3 Things Pharmacists Should Know About Kratom

Kratom (Mitragyna speciosa) is a plant native to Southeast Asia that’s considered an emerging public health threat to the United States because of its stimulant and opioid-like effects.

It’s important for pharmacists to be aware of the substance in order to educate and ultimately protect patients. These 3 key points shed some light on its abuse potential:

1. Kratom Isn’t Federally Classified as a Controlled Substance

The Drug Enforcement Administration (DEA) currently classifies kratom as a Drug of Concern,¹ which means it isn’t federally regulated as a controlled substance, but it has abuse potential.

Nevertheless, 6 states—Alabama, Wisconsin, Vermont, Tennessee, Indiana, and Arkansas—have banned kratom based on abuse concerns. Alabama has even classified it as a Schedule I drug among other illegal substances like heroin.² Other states are considering banning kratom altogether.

2. Kratom Causes Serious Adverse Events

Results from a CDC analysis showed US poison centers received 660 calls about kratom exposures between 2010 and 2015. Life-threatening outcomes accounted for 7.4% of exposures, including 1 death. Adverse effects included tachycardia, agitation, drowsiness, nausea, and hypertension, though kratom can also affect multiple organ systems and cause respiratory depression, weight loss, and constipation.¹

3. Kratom Is Easy to Get

Kratom is widely available through the Internet and tobacco and head shops. It’s been sold as a green powder in packets labeled “not for human consumption” to avoid suspicion.

The FDA has warned the public not to use any products containing kratom. Recently, more than 100 cases of products labeled as kratom were seized in California.

Pharmacists should educate patients on the dangers of kratom. Using it with other substances like benzodiazepines or alcohol could increase the risk of respiratory depression and death. During patient counseling sessions, it’s always important to inquire about the use of herbal products, including kratom.

References

• CDC. Notes from the Field (Mitragyna speciosa) Exposures Reported to Poison Centers-United States, 2010-2015. MMWR. cdc.gov/mmwr/volumes/65/wr/mm6529a4.htm. Accessed August 12, 2016.
• National Council on Alcoholism and Drug Dependence. Six states ban kratom over concerns about addiction potential. ncadd.org/blogs/in-the-news/six-states-ban-kratom-over-concerns-about-addiction-potential. Accessed August 12, 2016.