Derived from the leaves of a tree native to Southeast Asia and sold in the United States online and in bodegas and head shops, kratom has long been used as a mood booster, energy supplement and pain reliever.
It is also increasingly being used by those who swear by it as a curb for opioid addiction. Some veterans also say it helps control symptoms of post-traumatic stress. Several million Americans are now believed to use kratom.
But authorities warn that kratom can be dangerous. Reported side effects include seizures, hallucinations and symptoms of psychosis, and there have been calls from inside the Trump administration to curb its use.
“There is no evidence to indicate that kratom is safe or effective for any medical use,” Scott Gottlieb, until recently the commissioner of the Food and Drug Administration, said last year.
The FDA has warned people to avoid using kratom, saying it “appears to have properties that expose users to the risks of addiction, abuse and dependence.” It has also raised concerns about false marketing and impurities in the supply.
Last week, the federal Centers for Disease Control and Prevention weighed in, reporting that kratom had been found to be a cause of death by medical examiners or coroners in 91 out of 27,000 overdose deaths examined by the agency over an 18-month period ending in December 2017.
In almost all of the 91 fatalities, toxicology tests determined that other drugs were present. Fentanyl, the powerful opioid, was listed as a cause of death in just over half of them. Other prescription opioids, heroin and benzodiazepines like Valium were each listed as a cause of death in about a quarter of those 91 fatalities.
In seven deaths, kratom was the only substance found, though the CDC said that it could not rule out the presence of other substances in those cases.
The new CDC report is sure to fuel debate inside the government about whether to put kratom on the Drug Enforcement Administration’s permanent Schedule I list of controlled substances, which includes heroin and LSD.
This article originally appeared in The New York Times.