Kratom Contains Opioids, FDA Says

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Compounds in the botanical kratom (Mitragyna speciosa) are opioids, the FDA said in a statement. People use kratom recreationally or to self-treat opioid withdrawal symptoms.

Using computational models, the agency found that 22 of kratom's 25 most prevalent compounds bind strongly to mu-opioid receptors in a way that's similar to scheduled opioid drugs.

Forty-four deaths associated with kratom have been reported, including eight since November 2017. The agency reported one kratom-related fatality in a person with no evidence of other opioid use. Other fatality reports suggest that people are mixing kratom with other drugs, including prescription opioids, benzodiazepines, loperamide, and illicit drugs.

The agency cautions: "Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids. There is no evidence to indicate that kratom is safe or effective for any medical use. And claiming that kratom is benign because it’s 'just a plant' is shortsighted and dangerous."