Factor 6: what, if any, risk there is to the public health
Kratom has historically flown under the radar, until recently when it started to barge in on the profits of our federal government and Big Pharma. But let’s stick to the facts shall we DEA? Kratom has not been directly responsible for any emergency visits.
They estimated an average of 23,005 such emergency department visits annually, with 2154 hospitalizations annually. One fifth of the supplement-related visits involved unsupervised ingestion by children. The vast majority of the emergency visits involved products used for weight loss, energy, and sexual enhancement involving substance such as kava, hydroxytryptophan, caffeine, ephedra, ginseng, and yohimbine root. Less than 2% involved products used for pain or arthritis relief and these included substances such as arnica, glucosamine and pokeweed. None were reported to have involved kratom or mitragynines.
In addition, it was concluded that there were NO reports of any fatal overdoses of kratom.
In a recent review of the toxicology of MG and analogs, Ramanathan and Mansor (2015, p. 282) concluded as follows: “To date there have been no reports of fatal overdose of kratom per se. If there are such occurrences, they are probably the result of kratom products contaminated with synthetic adulterants.” This is consistent with other reviews of kratom pharmacology, toxicology, and epidemiology (Warner et al. 2016).
Moreover, if it were not for kratom, we’d have a whole new “mess on our hands.”
In fact, if kratom products were banned from the market, it appears likely that many users would turn to the illicit market that would immediately expand to meet the demand.
In addition, there are approximately 32 calls PER DAY for opioids by children, compared to kratom products as being “not listed.”
The US Poison Control Centers received approximately 32 calls per day for exposures to opioids by children and adolescents from 2000 to 2015 (Allen et al. 2017). Most of these do not result in death, but between 2011 and 2015, there were 51 reported pediatric (children less than 6 years of age) deaths from “analgesics” as well as 11 from “antihistamines,” 15 from “cleaning substances,” 12 from “cold and cough preparations”, and 13 from “batteries” among other substances (National Capital Poison Center 2017). Kratom products were not listed in these reports nor internet searches for local and national media that typically report such events as news stories. This does not mean that no such events have occurred, but it does suggest that the signal is very weak and that any exposures that have occurred have not been associated with severe consequences.
There are 3 factors that contribute to the aforementioned.
At least three factors plausibly contribute to the apparent low risk that kratom products pose to children, as well as to adults: (1) Low toxicity and harm potential of kratom and its alkaloids; (2) Poor taste of even commercially marketed products with a commonly described “yuck” factor that would be expected to discourage consumption by children; and, (3) Relatively low concentrations of alkaloids apparent in most marketed products and in raw leaf material.
In summary, kratom is virtually non-existent when it comes to dangers lurking in our society.