Scientific Report
Comparative Safety of Kratom Compared to Other Commonly Used Substances
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Understanding Kratom:
A Comparative Safety and Risk Analysis
All substances have the potential to cause consumer harm and it is important to understand the relative risks of experiencing harm when making personal decisions of products to use or formulating health policy for a population of people. By using publicly available data of adverse events reported to the Food and Drug Administration (FDA), poison control center calls, and data on prevalence, severity, and symptom endorsement of Substance Use Disorder (SUD) criteria as defined by the Diagnostic and Statistical Manual Version 5 (DSM-5), we can assess the risk profile of kratom relative to other substances.
Understanding Leaf Kratom: A Comparative Safety and Risk Analysis
Comprehensive analysis using publicly available data from the FDA, poison control centers, and DSM-5 Substance Use Disorder criteria to assess the relative risk profile of leaf kratom compared to other commonly used substances including alcohol, tobacco, opioids, cannabis, and caffeine. The report examines adverse event rates, prevalence and severity of substance use disorders, and contextualizes leaf kratom’s safety profile within the broader landscape of legal and controlled substances to inform evidence-based personal decisions and health policy development.
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Analyzing Reported Adverse Events
Poison Control Center Data
The American Association of Poison Control Centers (AAPCC) is an objective source of adverse events associated with different substances. Between 2017 and 2023, calls to Poison Control Centers regarding kratom were significantly fewer compared to other substances, such as opioids and alcohol.
Calls Per 100,000 Users
Some substances are used more commonly than others and may have more reported adverse events but fewer events per user. As such, dividing the calls by the number of users in the United States is an important additional metric.
Analysis of poison control center calls from 2017 to 2023 reveals that kratom-related incidents are considerably lower than those for opioids and alcohol when normalized per 100,000 users.
Deaths Associated with Substance Use
Even when kratom is associated with a death, there are frequently other substances being used in the patient at the same time. The extent to which kratom was the cause, a contributor, or an innocent bystander can often not be determined in these cases.
The data on deaths associated with substance use shows kratom has a relatively low mortality rate compared to other substances.
Upon review of the FDA Adverse Event Reporting System (FAERS) between 2019 to 2022, most cases that involved death involved multi-substance use. Data from the FDA Adverse Event Reporting System (FAERS) shows a decrease in deaths only involving kratom from 2019 to 2021.
Substance Use Disorder Data
Prevalence
The DSM-5 criteria for Substance Use Disorders (SUD) provide a structured approach to understanding addiction across various substances. Heroin exhibits a high prevalence of SUD, with 85.79% of users developing addiction and 61.00% of these cases classified as severe. Similarly, methamphetamine and opioids show high prevalence rates of 67.50% and 68.59%, respectively, with substantial portions of users experiencing severe addiction.
Kratom presents a lower SUD prevalence of 29.50%.
Severity of Substance Use Disorders
The severity of SUD among kratom users is typically less intense. Only 28.81% of kratom users experience severe SUD, while a majority, 47.46%, fall into the mild category. This distribution shows that kratom, while potentially habit-forming, demonstrates different patterns compared to other substances. Its profile is more similar to that of caffeine in terms of severity distribution.
Symptom Endorsement
Examining the symptom endorsement data from the DSM-5 provides information about how different substances impact users. Impaired control, social impairment, risky use, and physical dependence are the key categories considered.
- Impaired control involves using larger amounts or for longer durations than intended, repeated unsuccessful attempts to quit, and significant time spent on substance use
- Social impairment highlights the negative consequences on personal relationships and responsibilities
- Risky use emphasizes the dangers of consuming substances in hazardous situations
- Physical dependence is characterized by tolerance and withdrawal symptoms
Kratom tends to show symptoms more aligned with physical dependence and impaired control rather than risky use and social impairment. This contrasts with substances like heroin, cocaine, and alcohol, which exhibit higher levels of social impairment and risky use.
Data Summary
As the data illustrates, kratom has some physical impacts and can be habit-forming, but its risk profile differs from many other substances when measured across multiple metrics. Kratom’s safety and addiction patterns show similarities to substances like caffeine and alcohol rather than substances like heroin and methamphetamine.
Understanding these risks in the context of individual consumption patterns and risk profiles provides information for decision-making regarding substance use. By considering comprehensive data on kratom, individuals and policymakers can assess its place within the broader spectrum of substance safety and addiction potential.
This analysis is based on publicly available data from the American Association of Poison Control Centers, FDA Adverse Event Reporting System, and peer-reviewed research on substance use disorders.
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2024 Kratom Consumer Survey
This survey review offers key insights into the kratom user base, revealing who they are, why they use kratom, and their perspectives on its health effects. -
The Evolution of Kratom: A Historical Timeline
An infographic tracing kratom’s journey from its traditional origins in Southeast Asia to its current complex legal and political landscape in the United States. -
Not All Kratom Is Equal
An infographic of clear visual guide comparing the potency, history, alkaloid sources, and common product forms of leaf kratom, kratom extract, and synthetic 7. -
The Differences Between Kratom Products
A detailed diagram visual comparison of leaf kratom, extracts, and synthetic “kratom,” highlighting distinctions in their market entry, alkaloid profiles, and appropriate regulatory approaches. -
Kratom Safety, Taxonomy, and Regulation
Provides a general overview of kratom, addressing common confusion between product types and outlining the GKC’s goals for a safe and regulated marketplace.
