Kratom:The Legal High That Treats Chronic Pain and Addiction

Will Deadheads and Doctoral students join forces to put a stop to this DEA ban?

Posted Oct 08, 2016

Supporters will tell you that the herb kratom relieves pain, dampens depression, and counters anxiety.

Scientists report it plays a role in treating chronic pain, and may cure addiction to opioid medications.

Nonetheless, the United States Drug Enforcement Administration (DEA) announced several weeks ago that it intends to halt kratom’s unrestricted availability in this country, citing an “imminent hazard to public safety,” and planning to achieve this through designating kratom a Schedule 1 drug; translation: it will be in the same class of drugs as heroin, LSD, marijuana, and ecstasy.

The Agency’s decision is based on the concern that kratom has a high potential for abuse, and little proof that its use produces medical benefit.  As you might imagine, this imminent regulatory roll-out has rallied opponents of every ilk and many illnesses:  Almost 150,000 people signed a petition asking the federal government to reconsider, and my guess is that research scientists were among the signatories, as the banning of kratom would likely result in a grinding halt to the research that is being undertaken to assess the impact of kratom on chronic pain and addiction.

None other than the American Kratom Association (AKA) is calling on its website for “a reasonable comment period for the public, scientists, and other stakeholders to submit data and other relevant information on kratom.”  Their latest update:  “We survived another week without the DEA issuing its final notice!!!  But rumors are flying that DEA will publish an update to their proposed scheduling action as early as Tuesday (Monday is a holiday).  While it is not expected to be a final notice, it will likely provide for some time for public comment.”

Saved by Columbus Day.  (Finally, a use for this holiday, so politically incorrect for so many years?)

Derived from a tree (Mitragyna speciosa korth) grown in Southeast Asia, kratom has become increasingly popular as an alternative to opioids, both to treat pain and to ease opioid withdrawal. It is also used recreationally for both its stimulant and its relaxation properties.  Its leaves have been used for centuries to relieve pain.  Other names for kratom include Thang, Kakuam, Thom, Ketum, and Biak. This botanical can be eaten raw, but more often the leaves are crushed and brewed as tea; and the more industrious have formulated kratom into capsules, tablets, and concentrated liquids.

In low doses, kratom acts as a stimulant. In large amounts, it has sedative properties, and the DEA says it can lead to psychotic symptoms and psychological addiction.  The National Institute of Drug Abuse has identified kratom as an emerging drug of abuse. Published case reports have associated kratom exposure with psychosis.

According to the Centers for Disease Control and Prevention (CDC), as reported recently in their publication,” Morbidity and Mortality Weekly Report,” many kratom use mishaps occurred between 2010 and 2015, the period for which the most recent numbers are available.  Medical outcomes associated with kratom exposure were reported as minor (minimal signs or symptoms, which resolved rapidly with no residual disability) for 162 (24.5%) exposures, moderate (non-life threatening, with no residual disability, but requiring some form of treatment) for 275 (41.7%) exposures, and major (life-threatening signs or symptoms, with some residual disability) for 49 (7.4%) exposures. One death was reported in a person who was exposed to the medications paroxetine (an antidepressant) and lamotrigine (an anticonvulsant and mood stabilizer) in addition to kratom. 

The DEA says it knows of 15 kratom-related deaths between 2014 and 2016.

In mice, kratom targets a part of the brain that responds to drugs such as morphine, codeine, and fentanyl, according to a study published recently by a researcher at Memorial Sloan Kettering Cancer Center in New York.  But it was not found to cause the potentially fatal respiratory depression normally seen in the opioids morphine, codeine, and fentanyl.  And there are other reports that withdrawal from the drug only causes a little bit of nasal congestion, and has allowed for a more gentle withdrawal from opioids in those addicted to opioids.

Anecdotal reports suggest it is less addictive than opioids, and there are many companies in the United States that advertise it as a legal high.  In contrast, several Southeast Asian countries have outlawed it because of addiction concerns.

Scientists are holding out hope that the looming DEA ban will not stifle research, as  some of the compounds in kratom might at the very least be proven useful as the basis for the development of better drugs.

Will Deadheads and Doctoral students join forces to put a stop to this DEA ban?  Time will tell.

In the meantime, don’t be surprised should you see all across these United States a motley crew consisting of haggard-looking scientists in their white coats and millennials with runny noses, patiently standing in the queue at the local GNC.

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