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WMJ: Report illustrates potential harm of herbal supplement kratom

Release Date: February 29, 2016
Contact: Jennifer Wieman - 608.442.3748 jennifer.wieman@wismed.org

MADISON (February 29, 2016)—Kratom is advertised on the Internet as a “nonaddictive” herbal alternative to opioids for pain management. But as more information on kratom becomes available, the herb’s potential for addiction and associated withdrawal syndrome may be linked to more harmful health effects, according to a case report by David Galbis-Reig, MD, published in the current issue of WMJ.

The report cited a case in which a patient in southeastern Wisconsin became addicted to kratom, and as a result, experienced symptoms of severe opioid-like withdrawal syndrome. The patient’s kratom withdrawal was managed successfully through the opioid withdrawal protocol, but Dr. Galbis-Reig added that kratom is still relatively unknown by physicians in the United States.
According to the report, kratom is an herb indigenous to countries in Southeast Asia and has been used for hundreds of years by the people living there for fatigue, pain, opioid withdrawal and cough. However, it has been illegal in Thailand since 1943 and is the most abused drug there among illicit users. The patient in this case purchased kratom online.

“The Internet is ripe with sites and articles that proclaim the analgesic and stimulant properties of kratom while downplaying its adverse effects and addictive potential,” Dr. Galbis-Reig wrote. “Numerous case series and reports, however, have described the addictive potential of kratom, both in herbal form and extract.”

In the United States, the Drug Enforcement Administration (DEA) placed kratom on its “Drugs and Chemicals of Concern” list, but it is not currently scheduled by the DEA. It is, however, illegal in Wisconsin. In 2013, the state classified kratom as a schedule 1 controlled dangerous substance for its psychoactive properties, which include both stimulant and opioid-like effects. Meanwhile, its popularity continues to spread.

“Physicians should be aware of the growing availability of kratom and its potential adverse health effects, especially its toxicity, addictive potential and withdrawal syndrome,” Dr. Galbis-Reig wrote.

Published by the Wisconsin Medical Society, WMJ is devoted to the interests of the medical profession and health care in the Midwest. This peer-reviewed publication, which is available in print and electronic format, is one of the few state medical society-sponsored medical journals that publish a large amount of original research and academic content.

All articles published in WMJ represent the views of the authors, for which neither WMJ nor the Wisconsin Medical Society take responsibility, unless clearly stated.