August 31st, 2016
Yesterday the US Drug Enforcement Agency filed a notice of intent to classify a plant called kratom as a Schedule I controlled substance, the most restrictive category for drugs “with no currently accepted medical use and a high potential for abuse.”
The DEA said it was “issuing this notice of intent to temporarily schedule the opioids mitragynine and 7- hydroxymitragynine, which are the main active constituents of the plant kratom, into schedule I pursuant to the temporary scheduling provisions of the Controlled Substances Act.”
The scheduling is set to take effect on September 30.
Kratom, a tree in the coffee family (rubiaceae), is thought to act as an opioid receptor antagonist like naloxone (which attaches to opioid receptors without activating them), or as a partial agonist, like buprenorphine (which activates the receptors somewhat but not fully). Full opioid agonists, like heroin, fully activate the receptors.
Kratom has been used for thousands of years in Southeast Asia. It is sold in the US today in various forms, including teas, that can be bought in cafes and online.
Users report that a smaller dose of kratom has a stimulating effect, while a larger dose has a more peaceful, calming effect. Advocates also report using kratom to successfully recover from physical and psychological dependence on opioids.
Susan Ash, director of the American Kratom Association, tells The Influence that “many people also report using kratom to ease the symptoms of PTSD, lyme disease, chronic pain, and some people will take it to lessen their anxiety instead of using dangerous benzodiazepines.”
But the DEA says that kratom poses an “imminent hazard to the public safety.” The agency cites as evidence the fact that “the amount of kratom material seized by law enforcement for the first half of 2016 greatly exceeds any previous year totals.” From January 2010 through December 2015, the DEA adds, “US poison centers received 660 calls related to kratom exposure.”
“Kratom,” the DEA states, “does not have an approved medical use in the United States and has not been studied as a treatment agent in the United States” though it does acknowledge that kratom “has a history of being used as an opium substitute in Southeast Asia” and has “been used to self-treat chronic pain and withdrawal symptoms from opioid use.” Yet the DEA claims it’s “especially concerning” that “users have turned to kratom as a replacement for other opioids, such as heroin.”
The DEA’s notice comes on the heels of its recent announcement that it would not move marijuana from Schedule I.
It also came on the day as a New York Times editorial on alternatives to opioids. The Times names approaches for dealing with pain like “physical therapy, anti-inflammatory drugs, acupuncture, exercise and so on.” It’s telling that harm reduction approaches, such as methadone and Suboxone, supervised injection facilities, and medical marijuana, were ignored in the piece.
Kratom didn’t make the list either—and this new announcement means it likely won’t do anytime soon.
Ash says that the “announcement was of course an enormous shock to our community. We have been getting reports back from the community, literally hysterical that they will no longer be able to live with the quality of life kratom has afforded them. People are worried that they will be back in wheelchairs, worried about overdose [if losing access to kratom causes them to return back to opioids].”
“I am one of those very people,” she tells me. In the past, Ash developed an opioid addiction after being prescribed drugs to deal with pain from a case of lyme disease. She first turned to kratom in 2010 to “deal with withdrawal symptoms.” She then went on Suboxone for about a year, then tapered off it using kratom because she found herself “abusing Suboxone.”
“It was about two and a half years ago,” she says, “that I decided I no longer wanted a narcotic addiction…Within two weeks of starting to take this plant, I went from being bedridden except for doctors’ appointments, to being a productive member of society. I decided to start [the American Kratom Association] to help other people.”
In response to the DEA’s announcement, she is distraught: “Where does this leave us? Where does this leave me?”
She believes that the DEA is promoting a false sense of kratom’s dangers. “We do not believe that any death has ever been tied to kratom alone, and we do not believe it is possible to die from kratom alone,” she says. “And we have an affidavit from a toxicologist stating this. Any research that’s ever been done has shown that the only time kratom is associated with death is in a poly-drug episode, involving other drugs, whether prescription or illicit.”
In response to the reported calls to poison centers reporting adverse kratom experiences, she says: “When you look at the numbers—they get over 3 million reports a year. The kratom calls come to a fraction of a fraction of a percent. So we’re wondering, how does a small percent of calls with adverse reactions and no deaths mean a public safety hazard?”
“We cannot deny that there are people out there who will abuse it,” she continues, “just like people will abuse everything from sugar to water. There are people who are prone to abuse it because of the way the industry has been marketing the product in the US. Irresponsible marketing tactics sell kratom as a legal ‘high,’ when its just about the farthest thing from that. It relieves suffering. It doesn’t get you high—there’s no stoned feeling, no foggy feeling—that’s why I love it.”
“Most of our members have never struggled with addiction,” she says. “Our community is mostly older women who don’t want to be on narcotic pain medications. With the new regulation and guidelines—they are getting cut off by their doctors [from prescription painkillers] anyway—they have no options but Suboxone or methadone. And who wants to be on those for the rest of their lives when there’s a safe and natural alternative out there?”
“We also have an enormous amount of veterans who are saying this is the only thing that has ever worked for them for their PTSD,” she adds. “Our folks are feeling beyond devastated.”