There’s a war waging right now over whether or not Kratom should be banned. On the one side, you have Kratom advocates who insist that this plant has massive health benefits and has been in use for centuries to reduce pain. There are even reports of people that use it to help recover from opioid abuse.
On the other hand, you have critics who say that Kratom has latent addictive properties. At present, neither side has enough scientific evidence to support their arguments. What we do know is that Kratom originates from Southeast Asia and natives there have been using it for hundreds of years for recreational and medicinal purposes.
The advocacy group known as the American Kratom Association claims that a staggering 5 million Americans currently use Kratom to improve mood and alleviate pain.
However, due to the lack of scientific research on Kratom, it’s difficult to agree with either side, because federal regulators now say that there’s potential for some dangerous side effects. Again, there’s no real evidence to support these claims, so there’s no saying how accurate they are.
Controversy Around Kratom Ban
The U.S. Drug Enforcement Administration (DEA) recently put forth a motion to classify Kratom as a schedule 1 regulated drug. This happened in August 2016, after Kratom was linked to some deaths.
Schedule 1 Drugs –What Are They?
A Schedule 1 substance is an illegal drug that has been banned from use due to having a high potential for addiction. The DEA will only classify a substance as a schedule 1 drug if it’s proven to pose a danger to society. A few examples of known Schedule 1 drugs include substances like ecstasy, LSD, and heroin.
The DEA’s announcement attracted an almost immediate backlash from politicians and the general public as well. A White House petition aimed at maintaining Kratom’s legal status in the US was circulated and garnered more than 120,000 signatures from consumers in a short amount of time. Meanwhile, 60 Congress members formed a bipartisan group that signed letters to counter the DEA’s planned Kratom ban.
Kratom advocates maintain that Kratom is safe to use in recommended doses, as evidenced by the millions of American users who’ve benefited from the plant’s medicinal effects for years. Meanwhile, opioid misuse is a major problem in the US that led to an astounding 42,000 deaths in 2016 alone. So for now, Kratom use is seen as a catch 22 situation in the US.
Is Kratom Safe?
At present, no scientific data is available on Kratom, so there’s no telling how effective or safe it is to take. As such, advocates of the plant claim that a Kratom ban will prohibit research into it thus eliminating the chances of finding out how effective Kratom could be in treating ailments like opioid withdrawal symptoms.
Due to the backlash it received from Congress and the public, the DEA eventually rescinded its proposed Kratom ban in October 2016. The agency stated that additional research is required to determine Kratom’s safety before they can make a final decision on whether or not it should be scheduled.
Kratom is still legal in the US, save for a handful of states that have banned it. It’s also freely available online from various vendors who sell different strains of the plant. Plus, there are a few natural food stores and supplement shops that carry it as well.
What a Ban on Kratom Means?
Although there’s no nationwide federal ban on the sale and use of Kratom, a few individual US states have banned it, including Arkansas, Indiana, Wisconsin, Tennessee, and Vermont.
Is Kratom an Opioid?
In February 2018, the Food and Drug Administration (FDA) announced that a team of research scientists found 25 opioid compounds in the Kratom leaf. This is why the agency refers to Kratom as an opioid.
What is an Opioid?
The term “opioid” refers to a group of natural and synthetic substances that come from the opium poppy. Opioids are unique from other drugs due to their ability to bind with specific opioid receptors in the brain. As soon as the opioids connect to these special receptors, they instruct the brain to block pain and release calming endorphins. Some of the opioids that you might be familiar with include heroin, morphine, fentanyl (Duragesic), and oxycodone (OxyContin).
According to the FDA, the fact that Kratom can activate these opioid receptors is worrying because it means that the plant may have addictive properties like the other opioids.
However, Kratom advocates believe that it’s deceptive to classify Kratom as an opioid. Nine scientists came together to pen an open letter publicly opposing and questioning the reliability of the FDA’s findings. These scientists are backed by the American Kratom Association and state that Kratom is unique from other opioids. For example, the Kratom tree is in the same family as the coffee plant, and consumption of it hasn’t been shown to slow down breathing like other opioids. That’s why Kratom cannot be associated with accidental deaths caused by opioids.
Can Patients Be Affected If a Ban on Kratom is Enforced?
The clash between the DEA, FDA and Kratom advocates has been brewing for some time, and the recent Kratom ban proposal from the DEA is just another result of it. This is even though millions of people are already using the herbal supplement to heal some ailments.
According to a STAT report, the Department of Health and Human Services has been calling for a Kratom ban for years.
The report shows that HHS made the recommendation to ban Kratom in a November 2017 letter to the DEA, in which the organization cited the presence of 7-hydroxymitragynine and mitragynine as grounds to ban the substance. These two active compounds make up a large part of the Kratom plant so classifying them as a schedule 1 drug would have meant a total ban of the plant as a whole.
If the Kratom ban were successful, this plant would have been placed in the same category as LSD and heroin. Despite being forced to withdraw its proposal to ban the substance, the DEA still holds strong views about Kratom and the potential dangers that it poses.
