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Kratom exposures reported to United States poison control centers: 2011-2017.
Clin Toxicol (Phila). 2019 Oct; 57(10):847-854.CT

Abstract

Context: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety. Methods: This study analyzes exposures to kratom reported to poison control centers (PCCs) in the United States during 2011-2017 from the National Poison Data System (NPDS). Discussion: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016-2017. Most exposures occurred among adults ≥20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21-3.55) and a serious medical outcome (OR: 2.25; 95% CI: 1.77-2.85) compared with single-substance exposures. There were 11 deaths associated with kratom exposure, including two that occurred after exposure to kratom only. Among kratom-only exposures, 86.1% resulted in one or more clinical effects. The most common clinical effects were agitation/irritability (22.9%) and tachycardia (21.4%). There were seven neonatal exposures, including five experiencing withdrawal. Conclusions: Kratom is associated with a variety of serious medical outcomes, especially when used with other substances. More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances.

Authors+Show Affiliations

a Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus , OH , USA. b Northeast Ohio Medical University , Rootstown , OH , USA.c Central Ohio Poison Center , Columbus , OH , USA. d Department of Pediatrics, College of Medicine, The Ohio State University , Columbus , OH , USA.a Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus , OH , USA.a Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital , Columbus , OH , USA. d Department of Pediatrics, College of Medicine, The Ohio State University , Columbus , OH , USA. e Child Injury Prevention Alliance , Columbus , OH , USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30786220

Citation

Post, Sara, et al. "Kratom Exposures Reported to United States Poison Control Centers: 2011-2017." Clinical Toxicology (Philadelphia, Pa.), vol. 57, no. 10, 2019, pp. 847-854.
Post S, Spiller HA, Chounthirath T, et al. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854.
Post, S., Spiller, H. A., Chounthirath, T., & Smith, G. A. (2019). Kratom exposures reported to United States poison control centers: 2011-2017. Clinical Toxicology (Philadelphia, Pa.), 57(10), 847-854. https://doi.org/10.1080/15563650.2019.1569236
Post S, et al. Kratom Exposures Reported to United States Poison Control Centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. PubMed PMID: 30786220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kratom exposures reported to United States poison control centers: 2011-2017. AU - Post,Sara, AU - Spiller,Henry A, AU - Chounthirath,Thitphalak, AU - Smith,Gary A, Y1 - 2019/02/20/ PY - 2019/2/21/pubmed PY - 2020/6/2/medline PY - 2019/2/21/entrez KW - Kratom KW - National Poison Data System KW - dietary supplement KW - poison control center KW - poisoning SP - 847 EP - 854 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 57 IS - 10 N2 - Context: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety. Methods: This study analyzes exposures to kratom reported to poison control centers (PCCs) in the United States during 2011-2017 from the National Poison Data System (NPDS). Discussion: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016-2017. Most exposures occurred among adults ≥20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21-3.55) and a serious medical outcome (OR: 2.25; 95% CI: 1.77-2.85) compared with single-substance exposures. There were 11 deaths associated with kratom exposure, including two that occurred after exposure to kratom only. Among kratom-only exposures, 86.1% resulted in one or more clinical effects. The most common clinical effects were agitation/irritability (22.9%) and tachycardia (21.4%). There were seven neonatal exposures, including five experiencing withdrawal. Conclusions: Kratom is associated with a variety of serious medical outcomes, especially when used with other substances. More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances. SN - 1556-9519 UR - https://wwww.unboundmedicine.com/medline/citation/30786220/Kratom_exposures_reported_to_United_States_poison_control_centers:_2011_2017_ DB - PRIME DP - Unbound Medicine ER -