A delayed U.S. Drug Enforcement Administration (DEA) ban on kratom would stifle scientific understanding of the herb’s active chemical components and documented pharmacologic properties if implemented, according to a recent special report published in The Journal of the American Osteopathic Association.
The JAOA report emphasizes the extensive amount of anecdotal evidence and current scientific research indicating that kratom—sold in the U.S. as an herbal supplement—may be safer and less addictive than current treatments for pain and opioid withdrawal. The report also cites the need for further research of the pharmacologically active compounds in kratom, including mitragynine, 7-hydroxymitragynine, paynantheine, speciogynine and 20 other substances.
“There’s no question kratom compounds have complex and potential useful pharmacologic activities and they produce chemically different actions from opioids,” says author Walter C. Prozialeck, PhD, chairman of the Department of Pharmacology at the Midwestern University Chicago College of Osteopathic Medicine in Downers Grove, Illinois.
Indigenous to Southeast Asia, kratom was used for centuries to relieve fatigue, pain, cough and diarrhea and to aid in opioid withdrawal. The supplement drew DEA scrutiny after poison control centers noted 660 reports of adverse reactions to kratom products between January 2010 and December 2015.
“While the DEA and physicians have valid safety concerns, it is not at all clear that kratom is the culprit behind the adverse effects,” says Anita Gupta, DO, PharmD, who serves as a special advisor to the FDA.
Dr. Gupta, an osteopathic anesthesiologist, pain specialist and licensed pharmacist, has treated a number of patients who’ve used kratom. “Many of my patients are seeking non-pharmaceutical remedies to treat pain without the side effects, risk, and addiction potential of opioids,” she adds.
The DEA is scheduled to decide whether to place kratom on its list of Schedule 1 drugs, a classification for compounds thought to have no known medical benefit. Marijuana, LSD and heroin are Schedule 1 drugs, which prevents the vast majority of U.S.-based researchers from studying those substances.
The drug currently is banned in Alabama, Florida, Indiana, Arkansas, Wisconsin and Tennessee.