Herbal Supplement Kratom Connected to Nearly 100 Deaths

Herbal Supplement Kratom Connected to Nearly 100 Deaths April 12, 2019
Wikipedia Commons

The widely popular pain relief supplement kratom has been linked to almost 100 overdose deaths in recent years. Advocates for kratom have argued for years that people cannot die from using the drug. However, the new evidence appears to suggest otherwise.

In Notes from the Field update from the Centers of Disease Control, authors Emily O’Malley Olsen, Ph.D., Julie O’Donnell, Ph.D., Christine L. Mattson, Ph.D., Joshua G. Schier, MD, Nana Wilson, Ph.D., share their finding from a 17-month study of overdose records.

According to the report, the authors reviewed data collected from the State Unintentional Drug Overdose Reporting System (SUDORS). The database gathers overdose information from 32 states and the District of Columbia.

Through an analysis of 17 months of data, the authors found 91 overdose deaths connected to Kratom in 11 states.

Kratom is a tropical tree that is native to Southeast Asia. The plant is ground up and placed into capsules. According to the National Institute of Health, kratom produces psychotropic mind-altering effects. In low doses, Kratom acts as a stimulant and provides energy.

When taken in higher doses, the plant acts as a depressant and interacts with opioid receptors which reduce pain, produces sedation, and increases pleasure. Individuals with chronic pain have touted kratom as an alternative to strong narcotics like Vicodin, Percocet, and Oxy-Contin.

The same groups that have advocated for kratom as an alternative to other opioids have also insisted that the drug cannot lead to deaths. American Kratom Organization has argued for years that the plant is a safer alternative to heroin, fentanyl, and morphine. Additionally, the group insists that people cannot die from using kratom.

In the United States, kratom is not technically illegal. However, the FDA does not approve the drug to treat any diseases. The product is sold in packages often labeled as “not for human consumption.” Because kratom is not native to the United States, individuals typically purchase the product online.

Through the study, the authors determined that in at least seven deaths kratom was the only drug listed on the toxicology report by the coroner. In 84 cases, kratom combined with other drugs contributed to the death of the person. For these deaths, the toxicology reports included other narcotics such as fentanyl and heroin.

Most of the overdose deaths occurred in people with known substance abuse issues. In fact, 80% of the users had a history of drug misuse. Additionally, 90% of the kratom related deaths indicated the person had no evidence of receiving medically supervised treatment for pain.

Simply put, kratom users that died from the drug were using the drug and not seeing a doctor. Additionally, they were mixing kratom with other powerful medications not prescribed by doctors.  A doctor cannot advise patients on the use of kratom.

The report reviewed data from 11 states within the SUDORS database. Because the study examined a fraction of the states, the authors believe kratom related deaths could be much higher than the 91 cases they found. Some states do not document kratom on toxicology reports.

Because kratom is not illegal, users can purchase the product from various outlets. The U.S. Drug Enforcement Agency is currently researching the drug to determine if the states will schedule kratom as an illegal substance. In November 2018, the U.S. Department of Health and Human Services requested that the DEA ban kratom.

In the request, HHS stated that two chemicals found in the plant should be listed as a “Schedule 1 substance.” Schedule 1 Substances is a drug with a high potential of abuse and no known medical use for the drug. Other drugs in this category are heroin, LSD, and marijuana.

Kratom is available for purchase online with misbranded labels that say “not for human consumption.’ People that use the product have no idea the amount of kratom the bottle contains. Additionally, because no agency regulates kratom, the product receives no testing for safety.

Last week the FDA issued a warning that they found high levels of nickel and lead in 30 different kratom products. Additionally, in fall 2018, the FDA warned that dozens of kratom products had been linked to salmonella infections.

With so much concerning information continuing to flood the market about kratom, people still use the product. Users of the product I spoke to said they believed kratom was a better alternative to heroin. Others noted that kratom helped stop their use of heroin, fentanyl, and other power opioids. All of the people I spoke to were aware of the risks and understood the plant is addictive.

As more data comes forward, kratom may be closer to becoming illegal in the United States. Kratom is not legal in Australia, Canada, Parts of Europe, Malaysia, Thailand, and New Zealand.


*Katie Joy is a columnist and hosts Without A Crystal Ball on Patheos Non-Religious Channel. She writes articles on parenting, disability advocacy, debunking pseudoscience, atheism, and crimes against women and children.

