I'm sorry but I must say this is absolute nonsense.
Leave it to "Janessa Graves", associate professor of nursing to propagate some bs like this.
Those patients did not die as a result of kratom. To suggest that there is some sort of causal relationship between kratom and these deaths in a supposedly scholarly work can only be the result of bad methodology and assumption making. Its almost like saying older people who smoke marijuana die at a faster rate than those that don't, "so it must be the marijuana". Also what is this permanently disabling effect she described. Some of the weakest publications come out of nursing schools, particularly when they venture into areas such as this (pharmacology and toxicology).
Kratom is far safer than traditional opioids.