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2024 FDA Study: Kratom Dosing & Safety Results
A summary of an FDA-commissioned study that found controlled servings of dried leaf kratom were generally well-tolerated and resulted in no serious adverse events. -
FDA Pilot Study: Updates on Kratom Alkaloid Research
A presentation from the FDA detailing updates on its pilot dose-finding study of kratom alkaloids, including study design, preliminary observations, and next steps. -
Scientists’ Statement on 7-OH and MGPI Products
A statement from leading scientists clarifying that products with high amounts of 7-OH and MGPI are synthetic and do not constitute natural kratom. -
Scientific Statement on Kratom Products
An overview by scientists covering the history of kratom use, its current regulatory status, and the scientific understanding of its effects in the United States. -
Comprehensive Report on Substance Use Disorders
A detailed analysis comparing the prevalence, severity, and symptoms of Substance Use Disorders (SUDs) associated with kratom, caffeine, alcohol, opioids, and other substances. -
The Science of Leaf Kratom: Psychoactive Effects
This document reviews scientific evidence on leaf kratom’s effects, refuting claims about cognitive impairment and abuse potential while clarifying its atypical opioid profile. -
2024 FDA Pilot Study on Kratom Dose Response
Details of the FDA’s pilot study evaluating the effects, safety, and pharmacokinetics of orally administered botanical kratom in non-dependent, recreational polydrug users. - Show more
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Congressional Letter to the FDA on Kratom
A letter from members of Congress to the FDA expressing concerns about mislabeled kratom products and requesting information on consumer protection measures. -
GKC Letter to FDA on Public Safety Guidance
A letter from the Global Kratom Coalition to the FDA, expressing a desire to collaborate on public safety guidance for kratom products and regulatory approaches. -
Louisiana Voter Poll on Kratom Regulation
This poll assesses public opinion in Louisiana regarding kratom’s legality and regulation, including support for banning synthetic drugs while keeping leaf kratom accessible. -
List of Banned Zip Codes: USA
A data file listing zip codes across the country where the sale, possession, or distribution of kratom is currently illegal. -
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KCAC Position: Registration of Kratom Products
This statement advocates for a public registry of kratom vendors and products to ensure transparency, accountability, and a safer market for consumers. -
GKC Statement on Synthetic 7-OH Products
The GKC clarifies its opposition to synthetic 7-hydroxymitragynine (7-OH) products, arguing they are not kratom and should be regulated as new drugs, not supplements. -
KCAC Position: Status and Legality of 7-OH Products
This KCAC statement discusses the legal and regulatory status of 7-OH products, arguing they are not “kratom” and require a distinct regulatory approach. - Show more
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The Severity and Prevalence of Addictive Substances
This infographic visually compares Substance Use Disorder (SUD) severity and prevalence across various substances, including kratom, heroin, alcohol, tobacco, and caffeine. -
Comparative Safety Analysis of Kratom
This document provides a comparative risk analysis of kratom versus other legal and illicit substances, using data from the FDA and poison control centers. -
Contaminants in 7-Hydroxy Mitragynine Products Report
A detailed report identifying synthetic alkaloid contaminants found in 7-Hydroxymitragynine products and discussing the serious implications for regulatory oversight and consumer safety. -
Botanical Safety Handbook: Kratom Entry
An entry for Mitragyna speciosa from the American Herbal Products Association’s handbook, providing safety classifications, contraindications, and potential drug interactions for kratom leaf. -
Debunking Myths About “7”: The Facts
A fact sheet refuting misleading claims about “7” (a synthetic substance), arguing that it is not natural kratom, is not safe, and is deceptively marketed. -
In-Depth: Debunking Myths About “7”
A more detailed version of the fact sheet refuting claims about “7,” providing comprehensive evidence that it is a dangerous, unapproved, and illegal synthetic drug. -
KCAC Position: Proper Labeling of Kratom
This statement advocates for the importance of clear, comprehensive labeling on kratom products to ensure consumer safety and outlines essential information that should be included. -
KCAC Position: Kratom Use in Children
This statement outlines concerns about kratom use by minors, highlighting potential adverse events and the issue of products being marketed in ways that appeal to children. -
UCONN Continuing Education: Kratom Course for Pharmacists
An educational program from the UCONN School of Pharmacy designed to inform pharmacists about natural kratom, its effects, and key points for patient education. -
The Fourth Wave of the Opioid Epidemic
This presentation warns of a potential “fourth wave” of the opioid crisis driven by dangerous and addictive synthetic opioid stimulators, arguing they must be banned. -
Fact Check: “Synthetic 7” and the Opioid Crisis
This KCAC statement fact-checks and refutes misleading claims that the sale of “synthetic 7” products has reduced opioid-related deaths, citing a lack of evidence. -
GKC Perfect Label – Kratom Product Label Guidelines
This document from the Global Kratom Coalition provides comprehensive guidelines for labeling kratom products to ensure consumer safety and regulatory compliance. - Show more