She co-hosts the YouTube show, “The Smoking Nun,” with Kyle Curtis on The Non-Sequitur Channel. The show airs weekly and tackles pseudoscience, current events, and crime stories.

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  • Mark in Ohio

    Well, it sounds like another case where we get a potentially useful compound ignored and blocked from research, as a Schedule 1 designation will do (as it has with Marijuana research). Yes, it’s probably dangerous, but it sounds a lot less so than the current crop of opioids. Since it’s an organic that would be cheap, I assume that no one is doing research because the ROI is too low. Given the severity of the opioid crisis and the lack of good therapies for chronic pain, we can’t afford to ignore any possible solutions, especially inexpensive ones.

  • well, it’s not as effective as other pain relievers – that’s the thing. It’s actually less effective than what is already available. Also, the product is so toxic that the government does not want to introduce another drug that can further fuel the opioid crisis

  • If it hasn’t been rigorously tested, we don’t have much idea about either its effectiveness or its toxicity. Certainly, the information in the CDC report is little better than anecdotal. I have no idea how its risks and benefits compare with opioids. And as Mark notes, we’re unlikely to know that if it gets classified as Schedule I, which pretty much eliminates research into its active ingredients.

    Personally, I don’t think we need more restrictions on drugs themselves, we need more restrictions on how supplements are marketed. Basically, we need to disallow unproven claims and we need to hold supplements to the same purity standards as conventional drugs.

    (I’d argue that its toxicity must be pretty low, however, given the number of people taking it, the vast majority of whom apparently don’t die or suffer serious side effects. That’s the one large population we can actually draw some valid data from.)

  • LOL “toxic”, just like marijuana was “toxic”… sorry, no, the government has a history of freaking the fuck out over nearly-harmless plants.

  • Unfortunately, by treating it as if it were heroin it makes it nearly impossible to figure out just how harmful it might be, and just how beneficial. It replaces science with hysteria.

  • WallofSleep

    “Individuals with chronic pain have touted kratom as an alternative to strong narcotics like Vicodin, Percocet, and Oxy-Contin.”

    I’ll stick with edibles and alcohol, thanks.

  • Amy

    I know in the United States we love a good sensational, scary story about a new drug that is going to destroy our country, but honestly, kratom is not it. I would first question the methods and ways by which kratom was determined to be the unquestionable cause of death. For more information, I recommend Nick Wing’s reports on this topic on the Huffington Post.


  • kornovol

    Pretty irresponsible and borderline evil, click-bait headline.

    Consider that (and I quote the article) ‘In 84 cases, kratom combined with other drugs contributed to the death of the person. For these deaths, the toxicology reports included other narcotics such as fentanyl and heroin.’

    If someone has heroin/fentanyl in your system, it does not matter much to me what else is in there.

    I imagine millions of people have passed away with traces of caffeine in their system. Would it be fair to call out coffee as a key contributor to their deaths?

    Kratom is in the coffee family, and not surprisingly, the safety and addiction profile is very similar.

    Kratom is used by Millions, and has been used traditionally for thousands of years. It has changed and given countless people a great improvement in their quality of life. Time after time, kratom gets described as a ‘life-saver’ for people who have actual experience with it.

    A natural solution for more energy, less pain and a productive mood, with a similar cost as a cup of coffee, and a similar safety/addiction profile, makes me believe that kratom should not just be studied as a natural support in one of the largest health crises we are facing in the Western world (pain/opiates), but that it also should find its place, next to coffee, in every household and cafe around the world.

  • kornovol

    Alcohol is responsible for 88,000 deaths every year

    If there is a natural alternative that works for Millions, with a much safer safety profile, I personally would like to have it studied, understood and made available to everyone.

  • And alcohol is 100% legal.

  • WallofSleep

    “Alcohol is responsible for 88,000 deaths every year”

    And that is why I drink responsibly. Well, at least one of the reasons.

    “If there is a natural alternative that works for Millions, with a much safer safety profile, I personally would like to have it studied, understood and made available to everyone.”

    If it hasn’t been studied yet, then you can’t reasonably make any efficacy or safety claims. I’d like to see it researched as well, just as I would like to see marijuana stop being classified as a schedule 1 contraband so that it would be easier research as well.

    Personally I’m going to take a hard pass on kratom for now. My days of experimenting with unknown (to me) intoxicants are long behind me, and I’ve experimented with many in my day.

