Is Kratom the Answer to the Opioid Crisis — or the Start of a New One?

Courtney True had been dependent on opioids since she was a 14-year-old, when a doctor prescribed her Percocet to treat chronic migraines. By the age of 24, she was shooting OxyContin. A decade after that, True started on heroin. She’d tried to quit many times over the years, using Imodium A-D, quinine, valerian root. Nothing worked. So here she was, reading earnest online testimonials about an obscure leaf from Southeast Asia named kratom.

Her husband drove her to a smoke shop in Portland where she bought a small bag of crushed kratom leaves, some capsules, and two tiny bottles of extracts, for about $100. True swallowed some of the capsules and downed a bottle, then sat waiting, skeptically, to feel something like a high. She never did, but within 20 minutes her withdrawal symptoms had faded away. Now 18 months have passed, and True has been heroin-free for 17. She drinks a murky kratom-grapefruit juice mix several times a day, and credits the plant for saving not only her own life, but also her family’s.

Kratom is a billion-dollar business, with thousands of vendors selling it to an estimated 3 million to 5 million people. True is part of a growing grassroots movement of former drug users who see kratom as the cheap, safe way to curb the opioid epidemic killing more than 40,000 people in the US every year. The American Kratom Association claims that kratom is a billion-dollar business, with thousands of vendors selling it to an estimated 3 million to 5 million people.

There’s just one problem. The government is in secret talks to possibly ban the plant, suspecting that kratom is the start of a new opioid crisis. Kratom latches on to some of the same brain receptors that heroin, morphine, and fentanyl do. From the government’s perspective, that makes kratom an opioid like any other, and too dangerous to leave unregulated. The FDA has circulated notices about kratom strains contaminated with salmonella and has linked the plant to the deaths of 44 people. Last month, the FDA sent warning letters to three distributors for making unproven claims about kratom’s ability to treat pain, opioid addiction, and cancer. But kratom advocates point out that these drugs are too often inaccessible to the uninsured, don’t work for some people, and can be abused. Beyond a few medical case reports on kratom, there isn’t much science to support the idea that the plant is safe or dangerous.

The DEA had recently announced its intention to make the two main compounds in kratom — mitragynine and 7-hydroxymitragynine — Schedule I controlled substances, a label given to heroin and other drugs with high potential for abuse. The agency cited a CDC report showing that the number of calls about kratom to poison control centers had increased tenfold, from 26 calls in 2010 to 263 in 2015. Despite this, some 140,000 people signed a White House petition to keep kratom legal, and more than 60 members of Congress, spearheaded by supplement industry ally Sen. Orrin Hatch of Utah, compelled the DEA to hold a public comment period to reconsider their decision, which resulted in more than 23,000 responses.

If it does get banned, the US will follow in the footsteps of 16 other countries, including the UK, Germany, Sweden, and even two places, Thailand and Malaysia, where kratom is natively grown.
From poppies to cannabis, people have been turning plants into medicine for more than 60,000 years. Today, out of the 252 drugs considered “essential” by the World Health Organization, 11% are exclusively derived from plants. The difference between essential medicine and dangerous drug has historically been tough to pin down. Coca-Cola’s name comes from the coca plant, its signature ingredient before cocaine became illegal. Heroin was first derived to treat morphine addiction, or “narcomania”; now it’s illegal, and morphine prescribed. And OxyContin, the legal painkiller that made its manufacturer a reported $35 billion, launched a national epidemic.

Which is why kratom’s chemical makeup — and specifically, whether it’s an opioid — is the subject of such fierce debate. Researchers have long known at least two of its alkaloids — mitragynine and 7-hydroxymitragynine — latch on to the mu-opioid receptor in the brain, the same one that responds to morphine and heroin and triggers pain relief. The difference between essential medicine and dangerous drug has historically been tough to pin down.“The evidence that the agency has shows us that kratom is an opioid,” the FDA spokesperson said. “And it’s not clear to us if kratom is fueling the opioid epidemic or causing an epidemic of its own.”

If you have been charged with distribution or possession of heroin, cocaine or marijuana with intent to distribute in Bergen or Passaic County, you should contact Frank T. Luciano who has been defending cases of these types for over 40 years. He is a lifetime member of NORML’s legal committee and a longtime member of the National Association of Criminal Defense Lawyers. You can assess Frank T. Luciano’s skills by visiting his Testimonials page on this website.

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