“An Atypical Opioid”
For people like Teem and DeMott, for whom legal, FDA-approved prescription drugs haven’t been sufficient to improve their quality of life, kratom can seem like a great option. But its ambiguous legal status makes it hard to figure out the best way for them, and others like them, to obtain and use it.
C. Michael White, Pharm.D., head of the Department of Pharmacy Practice at the University of Connecticut, sees potential in kratom but also acknowledges there’s still a lot we don’t know.
“One of the big problems with kratom is that we have animal studies that’ll tell you some of the potential mechanisms by which kratom does what it does, and they’re very interesting, and they’re different than many of the other pain relievers that we currently have as prescription therapies, so to that extent it’s very promising,” he tells Inverse. “But the problem is that when you actually are looking for human data in clinical trials to really be able to understand it, there’s not a lot of data, and the data that we have is mostly anecdotal information.”
“There’s not a lot of data, and the data that we have is mostly anecdotal information.”
Even though the improvements reported by Teem, DeMott, and people on r/kratom who say their lives have been improved by kratom are compelling, they don’t constitute sufficient scientific evidence on which regulators can make nationwide decisions.
White also questions the scientific validity of the case reports the FDA cited back in February. In the reports, the agency said kratom was associated with 44 deaths since 2009. For comparison, opioid overdoses killed over 40,000 Americans in 2016 alone. And just as we don’t have clinical trials showing kratom’s safety and efficacy as a therapy, we also don’t have sufficient scientific evidence that shows how dangerous it is and how it interacts with other drugs. “It’s hard to tease out effects when you’re only looking at case reports,” he says.
“In a lot of those individual cases, we don’t know the doses that were used. Very often, they were using [kratom] with other drugs, and we don’t know how those other drugs were either co-factors for harm or whether the other drugs may have been causing the harm, and kratom may have been an innocent bystander in the adverse effects that people have.”