FDA’s Groundbreaking Kratom Study Suggests Safety of Capsules, But Questions Remain

In a significant development for the controversial botanical substance kratom, the U.S. Food and Drug Administration (FDA) has conducted its first preliminary study on the compound, yielding results that suggest kratom capsules may be safe even at high doses. This research marks a crucial step in understanding a substance that has been both praised for its potential benefits and scrutinized for its possible risks.

Kratom, derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia, has been used for centuries in its traditional regions. In recent years, it has gained popularity in the United States, with an estimated 1.7 million Americans aged 12 and older using kratom in 2021. Users often turn to kratom for pain relief, mood enhancement, and as an alternative to opioids.

The FDA’s study, while preliminary, represents a significant shift in the agency’s approach to kratom. Previously, the FDA had issued warnings about kratom’s potential risks, citing concerns about its opioid-like effects and potential for abuse. However, this new research suggests that, at least in capsule form, kratom may not pose the severe health risks initially feared.

Dr. Scott Gottlieb, former FDA Commissioner, had previously expressed concerns about kratom, stating in 2018 that the FDA had identified 44 reported deaths associated with kratom use. However, these reports were often complicated by the presence of other substances or underlying health conditions, making it difficult to isolate kratom’s role.

The recent FDA study focused on kratom in capsule form, which is just one of several ways the substance is consumed in the U.S. The research found that even at high doses, kratom capsules appeared to be safe. This finding is particularly noteworthy given the FDA’s previous stance on the substance.

However, it’s crucial to note that this study has limitations. Importantly, it did not examine kratom in its more popular forms in the U.S., such as drinks and concentrates. These preparations often contain higher levels of kratom’s active compounds and could potentially pose different risks to consumers.

Mac Haddow, senior fellow on public policy at the American Kratom Association, welcomed the FDA’s research, stating, “We’ve been asking the FDA to do this research for years.” The association has long advocated for regulation rather than prohibition of kratom, arguing that banning the substance could drive users to more dangerous alternatives.

The FDA’s study is part of a broader effort to understand kratom’s effects and potential risks. The National Institute on Drug Abuse (NIDA) has also been funding research on kratom, recognizing the need for more scientific data on this widely used but poorly understood substance.

Despite these positive findings, the FDA maintains a cautious stance. The agency continues to advise against kratom use, citing the lack of FDA-approved uses for the substance and ongoing concerns about its safety profile. This position underscores the complex regulatory landscape surrounding kratom.

The legal status of kratom varies across the United States. While it remains legal at the federal level, several states and municipalities have banned or restricted its use. This patchwork of regulations reflects the ongoing debate about kratom’s safety and efficacy.

Proponents of kratom argue that it offers a safer alternative to opioids for pain management and can aid in opioid withdrawal. A 2019 study published in the journal Psychopharmacology suggested that kratom may have a lower abuse potential compared to traditional opioids. However, more research is needed to fully understand its long-term effects and potential for dependence.

The FDA’s study is part of a larger research initiative aimed at filling the knowledge gaps surrounding kratom. In 2024, the agency announced plans for a human abuse potential (HAP) study of botanical kratom. This study will help characterize the abuse potential and subjective effects of kratom, providing crucial information for future regulatory decisions.

As research progresses, the kratom industry continues to grow. The American Kratom Association estimates that the U.S. kratom market is worth approximately $1.3 billion annually. This economic impact adds another layer of complexity to the regulatory discussions surrounding kratom.

The international perspective on kratom also varies. In Thailand, where kratom has been used traditionally for centuries, the government recently decriminalized the plant, recognizing its potential benefits and cultural significance. This move contrasts with the more cautious approach taken by many Western countries.

As the scientific community continues to study kratom, healthcare providers are grappling with how to advise patients about its use. The Mayo Clinic advises caution, noting that while some people report benefits from kratom use, its safety and effectiveness have not been clinically proven.

The FDA’s recent study marks a significant step forward in understanding kratom, but it also highlights the need for further research. Questions remain about the safety of kratom in its various forms, its long-term effects, and its potential interactions with other substances.

As the scientific and regulatory landscape continues to evolve, consumers, healthcare providers, and policymakers will need to stay informed about the latest findings on kratom. The FDA’s study, while promising for kratom capsules, underscores the complexity of regulating botanical substances and the importance of comprehensive, evidence-based approaches to public health policy.

In conclusion, while the FDA’s study suggests that kratom capsules may be safer than previously thought, it also emphasizes the need for continued research and careful consideration of kratom’s various forms and uses. As the debate over kratom’s place in medicine and society continues, this new research provides a valuable foundation for future discussions and policy decisions.