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Inquirer provides balanced and complete summary of debate over kratom, an herbal opioid

Rating

5 Star

Is kratom a safe herbal remedy or a dangerous opioid?

Our Review Summary

Many stories about kratom, an herbal product often promoted as an alternative to opioid drugs, give undue weight to statements from kratom advocates and pay insufficient attention to the science. This Philadelphia Inquirer piece is not one of those stories.

This story does a number of things well:

  • It effectively explains why kratom, despite anecdotal benefits reported by some users, should not be considered safe or effective for pain relief or for managing withdrawal from other opioid drugs.
  • It prioritizes reputable published science over unpublished research commissioned by kratom advocates.
  • It demonstrates that self-serving claims of kratom’s harmlessness — e.g. “You can’t take enough to hurt yourself” — should not be taken at face value.

Overall, this is a balanced and complete report that will help readers better understand the debate over this controversial substance.

 

Why This Matters

We’re in the midst of an opioid epidemic, and kratom is being touted by many advocates as a potential non-addictive tool to manage withdrawal from opioid drugs. That sounds like a great benefit, and many desperate people might be tempted to use kratom based on such claims — and without sufficient understanding of the potential downsides. But as this well-reported story points out, the purported benefits of kratom are not based on sound science and are often promoted by those with a commercial interest in the product.

The story did touch upon a complicated back story here, too — the involvement of Big Pharma in the opioid epidemic. Some pharmaceutical companies have admitted to overselling the benefits and underselling harms of opioids. That understandably makes many of us leery of their claims and their stance on kratom. Yet, that doesn’t imply that herbal remedies are automatically a better option, so it was good to see the story balance this issue well.

 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story states, “Ten one-gram capsules of kratom cost $20, while 30 grams of powder is $34.99.”

(However, it’s not clear how much a person might use per day.)

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

According to the story, kratom users and advocates say the herb “helps to relieve pain, gives a mild boost like coffee (the tree is part of the coffee family) — and can even help ease the pain of opioid withdrawal.”

These benefits aren’t quantified, but that’s because there is no good-quality research that demonstrates those benefits. The story calls attention to the lack of evidence on kratom, which is why we’ll rate this satisfactory.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story pushes back against misleading claims of safety and notes that kratom has been linked to at least 44 deaths. It also notes one confirmed instance of fatal kratom overdose, which contradicts one advocate’s statement that “you can’t take enough to hurt yourself.”

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story emphasizes the lack of sound scientific evidence supporting claims of kratom’s effectiveness for pain relief or opioid withdrawal.

It also deftly counters claims that kratom isn’t an opioid by pointing to peer-reviewed, published evidence showing that kratom works the same way as other opioid drugs.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story features comments from independent public health and toxicology experts. It notes that some of the research supporting the benefits of kratom was commissioned by a kratom advocacy group. We think including perspective from an independent health expert would have made the story even stronger, but wasn’t critical.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story notes that there are effective existing treatments for opioid withdrawal.

Scientific studies have indicated that the most effective treatment for opioid withdrawal includes the medically supervised use of opioid medications such as methadone.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story notes that kratom is widely available in Philadelphia at gas stations and convenience stores, but that a number of states have banned kratom or have legislation to ban it pending.

Does the story establish the true novelty of the approach?

Satisfactory

The story establishes why this issue is newsworthy.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story clearly goes beyond any news release that might have been issued.

Total Score: 10 of 10 Satisfactory

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