“It is about how it is used, how much is used, and by whom.”
The question about whether or not Kratom is safe has been in the news with increasing frequency. Proponents and users say that there have never been any deaths attributed to Kratom use. However, politicians and advocates for banning the sale of Kratom in the USA claim otherwise. A 2016 report published by the CDC claims that between 2010 and 2015 there were 660 calls to US Poison Centers attributed to Kratom use or exposure, with one death reported.
This may seem alarming, however it is important to remember how we define ‘safe.’ Every substance on earth can be toxic in high enough doses, when taken with other substances, or merely because of biological differences between individuals. Even water, a most benign and vital substance, can be fatal if too much is ingested. This condition is called hyperhydration, of which there have been many cases including more notable ones such as the death of Andy Warhol.
What is meant by Toxicity?
To quantify toxicity, scientists use a scale called LD50, which represents the amount of a substance that would have to be ingested to kill 50% of the sample size. To put things into perspective, the LD50 for Fentanyl is just 0.0003 g/kg (grams per kg of body weight), and for cannabidiol (CBD) it is 0.98 g/kg. For studies using Kratom (mitragynine extracted from the plant Mitragyna speciosa) the LD50 was found to be about 0.592 g/kg, meaning that a 150 pound person would have to consume about 3.6 pounds of it to have a 50% chance of mortality. Since no human would or could ingest that much Kratom, how did this reported death occur?
As the report briefly mentions, the user who died was also on several other medications, including the antidepressant Paroxetine and the mood stabilizer Lamotrigine. Upon further investigation, the autopsy report noted that the 17 year old male also had a history of heroin abuse and was found to have “pulmonary congestion and edema and a distended bladder, both of which are consistent with, though not diagnostic of, opiate use.” So, it becomes obvious that the unfortunate death was likely caused by interactions of several substances in an already unhealthy body, and not directly from Kratom. In the literature regarding SE Asia where the plant is endemic and has been in use for thousands of years there are no reports of death.
The Actuality of Kratom incidences
What about the other 660 calls to the US Poison Center? The paper states that 66.2% were “non-life threatening, with no residual disability,” and only 7.4% were life threatening. It does not however explain if those callers had taken only Kratom, or had taken other substances as well, nor does it explain if those people had any comorbidities which could have contributed to their symptoms. The most common symptoms were tachycardia, irritability, drowsiness, and nausea. All of which are non-life threatening and similar to drinking an excess of coffee or energy drinks. To put these numbers in perspective, over the 6 year study period 660 cases were reported, or approximately 110 cases per year. In 2017, 129,917 calls were made to the US Poison Center regarding pain killers, 114,212 for sedatives, and 41,266 for stimulants (these numbers only include adults). Interestingly, over the period from 2000-2013 there was an average of 3,441 calls per year for caffeine. So, in context the number of calls pertaining to Kratom are very small, and also not very serious.
All of this evidence points to the conclusion that any substance is neither inherently dangerous nor inherently safe. It is about how it is used, how much is used, and by whom. For these reasons, we suggest that you first start small when taking Kratom or switching brands/strains. See how it affects you and then increase your dosage until you reach the desired effect. And of course, as with any medications or supplements check with your doctor or pharmacist to ensure that it will not interact negatively with other medications you are currently taking. No matter what the reason for you to try Kratom, it is many orders of magnitude less toxic than the other medications or supplements you may already be taking to improve your health or increase your energy levels. This is especially the case if you are interested in Kratom to help kick an addiction to opioids or other drugs.