Thursday, October 6, 2016

Mitragyna speciosa: Miracle Herb or Killer Opiate?

The DEA has a long and questionable history in the ‘war on drugs’. Lately, it has come to the public’s attention that the infamous government agency plans on emergency scheduling two chemical compounds from the Kratom plant as Schedule 1 Substances- the most restricted categories of drug compounds. As you can imagine, this has faced considerable backlash from proponents of Kratom as well as those who see its potential in the field of medicine.

Kratom is almost as commonplace in Southeast Asia as a cup of coffee in the United States. Mitragyna Speciosa is literally in the coffee family and the DEA thinks it can outright destroy lives.

The Transnational Institute, a research and advocacy group, reported in 2011 that kratom "is chewed in teashops, at certain ceremonies (though this practice is fading), and other informal social events, as well as while engaging in manual labor and in the comfort of one’s own home. Eating kratom is a tradition that has been practiced for centuries in southern Thailand and up to 70 percent of the male population in some districts use kratom daily. Indeed, many people in southern Thailand consider chewing kratom similar to drinking coffee."[1]

Despite this, the DEA has taken precautionary measures in banning the substances that can be derived from Kratom because they believe that there isn’t enough research that supports its purported benefits. The agency has established a two-year probationary ban in order to establish the possible medicinal effects of this plant. I can empathize with their cautionary sentiments but their timing could not be any worse. Currently, there is an opioid painkiller and heroin epidemic in the United States and Kratom could be the key to harm reduction and potentially saving thousands of lives.

Kratom, according to a study done for the Journal of Psychoactive Drugs, can be a safer analog to opioids as it helps reduce pain with only minimal negative side effects.

The study found several positive effects (from most to least common): euphoria, relaxation, enhanced sociability, increased energy, pain relief, sensory enhancement, and warmth or tingling. It also found some negative effects (from most to least common): nausea and stomachaches, withdrawal (from addiction), chills and sweats, dizziness and unsteadiness, vomiting, hangovers, and itching. Reviewing other research, the study found no good evidence that kratom alone has caused deadly overdoses.

According to the study, the pain relief element has become particularly promising for pain patients who want to seek alternatives to highly addictive, potentially deadly opioid painkillers. The study also found that kratom may aid with easing withdrawal from opioid addiction.(1)

The study is bolstered with evidence from the transnational institute, which reports that Kratom use in Thailand within the past few decades has been tied to reduction of pain from withdrawal symptoms. It was even widely used to wean off of alcohol and nicotine dependence and was not exclusively effective for opiate withdrawals.

However, this evidence is not up to par with the Government’s expectations for ‘medicinal value’. Large Scale clinical trials like the ones the FDA conducts are needed to prove that Kratom is more than just another illicit and highly addictive substance. This process of testing and research could take a lot more than two years, as we have seen with Medical Marijuana legalization on the federal level. That is a scary prospect for people who desperately need to wean off opiates or risk dying from withdrawal from the likes of heroin and fentanyl (another opiate).

Meanwhile, thousands of Americans are dying because of opiate addiction and dependence on heroin, a drug that is arguably much more harmful than Kratom. The idea of Kratom being banned terrifies me because we as a society could lose out on a potentially wonderful alternative to opioid painkiller addiction. I can see why the DEA wants to put a short term ban on it- they want to be absolutely positive that the plant does have some medicinal value, but I am incredibly fearful of Kratom becoming mired in the bureaucratic bog of drug legalization. It’s terrifying to think about all those opiate-addicted victims that are going to suffer in the short term while waiting for what seems to be a decent alternative to withdrawal and a valuable tool to wean off truly harmful ‘hard’ drugs.





[1] http://www.vox.com/2016/9/19/12941112/kratom-dea-ban

4 comments:

  1. Interesting post. Kratom seems to have some therapeutic potential that could definitely be studied more. However, from my perspective, the probationary ban on such a little-researched drug/series of compounds is justified when viewing this issue through a lenses of public safety.

    With that being said, how do you think the DEA and other federal agencies like it should handle drug-ban situations in general? Should surprise 'emergency bans' even exist?

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  2. I think this touches on an interesting question. How much should government be able to regulate culture (when it comes to drug, substance usage)? If using Kratom is a well-practiced "tradition" by a culture, does the government have the right to take it away? I personally believe the only real way we can prevent people from using drugs, for the purpose of safety and health, is to educate them, not criminalize its usage. Government should use its resources to make sure people have the information necessary to decide rather than to criminalize a personal health choice. That's just my opinion. But if the use of Kratom or some substances infringes upon the safety and security of OTHERS, then I have a problem. It's a fine line to walk. I think the U.S. government also encountered this problem with certain substances traditionally used by Native American populations. Interesting parallel to research if you are interested.

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  3. I thought this post was incredibly interesting. I liked how you delved into this topic through your narrative, as government regulation does seem to touch base on every social topic these days (i.e. culture, policy, etc.) It reminds me of how Middle-eastern culture is known to lean towards using opiates. Nevertheless, policing culture is quite tricky. Although I must agree with Mystery Man-- that the probationary is justified due to public safety. There are also a whole set of rules that we must take into consideration when it comes to Eastern v. Western thinking. With my experience, the West tends to police substances they do not quite understand yet while the East is very open to traditional cultures that have been passed down through generations -- perhaps there is also a difference in the way of processing such topics.

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  4. Very insightful. I'm just waiting for the FDA to okay a kratom derivative that has been put forth to clinical trials by Pfizer or another pharmaceutical company. You're absolutely right in tapping into the East vs. Western culture. We don't mind (and even abuse) drugs so long as they are packaged with an FDA logo, so what's the difference for kratom? For me it's only that it's a plant based medication, and that's what has lawmakers scared. Lawmakers aren't scientists, and when it's a clean white pill it's not perceived as something abusable, especially if it can make money to constituents.

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