Meanwhile, the FDA recently issued a statement saying that Kratom has also been associated with a recent salmonella outbreak. However, this doesn’t prove anything because it relates to how Kratom is packaged and manufactured and not to its mechanism of action.
The FDA Claims Kratom is Dangerous
The FDA recently alleged that Kratom use had been linked with the death of 44 users. But as a Huffington Post article shows, the victims had other substances like illegal drugs in their system at the time of death. One of them fell out of a window, and another was shot as well, so it’s unfair to point at Kratom as the cause of death because there’s a lot at play in each case.
In light of this evidence, the FDA claimed that Kratom’s opioid properties might lead to addiction. To be fair, the Mitragynine compound in Kratom can trigger opioid receptors in the brain that can also be activated by heroin and other opioids. However, unlike other opioids, Kratom doesn’t have any adverse respiratory side effects.
If the DEA’s proposed Kratom ban were a success, thousands of patients would have been placed in a very difficult position.
A Kratom Ban Would Stop the Research on Kratom
If Kratom had been classified as a Schedule 1 drug, then researchers would have had a hard time researching it. That’s because research into schedule 1 substances requires special permission from the DEA, which is extremely hard to come by. That’ why it took such a long time for the medical community to get going on marijuana research in the first place.
Plus, a Kratom ban would have led to the substance going underground because the demand is still there for it even though it would be illegal to sell. As a result, access to quality Kratom would diminish, and the number of people who use it for its opioid qualities would increase. It’s important to note that Kratom is a lifeline for people who’re trying to avoid opioid use in treating different kinds of pain, so banning it was going to place those people in great danger.
Can New Regulations Avoid the Scheduling of Kratom?
It seems like the FDA needs to get back to the basics and start by listening to Kratom advocacy groups and what they have to say because so far they seem to have failed at doing that. That’s why scientists who have studied Kratom signed a letter by the American Kratom Association, to reach DEA, FDA, HHS, and the National Institute on Drug Abuse (NIDA).
The letter clearly shows the DEA’s lack of research by revealing that the agency failed to consult with Kratom research groups and NIDA. The group of scientists also requested that the DEA should collaborate with NIDA to research the abuse potential claims made by the FDA as part of their case against Kratom use. Perhaps the results of this investigation will lead to a different regulatory decision.
The letter goes on to say that the FDA should cooperate with groups in the Kratom industry to develop manufacturing regulations to complement the framework put together by the AKA.
At the very least, the DEA and FDA should consider and act upon the recommendations made in the letter because at the end of the day Kratom is helping a lot of people. Plus it’s bad for organizations like the DEA and FDA to make zealous accusations and decisions without thoroughly investigating the facts. A Kratom ban would be devastating for patients, and the matter shouldn’t be taken lightly.
The Pharmacology of Kratom
The main concern over Kratom’s possible abusive properties stems from its two main compounds; namely 7-hydroxymitragynine (7-HMG) and mitragynine (MG). When taken together, these compounds can activate certain opioid receptors in the brain which is what makes them so effective at alleviating pain. But they are not necessarily the same as opioids.
According to the available research, these compounds have manageable and mild withdrawal symptoms that include difficulty getting to sleep and mild pain. However, these side effects are so mild and bearable that the research subjects didn’t ask for any form of treatment for them.
A recent study that was done on rats showed that MG might even help reduce self-administration instead of perpetuating it. In yet another rat study MG was shown to reduce morphine intake which completely debunks the DEA’s claims. With that said, 7-HMG did show potential for abuse though but only when taken in isolation. Plus, it’s important to keep in mind that 7-HMG makes up only 2% of the alkaloids found in Kratom while MG makes up 60%.
Now, let’s talk about pure opioids for a bit to help us understand the difference between these two substances. For example, when you take a drug like morphine which binds with μ-opioid, it brings in a protein known as β-arrestin. This protein is responsible for releasing the chemicals that lead to respiratory failure (which is a common side effect of morphine), and other fatal overdose symptoms.
Meanwhile, 7-HMG and MG don’t activate β-arrestin in any way, so there’s no real evidence to associate Kratom with opioid risks like a fatal overdose legitimately.
So, even though Kratom might exhibit some opioid-like effects and is somewhat addictive to some people, it’s not nearly as dangerous as morphine and other opioids. Still, clinical trials would have to be conducted to reach a conclusion on the matter, and the DEA’s call to ban Kratom is making this increasingly difficult.
There are reports of two human studies that were canceled because of this proposed ban.
Before a substance such as Kratom can be banned, it has to go through the 8-factor analysis test. Kratom researches have already put the compound through this analysis test, and it passed with flying colors.
This completely precludes Kratom from being considered as a schedule 1 drug. That’s why the DEA couldn’t proceed with their Kratom ban, and that’s why it’s so important to educate people about the true nature of Kratom, especially after the massive smear campaign that the plant has been through at the hands of the FDA and general media.