Volume 69, Issue 8 p. 2176-2184
Clinical Investigation

Kratom exposures among older adults reported to U.S. poison centers, 2014–2019

Janessa M. Graves PhD

Corresponding Author

Janessa M. Graves PhD

College of Nursing, Washington State University, Spokane, Washington, USA

Correspondence

Janessa M. Graves, College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA 99202, USA.

Email: [email protected]

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Julia A. Dilley PhD

Julia A. Dilley PhD

Multnomah County Health Department and Oregon Public Health Division, Program Design and Evaluation Services, Portland, Oregon, USA

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Lucia Terpak MA

Lucia Terpak MA

Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA

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Ashley Brooks-Russell PhD

Ashley Brooks-Russell PhD

Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA

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Jennifer M. Whitehill PhD

Jennifer M. Whitehill PhD

Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA

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Tracy A. Klein PhD

Tracy A. Klein PhD

College of Nursing, Washington State University, Vancouver, Washington, USA

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Erica Liebelt MD

Erica Liebelt MD

Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

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First published: 18 June 2021
Citations: 8

Funding information: Washington State University, Alcohol and Drug Abuse Research Program (ADARP)

Abstract

Background

In recent years, use of the herbal supplement kratom has increased in the United States. The reasons for use include pain relief, particularly as a substitute for opioids.

Objectives

To describe epidemiologic trends in kratom-related exposures among older adults reported to U.S. poison centers.

Design

Retrospective analysis of American Association of Poison Control Center's National Poison Data System (NPDS).

Setting

Data from all U.S. poison centers from 2014 to 2019 were examined.

Participants

Kratom exposure cases involving adults aged 18 and older. Kratom cases were identified by product and NPDS generic codes. Non-human and information-only calls were excluded. Data were examined for all calls for exposures among adults, with a focus on older adults aged 60–69 years and above 70 years.

Measurements

Descriptive analyses were used to characterize individual demographic, exposure information, clinical effects, and medical outcomes associated with kratom exposures among older adults. Comparisons across age groups (18–59, 60–69, and 70+ years) were made using Fisher's exact tests.

Results

Among 3484 kratom-related exposures reported between 2014 and 2019, 4.6% (n = 162) were among adults over 60 years. The number of kratom-related exposures increased over time. Most cases originated with calls from healthcare facilities (81.1%) and involved kratom as a single ingestant (63.0%). The reason for most ingestions was intentional (74.5%). One in five exposures among adults aged 70 and older involved an adverse reaction (e.g., drug interaction; 21.9%), compared with 12.3% among ages 60–69 and 9.6% among ages 18–59 years. Neurological and cardiovascular clinical effects were observed. Twenty-three deaths were observed among older adults.

Conclusion

Healthcare providers and older adult patients should be aware of the potential risks of kratom use, including medication interactions and falls. When reviewing medication lists, providers should query this population for all medications and substances being used, especially in people being treated for pain.

CONFLICT OF INTEREST

The authors have no conflicts of interest to report.