War Against Kratom Heats Up

Published August 27, 2015

Florida has become the latest front in the war against kratom—a substance derived from a tree whose leaves can be brewed as a tea to relieve pain and anxiety, but can also produce feelings of euphoria. Opponents of kratom say it is highly addictive, claiming it is responsible for several deaths and increasing emergency room visits across the country since it was introduced to the United States from Southeast Asia.

Currently, kratom is banned in two countries where it is grown: Malaysia and Thailand. It is also banned in Australia and Burma, as well as in Indiana, Tennessee, Vermont, and Wisconsin. There is also a ban in Sarasota County, Florida.

State Rep. Kristen Jacobs (D–Broward) filed House Bill 287 in the Florida House of Representatives in January 2015. Her bill would have made kratom a Schedule I controlled substance in the state, classifying it as a drug with a high potential for abuse and no medical benefit. About the same time, state Sen. Greg Evers (R-Pensacola), introduced Senate Bill 764 in the Florida Senate in February. Neither bill made it out of committee.

Opponents of the kratom ban say efforts to ban use of the substance are misguided. They say it is quite safe if used properly in its unadulterated form.

Used As Traditional Remedy

Kratom is a natural botanical substance that shares many biological similarities to coffee and has been used for hundreds of years by Southeast Asians as a stimulant, sedative, anti-diarrheal, and painkiller.

In the United States, kratom is popular as an over-the-counter analgesic and is used as an alternative to prescription drugs for severe pain, multiple sclerosis, and fibromyalgia. Kratom users see it as a natural solution for persistent aches and pains without the side effects of many prescription or over-the-counter medications, says Susan Ash, director of the American Kratom Association (AKA).

Gail Charnley, a toxicologist, human health risk expert, and principal of HealthRisk Strategies, says science has yet to identify kratom’s precise effects.

“There is no large body of evidence from many well-conducted and replicated scientific studies either supporting or refuting the efficacy of kratom,” Charnley said. “On the other hand, people have used it for hundreds of years based on their belief it reduces pain and improves energy.

“In the body, kratom interacts with special cell receptors associated with alleviating pain,” Charnley said. “It can also act in a way similar to adrenaline, which is why some people report it makes them more alert and energetic.”

Ash said, “We’ve found what we believe to be a superior, healthier choice to dangerous and sometimes deadly pharmaceutical medications, and our right to that choice is being threatened because of a few user reports from people obviously consuming something other than natural kratom.”

Purity, Dosage, Interactions Crucial

Despite enthusiastic support from users, kratom is considered dangerous by many legislators, regulatory agencies, and law enforcement agencies. A fact sheet on kratom released by Jacobs’ office stated the drug is addictive and can cause psychotic symptoms, including hallucinations, delusions, and confusion. It claimed long-term users experienced anorexia, weight loss, insomnia, and darkening of the skin.

Failures to understand the differences between the naturally occurring kratom plant and concentrated or adulterated kratom have led to misguided, although well-intentioned, regulatory efforts, Ash says. Charnley stresses the importance of dosage levels, purity, and interactions in the use of kratom and other drugs.

“What scientists know about its mode of action in the body and what we’ve learned anecdotally from hundreds of years of its use around the world indicate that, when used cautiously and according to product instructions, kratom can be used safely,” Charnley said. “Any drug or supplement can have side effects in some people, so it should be used cautiously and only according to product instructions,” she said.

“Side effects have been reported when people have abused kratom by taking it in combination with other substances that act like morphine,” Charnley said. “Taking morphine-like anti-pain medications in combination can cause overdosing problems, just like taking too much of any drug alone. For example, ‘Krypton’ is a combination of kratom and a powerful pain medication called O-Desmethyltramadol, which can be dangerous when abused.”

Instead of imposing additional laws and regulations, law enforcement agencies should target the criminals who turn the natural kratom plant into a dangerous substance, Ash says.

Jeff Stier, a senior fellow at the National Center for Public Policy Research, says an overreaction by government can distract from the real problem, which is adulteration and abuse of the substance.

“There’s a long history of overregulation [by government], including the prohibition of alcohol and relatively harmless drugs, and the outcomes always look alike,” said Stier. “[There are] more black markets, less quality control, and a forced shift to less appealing but higher-risk alternatives.

Suicide Caught Attention

Dave Murzin, legislative assistant to Evers, says a widely reported suicide of a kratom user and the spread of kratom to bars, smoke shops, and other retail businesses in other districts grabbed legislators’ attention.

“Kratom was being sold in businesses located right next door to their offices, in some cases,” Murzin said. Despite the negative publicity, the effort to regulate kratom generated little enthusiasm among the public, Murzin says.

“Nearly all the calls, letters, and e-mails sent to Sen. Evers’ office were against regulation,” he said.

Kenneth Artz ([email protected]) is managing editor of Health Care News.