 [Epub ahead of print]. https://www.sciencedirect.com/science/article/abs/pii/S0376871620300144. Accessed February 6, 2020.

2. Federal Drug Administration. FDA and kratom. September 11, 2019. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom. Accessed February 6, 2020.

3. Natural Herb Kratom May Have Therapeutic Effects And Relatively Low Potential For Abuse Or Harm, According To A User Survey [press release]. Johns Hopkins Medicine. January 31, 2020. https://www.hopkinsmedicine.org/news/newsroom/news-releases/natural-herb-kratom-may-have-therapeutic-effects-and-relatively-low-potential-for-abuse-or-harm-according-to-a-user-survey.