Health
Amid kratom overdose claims, groups call for regulation, better testing of drug
As the U.S. weathers its fourth wave of the opioid epidemic crisis, more people are turning to non-opioids — including a natural remedy known as kratom — to combat their pain.
Yet medical examiners and coroners have found that kratom caused 1.5% to 1.7% of overdose deaths between Jan. 2020 and Dec. 2022.
That’s according to data from the State Unintentional Drug Overdose Reporting System (SUDORS) that the Centers for Disease Control and Prevention (CDC) shared with Fox News Digital.
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Here’s a closer look at this important issue.
What is kratom?
“Kratom is derived from the leaves of a Mitragyna speciosa, a Southeast Asian tree found in Malaysia and Thailand,” Lori Karan, M.D., professor of internal and preventive medicine at Loma Linda University in Loma Linda, California, told Fox News Digital.
The leaves of the tree have more than 40 different active compounds; the most primary is mitragynine, 7-hydroxymitragynine and speciofoline.
The plant is thought to have dual properties.
It produces a stimulant effect at low doses, and an opioid-like analgesic effect when taken in higher amounts, according to Dr. Richard Clark, medical director of the San Diego division of the California Poison Control System.
“It has activity at opioid receptors in the brain (like opioid analgesics), and for that reason has been used as either a substitute for opioid analgesics or a tool to improve symptoms of opioid withdrawal,” Clark told Fox News Digital.
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Americans most commonly use kratom for self-treatment of chronic pain and to help battle opioid withdrawal symptoms, he said.
The drug is banned in six states — Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin — although people can still buy products prepared from kratom leaves online and in stores across the U.S.
“There are currently no specific laws against possession of kratom in the United States,” Clark noted.
Approximately two million Americans aged 12 and older used kratom in the past year, according to a 2022 national survey on drug abuse.
“There are no drug products containing kratom or its two main chemical components that are legally on the market in the U.S.,” according to the website of the U.S. Food and Drug Administration (FDA).
“FDA has not approved any prescription or over-the-counter drug products containing kratom or its two main chemical components, mitragynine and 7-hydroxymitragynine (7-OH-mitragynine).”
Potential risks of kratom
While vendors may advertise kratom as safe and “all natural,” the composition can vary widely and may not accurately reflect the product labeling, experts caution.
It’s uncommon for kratom to cause major toxic effects, but when people ingest large amounts or combine it with other drugs, they may experience hallucinogenic reactions, convulsions, coma and, in rare cases, death, Clark warned.
“There is also a potential for individuals to develop dependence and withdrawal with heavy kratom use,” he said.
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Other side effects may include nausea, dizziness, confusion and tremors, according to Karan.
“Despite U.S. Food & Drug Administration warnings of the risks of kratom use, the agency continues to receive concerning reports of adverse events associated with its use by the public,” an FDA spokesperson told Fox News Digital.
“The FDA has also warned consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures and substance use disorder (SUD).”
Kratom’s role in overdose deaths
Among the 144,189 overdose deaths between 2020 and 2022, kratom was “detected” in 2,966 cases, according to the SUDORS report, which means some amount of the substance was detected in post-mortem toxicology testing, whether or not it was a cause of death.
(The SUDORS report includes data from 30 states and Washington, D.C.)
Kratom was “involved” in the deaths of 2,343 cases, which means medical examiners and coroners listed it as a cause of death.
When kratom is found in post-mortem testing in overdose cases, the deaths almost always occur as a result of multiple medications — not just kratom, experts say.
“Most fatal overdoses occur in persons who have consumed other substances in addition to kratom.”
“Most fatal overdoses occur in persons who have consumed other substances in addition to kratom,” Karan told Fox News Digital.
In many cases, people were also taking fentanyl, alcohol or medication for anxiety or depression.
Advocates speak out against claims
The American Kratom Association, based in Virginia, supports the right of Americans to consume kratom in a safe and responsible way.
Advocates for kratom noted that the substance was found in a small minority of more than 300,000 lethal overdoses in the study.
“Research shows that virtually every death associated with the consumption of kratom involved polydrug use, which is not surprising given that many afflicted with drug use disorders have found kratom helps them to wean off more dangerous drugs,” Mac Haddow, senior fellow on public policy at the American Kratom Association, told Fox News Digital.
“While it is possible that a consumer could harm themselves by abusing kratom products, like most consumer products already on the market, those occasions are both rare and not related to the safety profile of kratom when it is responsibly consumed,” he added.
The FDA also said that it’s rare for deaths to occur from kratom use alone, and that these deaths usually occur in combination with other drug use, concluding that “the contribution of kratom in the deaths is unclear,” as stated on its website.
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Cornel N. Stanciu, M.D., director of addiction services at New Hampshire Hospital and assistant professor of psychiatry at Geisel School of Medicine at Dartmouth, told Fox News Digital that to her knowledge, there have been no deaths in which kratom was the only involved substance.
The doctor is currently working on a paper examining overdoses that are attributed to kratom by medical examiners.
“So far, what I am seeing is that there is tremendous variability in reporting and testing,” Stanciu said.
Comprehensive testing is lacking among medical examiners, she noted, with most labs not testing for active metabolites of kratom after someone dies.
“Second — and more concerning — I am seeing that even when more toxic substances are found, some may still call it a kratom-only death,” she cautioned.
Calls for regulation in testing
Haddow from the American Kratom Association claimed there is “rampant misinformation” associated with kratom risks — and argues for standardized toxicology testing protocols to better determine the substance’s role in overdoses.
On Feb. 8, he noted, the U.S. District Court for Southern California requested that the FDA present supporting evidence that kratom is dangerous.
