Last Tuesday (February 20), the Centers for Disease Control and Prevention (CDC) issued a recommendation warning consumers to avoid kratom, citing a multistate outbreak of Salmonella that has been linked to the dietary supplement. The US Food and Drug Administration (FDA) followed on Wednesday by announcing a voluntary recall and destruction of kratom supplements sold by the Missouri-based company Divinity Products Distribution.
The Salmonella outbreak began in October, and cases have been documented in 20 states. No deaths have been reported as a result of the outbreak, but eleven individuals have been hospitalized. The CDC used whole genome sequencing to determine that the Salmonella samples from affected people were “closely related,” indicating they probably share a common infection source. Eight of the hospitalized individuals said they had consumed kratom in the form of pills, powder, or tea, the agency says.
In the FDA’s announcement, it cites “serious risks” associated with using kratom, which the agency recently classified as an opioid, and encourages all companies involved in the sale of the supplement to remove their products from the market. “[C]ompounds contained in kratom are opioids and are expected to have similar addictive effects as well as risks of abuse, overdose and, in some cases, death,” FDA Commissioner Scott Gottlieb says in the statement. He adds that there is no evidence indicating the supplement is “safe or effective for any medical use.”
The FDA notes that no recent reports of illness were linked specifically to Divinity Products Distribution’s kratom-containing supplements. However, in addition to the recall and destruction of its existing kratom products, the company has agreed to cease selling them in the future.
The CDC says kratom is an “opioid substitute” that provides stimulant effects to the user. Earlier this month, the FDA announced that based on an evaluation using a computational model of the molecular structure of kratom, the agency felt “confident in calling compounds found in kratom, opioids.”
Advocates for kratom argue that the supplement has clear differences from classic opioids, and that the two substances have distinct user populations. On February 8, scientists from the American Kratom Association sent a letter to the White House stating that “the current body of credible research” shows that kratom is neither addictive nor opioid-like.