American health officials are urging the public not to use Kratom, a herbal supplement derived from a psychoactive plant native to Southeast Asia thought to contain potential therapeutic benefits. Between July 2016 and December 2017, the Centers for Disease Control and Prevention (CDC) report 91 people died after unintentionally overdosing.

Mitragyna speciosa contains the alkaloid mitragynine, which in low doses produces a stimulant effect but results in opioid-like effects when consumed at higher doses. As such, it affects the same opioid brain receptors as morphine, further exposing users to the risks of addiction, abuse, and dependence.

Last Fall, the US Food and Drug Administration (FDA) issued a health advisory urging consumers not to use kratom. Since 2012, the agency has monitored the drug and more recently identified it as one of concern. A comprehensive review of studies on kratom use and mental health conducted since the 1960s found that kratom, which is sometimes used as a substitute for people addicted to opioids, also causes withdrawal symptoms.

Additionally, the FDA concludes that there are no approved uses for the herb.  

"Taken in total, the scientific evidence we’ve evaluated about kratom provides a clear picture of the biologic effect of this substance. Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids,” said the FDA in a statement. “There is no evidence to indicate that kratom is safe or effective for any medical use. And claiming that kratom is benign because it’s 'just a plant' is shortsighted and dangerous.”

In order to determine the associated number of deaths from kratom, the CDC analyzed data from the State Unintentional Drug Overdose Reporting System (SUDORS). Between 2011 and 2017, the national poison control database reported 1,807 calls concerning potential poisonings that ultimately pinpointed kratom use as the cause of death in 11 states between June 2016 and 2017, more than doubling to 27 states the following year.

During that time, 152 of more than 27,000 total overdose deaths (0.56 percent) tested positive for kratom, while the supplement was determined to be the cause of death in 91 of these cases (nearly 60 percent). Traces of other drugs were also found in the bodies of many of those that died, most commonly fentanyl (65 percent) and heroin (nearly 33 percent).

What’s particularly worrying about these overdoses is that 80 percent of these cases had a history of substance abuse, while 90 percent had no evidence of currently receiving medically supervised pain treatment.