“The FDA refused to attend the hearing and the U.S. attorney explained to the court that the FDA ‘has not yet determined whether kratom is dangerous,’” he told Fox News Digital.
When contacted for comment, the FDA told Fox News Digital that it “does not comment on possible, pending or ongoing litigation.”
The FDA recently conducted a human dose-finding study, which found that no significant adverse events occurred when participants took kratom, even at high doses, Haddow claimed.
“The FDA has warned consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures and substance use disorder.”
The finding, which the FDA presented at a scientific conference in February 2024, was that “kratom appears to be well-tolerated at all dose levels,” Haddow added.
“The FDA’s current pilot study on dose-finding was conducted in a small sample and is still blinded,” an FDA spokesperson noted, cautioning that the data is preliminary and unvalidated.
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“We need to wait until final analysis to draw any definitive conclusion or interpretation of the results,” the FDA spokesperson added.
“Ultimately, we anticipate that the data in this pilot will be informative and can support future studies of botanical kratom.”
One of the FDA’s top priorities as part of its Overdose Prevention Framework is to protect the public from the risks of unapproved drug substances, including kratom, the agency told Fox News Digital.
“We will continue to collaborate with federal partners to engage proactively in meaningful research to advance science-based, regulatory decision-making,” the FDA spokesperson said.
“As new scientific and validated knowledge emerge that is based on rigorously designed studies, the agency will update the public.”
For more Health articles, visit www.foxnews.com/health.
Health
High levels of resistant bacteria found in uncooked meats and raw dog food: ‘Red flag’
High levels of E. coli were found in uncooked meats and raw dog food sold in grocery stores in the U.K., according to research presented last week at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Barcelona.
Researchers from the University of Bristol examined 58 samples of raw beef, chicken, pork and lamb sold at grocery stores in the U.K., along with 15 samples of raw dog food sold at “specialty pet stores,” according to a press release.
Eighty-one percent of the meat samples and 87% of the dog food samples were found to contain E. coli (Escherichia coli) that was resistant to antibiotics.
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The raw chicken had the highest levels of the resistant intestinal bacteria.
“E. coli is an intestinal bacteria that may propagate in cows and chickens used for meat, especially when they are raised in squalor or close together,” Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, told Fox News Digital.
“Since poultry and meat cows are often fed antibiotics to help them grow and to ward off infections, this helps to breed resistant strains, which emerge amid antibiotic overuse.”
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Siegel was not involved in the study.
“This study confirms that uncooked meat carries multiple resistant E. coli, commonly including resistance to critically important antibiotics important for human health,” the study authors said in a press release from ESCMID.
If ingested, the bacteria could colonize the intestines and cause resistant infections, according to study author Matthew B. Avison, a professor at the School of Cellular & Molecular Medicine, University of Bristol.
“They can sit in your gut for years without causing sickness, and in some cases the bacteria will cause different types of disease later on, including urinary tract infections and bloodstream infections that can kill,” Avison told Fox News Digital.
“Infections with resistant bacteria are more difficult to treat and so are more likely to get worse.”
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Uncooked meat sold to be eaten by people after cooking is “commonly contaminated” with antibiotic-resistant E. coli, Avison noted.
The study results weren’t surprising, he said, as there have been “numerous reports” of antibiotic-resistant bacteria in uncooked meat and some studies showing this in raw dog food.
“In some cases, the bacteria will cause different types of disease later on, including urinary tract infections and bloodstream infections.”
“People often believe that because raw dog food is sold frozen, the freezing kills the bacteria, but we have shown that it does not,” Avison told Fox News Digital.
“There were just as many samples of chicken-based raw dog food contaminated with resistant E. coli than there were samples of raw chicken meat. If you feed your dog raw meat, therefore, you are likely feeding it antibiotic resistant E. coli.”
These findings explain why researchers previously found a strong link between feeding dogs raw meat and the dogs excreting resistant E. coli in their feces, Avison noted.
Most people are not aware of the risk of these antibiotic-resistant pathogens, the researchers stated in the release.
They emphasized the importance of cooking meat thoroughly before eating, and using “appropriate hygiene practices” while preparing it.
“Cooking the meat properly will kill those bacteria,” Avison advised.
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“Treat all raw meat as if it were contaminated with antibiotic-resistant bacteria and assume dogs fed raw meat will be excreting resistant bacteria,” he went on.
“Use appropriate hand-washing and general hygiene practices to minimize the risk that you and other people will accidentally ingest these bacteria.”
“If you feed your dog raw meat, you are likely feeding it antibiotic resistant E. coli.”
Dog owners who feed raw meat to their pets should dispose of the animals’ waste hygienically, Avison said.
“Don’t let your dog lick your face or share your bed, and wash your hands after petting it,” he recommended. “These are all common sense practices anyway, but even more important if you raw-feed your dog.”
“And, of course, treat raw dog food as if it were any raw meat, in terms of hygiene and cleaning practices.”
The study raises a “red flag,” Siegel said, underscoring the importance of making sure that poultry and meat is fully cooked prior to human consumption, and that dog food is also cooked.
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Andre Delattre, chief operating officer of Public Interest Research Groups (PIRG) in Washington, D.C., said the study “underscores the importance of ending the practice of routine use of antibiotics in animal agriculture.”
“An inevitable byproduct of antibiotic overuse is resistance to these drugs,” he told Fox News Digital.
“Studies have also shown that meat raised without antibiotics is less likely to be contaminated with resistant bacteria.”
The University of Bristol study was published on a pre-print server and has not yet been peer-reviewed.
Fox News Digital reached out to the U.K. Food Standards Agency (FSA) and the U.S. Food and Drug Administration (FDA) for comment.
For more Health articles, visit www.foxnews.com/health.
Health
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