Pubdate: Fri, 09 Feb 2018
Source: Morning Call (Allentown, PA)
Copyright: 2018 The Morning Call Inc.
Author: Matt Coughlin


A coffee-like plant from southeast Asia was classified Tuesday as a
dangerous opioid by the U.S. Food and Drug Administration.

Kratom is an unregulated plant imported from southeast Asia which is 
commonly sold in convenience stores and used as a home remedy to combat 
pain and opioid withdrawal, among other uses.

The FDA posted reports of kratom-related deaths on its website in
December and again earlier this week.

Here are a few examples of kratom-related deaths from those reports:

* An April 2011 report summarizes the case of a 20-year-old man who
was found dead under his bunk in his home. A roommate said it was not
unusual for the man to sleep under his bed. Investigators found 39
different nutritional supplements, herbal supplements, prescription
and nonprescription drugs at the scene. He was reportedly using kratom
to treat insomnia and had also researched altering the propylhexedrine
from over-the-counter inhalers for use. The autopsy found fluid in and
around the man's lungs. His death was ruled accidental as a result of
propylhexedrine toxicity and an expert suggested the combination of
mitragynine -- an active agent in kratom -- and propylhexedrine may
have "added to the toxicity of each drug.

* Another report details the death of a 24-year-old man whose case was
detailed in a medical journal in December 2014. This man also had
fluid in and around his lungs. The cause of his death was reported in
the journal as "mixed drug intoxication -- primarily mitragynine." The
man had a history of alcohol abuse and depression. He was at a
friend's home where he drank a glass of wine, a beer and took a
sleeping pill. Experts estimated that he also consumed prescribed or
less-then-prescribed amounts of venlafaxine, mirtazapine and omeprazole.

* Another medical report from January 2015 details the death of a
17-year-old boy who had a high concentration of kratom in his blood.
The death was reported as a possible kratom toxicity. Multiple
containers of kratom, including a box and an empty bottle of liquid
kratom were found at the scene. The boy had a history of heroin abuse
and back pain and was reportedly self-medicating to treat both conditions.

* A poisoning exposure report on the death of a 36-year-old man in
2013 notes that mitragynine was one of three substances in his system
at the time of death. He was found at home by family members after he
had a seizure. Empty bottles of lamotrigine, paroxetine and a packet
labeled "Da Pimp Bomb" -- described as pure kratom -- were found with

* A middle aged man with a history of substance abuse and psychiatric
disease was found dead in his bed. According to the FDA report, the
man had purchased kratom on the internet to help him avoid a positive
drug test at work. He had reportedly said the most recent batch of
kratom he had received was more potent than previous batches. The
afternoon before his death, family members reported he was unwell and
clearly intoxicated before bed. He was overweight and had pneumonia
caused by intoxication and his cause of death was considered
intoxication with kratom, possibly in combination with other substances.

* In February 2014, a woman was pronounced brain dead and doctors
cited her use of kratom. The woman had a prior history of heroin
abuse, according to records.

* In another example, a 27-year-old man in good physical shape
suffered cardiac arrhythmia while swimming and died. The coroner cited
acute mitragynine and o-desmethyltramadol intoxication as contributing
- ---
MAP posted-by: Matt