SEP 17, 2016 5:17 AM PDT

Is it Fair to Lump Kratom with Dangerous Opioids?

WRITTEN BY: Xuan Pham
The leaves of a plant indigenous to Southeast Asia were recently added to the list of banned substances in the US. This promptly elicited a huge outcry from the thousands of Americans who use it to manage pain and as a means to wean off opioids or alcohol.
 
Kratom and the war on an ‘herbal supplement'? | Image: wikipedia.org

The Kratom drug comes from the leaf of the Mitragyna speciosa tree in Southeast Asia. For centuries, natives have chewed the leaves or brewed it as tea for religious purposes or as a natural stimulant to combat fatigue.
 
There are many active compounds in Kratom, but scientist pinpointed 2 in particular to which they attribute Kratom’s effects: Mitragynine, and 7-hydroxy-mitragynine. Both bind to the same receptors as opioids, which is why this drug is often considered an opioid substitute. Of note, the chemicals in Kratom don’t elicit the same intense high as that of opioids, unless at really high doses.
 
In its review of the drug, the US Drug Enforcement Agency (DEA) cited many concerns for Kratom. The list included side effects such as depression, anxiety, insomnia, and mood changes. Of these, the biggest fear appears to be the risk for dependency. In other words, people using Kratom to treat pain or opioid addiction may end up with a Kratom addiction.
 
As such, the DEA now lists it as a Schedule 1 drug citing “imminent hazard to public safety” with “no medicinal use.”
 

 
But hoards of users have vehemently disagreed, calling the ban unfair and unjustified. A petition on Whitehouse.gov against the ban has garnered over 129,000 signatures. These include people suffering from chronic pain, veterans dealing with PTSD, and recovering alcoholics and opioid addicts.
 
Some people who oppose the ban argue that Kratom is a natural means to alleviate their symptoms. But just because a plant is “natural” doesn’t make it safe. Consider the opium plant – that’s natural too, but it’s clearly not safe for unregulated distribution.
 
Still, many people are fighting to lift the ban on Kratom, at least until more research can validate the dangers of this drug in the long-term. So far, Kratom hasn’t been well researched, and the evidence we do have can be conflicting. One pharmacologist, David Kroll, argues that lumping Kratom with other opioids is not fair. “It turns out mitragynine has a very low risk of respiratory depression," Kroll said. "It also appears that it's very difficult to at least get animals, get mice addicted to 'mitra' — either with the herb or with the pure chemical."
 
Hopefully, with the recent publicity, more funding will be available for researchers to study the long-term effects of Kratom. Perhaps in a few years we will know whether Kratom should or should not be banned.
                                                                                                     
Additional sources: Scientific American, NPR
About the Author
  • I am a human geneticist, passionate about telling stories to make science more engaging and approachable. Find more of my writing at the Hopkins BioMedical Odyssey blog and at TheGeneTwist.com.
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