Asian Leaf ‘Kratom’ Making Presence Felt in US Emergency Rooms

When a patient showed up in a West Coast emergency room early this month suffering withdrawal from something he called “kratom,” the psychiatrist on duty was forced to scramble for information. But when the doctor looked it up, she found that the opiate-like leaf from Southeast Asia is well known in the worlds of alternative medicine and the drug culture.

What the doctor, who asked not to be named for patient confidentiality reasons, found in an Internet search were Web pages set up by dozens of companies selling kratom leaf and touting it as a way to combat fatigue, pain and depression — even as an antidote to heroin addiction.

But in addition to its possible medicinal uses, kratom is beginning to show up in U.S. emergency rooms, with doctors saying they are dealing with people sick from taking it — especially teens who try it to get high.

“Every month somebody is trying to get a new ‘safe high’,” said Frank LoVecchio, medical director of the Banner Good Samaritan Poison and Drug Information Center in Phoenix, Ariz. “(Kratom) is definitely not safe.”

Estimating usage of the drug is impossible, but emergency events involving kratom appear to be increasing, he said. In 2005, only two incidents were reported by poison control centers nationwide. But Banner’s center dealt with six emergencies involving kratom in 2011, he said.

As with many herbal and chemical products on the market, science and law enforcement are playing catch-up. Little research has been done to determine the risks of taking kratom, so it remains legal and unregulated in the United States.

The leaf, which is indigenous to Southeast Asia, has been around for thousands of years, and proponents argue that it is safe and effective for many maladies, while having fewer side effects and being less addictive than pharmaceutical alternatives, such as oxycodone. In small doses, they say, kratom provides an energy boost — the plant is in the coffee family — and in larger doses it creates a mellow, sedating effect, acting on the opioid receptors.

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Like “bath salts” and “spice” — drugs that are now illegal but were legal and trendy until law enforcers and medical researchers gathered data on their dangers — kratom is under scrutiny, having been added to a Drug Enforcement Administration’s list of “drugs and chemicals of concern.”

If the DEA concludes that kratom poses a public health risk, the agency can request that the Department of Health and Human Services place it on a schedule of banned and controlled substances.

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Kratom is illegal in a number of countries in Europe and Asia — most notably Thailand, where much of it is produced. It is now the third most commonly used illegal drug in Thailand, according to the DEA. In that country’s drug culture, the leaf is sometimes combined with cough syrup and Coke, tranquilizers and marijuana to produce a narcotic drink called “4×100.”

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