Asian leaf 'kratom' making presence felt in US emergency rooms
When a patient showed up in a West Coast emergency room early this month suffering withdrawal from something he called "kratom," the psychiatrist on duty was forced to scramble for information. But when the doctor looked it up, she found that the opiate-like leaf from Southeast Asia is well known in the worlds of alternative medicine and the drug culture.
What the doctor, who asked not to be named, found in an Internet search were Web pages set up by dozens of companies selling kratom leaf and touting it as a way to combat fatigue, pain and depression — even as an antidote to heroin addiction.
But in addition to its possible medicinal uses, kratom is beginning to show up in U.S. emergency rooms, with doctors saying they are dealing with people sick from taking it — especially teens who try it to get high.
"Every month somebody is trying to get a new 'safe high'," said Frank LoVecchio, medical director of the Banner Good Samaritan Poison and Drug Information Center in Phoenix, Ariz. "(Kratom) is definitely not safe."
Estimating usage of the drug is impossible, but emergency events involving kratom appear to be increasing, he said. In 2005, only two incidents were reported by poison control centers nationwide. But Banner’s center dealt with six emergencies involving kratom in 2011, he said.
As with many herbal and chemical products on the market, science and law enforcement are playing catch-up. Little research has been done to determine the risks of taking kratom, so it remains legal and unregulated in the United States.
The leaf, which is indigenous to Southeast Asia, has been around for thousands of years, and proponents argue that it is safe and effective for many maladies, while having fewer side effects and being less addictive than pharmaceutical alternatives, such as oxycodone. In small doses, they say, kratom provides an energy boost — the plant is in the coffee family — and in larger doses it creates a mellow, sedating effect,
acting on the opioid receptors.
"Kratom makes people feel pain free, strong, active and optimistic," according to the Website Kratom.com. It has multiple functions, said the site, which sells kratom leaves, powder and extracts from Thailand — "as a strong and reliable herbal painkiller, to relieve depression and as a social and professional enhancer to intensify communicational skills and induce higher motivation."
Just as its safety has not been well studied, the drug has no scientifically established medical uses — though it has many enthusiastic adherents who swear by it. Testimonials in support of its ability to relieve chronic pain, depression, diabetes and other maladies surface in droves whenever kratom makes the news, as witnessed in the comments following this blog published in the Phoenix New Times in August 2011.
But even promoters warn that daily use of kratom can lead to dependence and nasty side effects.
“Long-term daily high dose kratom consumption is also reported to induce nervousness, sleeplessness, loss of libido, constipation and the darkening of skin complexion,” Kratom.com says in its "dangerous effects" section.
Although there have been no fatalities from kratom,
"The known risks and dangers of Kratom overdoses include hallucinations, delusions, listlessness, tremors, aggression, constipation and nausea," the site said.
The emergency room psychiatrist said the patient who recently came in reported using kratom several times a day, every day, "because he discovered that if he stopped it he started getting withdrawal." The doctor said the
man's symptoms appeared "identical to heroin withdrawal."
Upon arrival, the patient was suffering "severe depression and anxiety and emerging opiate withdrawal symptoms," including chills, aching muscles and gooseflesh, the psychiatrist said. The patient was treated to ease withdrawal symptoms and then hospitalized, according to the doctor.
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