  • WallofSleep

    Thank Scients! It may not work as well as edibles for pain relief in my case, but it works a damn sight better than opioids do. I have a naturally high tolerance to opioids, and the best they have to offer me is unmerciful constipation.

  • There may indeed be an active ingredient in kratom that is medically useful. After all, willow bark gave us ASA and marijuana gave us cannabidiol and THC.

    It’s necessary to research these things carefully to determine if and how they work, and to work out the pharmacokinetics and interactions so that proper dosages and contraindications be set. Scarfing down untested substances just because they’re “natural” is not a wise thing to do.

  • Liz Leyden

    “The same groups that have advocated for kratom as an alternative to other opioids have also insisted that the drug cannot lead to deaths. American Kratom Organization has argued for years that the plant is a safer alternative to heroin, fentanyl, and morphine. Additionally, the group insists that people cannot die from using kratom.”

    Kratom enthusiasts sound a lot like marijuana enthusiasts.

  • Liz Leyden

    Marijuana has been studied in several other countries.

  • kenofken

    Another spun up “new drug menace of the year” to justify continued investment in a brutal and utterly failed drug war. “We need sweeping new regulations….”

    What this boils down to is that people who were already dying from powerful opiates also died when a mild opiate like plant was thrown into a toxic brew that would have killed them anyway without it, sooner or later.

    The DEA is desperate to find ways to remain on the government teat as marijuana prohibition winds down.

  • Sharing Ideas

    The report stated that all the deaths, aside from 7, had multiple substances in their system. 80 percent of which being fentanyl, the rest being other hard drugs. Furthermore, the report stated that it couldn’t be concluded with certainty that kratom was the actual cause of death in those 7 instances where kratom was found to be present .

    There is no conclusive consensus on how kratom would lead to death, as all of these people died in various ways. In one report kratom was listed as the cause of death, even though the individual died of a gun shot wound. (If you would like more information on what the FOIA requests to the FDA have uncovered pertaining to kratom I suggest contacting Nick Wing, who was a reporter at Huff Post. You can reach him through twitter @nickpwing .)

    There is a picture being painted here that is not complete and with over 5 million consumers in the t USA the full truth should be provided aside from vague warnings. If kratom is a danger.. how is it dangerous? The research done by Dr Christopher McCurdy of University of Florida, Dr. Jack Henningfield of John Hopkins show that kratom has high safety profile. It does not cause respiratory depression. Yet if there are deaths attributed to kratom and they all died in different ways, how did kratom kill them?

  • andy

    There was a research study done by the New England Journal of Medicine Investigating the so called kratom deaths in 15 cases, 4 of which were designated to be caused by kratom as the only substance present. I will quote an excerpt and provide a link for you to read further

    the New England Journal of Medicine that looked at 15 deaths that coroners in Colorado had determined included four deaths ”reported to involve mitragynine only, and coroners attributed each to mitragynine only. (8) ” When the investigators looked at those 4 deaths attributed to kratom toxicity alone, they performed a more comprehensive toxicology analysis with tandem mass spectrometry for the 3 cases for which residual blood was available.
    These investigators concluded that of all 15 kratom-related deaths, 14 deaths ”clearly involved multiple drugs.” For the remaining case, residual blood was not available for confi1matory testing to determine if there were other substances involved in that death. That is the reason the CDC report correctly concludes that documentation of postmortem toxicology testing protocols is needed to clarify the extent to which kratom contributes to fatal overdoses and the extent to which other substances are unequivocally excluded.


    This raises the possibility that at least some of this supposed “kratom-only” deaths are the result of inaccurate or negligent toxicology screening.

    Furthermore the CDC told Peter Hess, a science reporter at Inverse, that they’re just reporting numbers given to them by medical examiners and coroners. But there’s no way they can accurately pinpoint the extent kratom supposedly contributes to a death.

    The media is perpetuating panic by not fully understanding what the CDC report is saying. The CDC is reporting numbers, that is all, but it cannot be verified that the numbers they are reporting accurately represent what is happening in regard to kratom deaths. There have never been any reported kratom deaths in the home countries where kratom is sourced.

  • Baby Buddha Belly

    I don’t understand why any group would make the claim that individuals can’t die from ingesting Kratom. People can die from drinking too much water. Too much of anything will kill a person.