Kratom is a tropical evergreen tree found abundantly in Southeast Asia. It is native to the forest regions of Indonesia, Malaysia, Thailand and Papua New Guinea. Kratom, the name originated from Thailand where it has been used extensively for medical purposes. It belongs to the plant family Rubiaceae. That places it in the same family of coffee and gardenia.
The kratom leaves can be consumed by chewing or after drying. It can be ingested as tablets, capsules or extracts. In ancient times, it has been an ingredient of tea.
The specialty of kratom is that it produces unique stimulation at lower doses. At higher doses, it produces euphoric and opioid-like depressant effects. This unique property of kratom makes it an ideal ingredient in the treatment of pain. It helps to prevent withdrawal symptoms from opiates such as heroin and other prescription narcotics. It is also used for mild stimulation for specific medical conditions.
Kratom leaves have been used in traditional medicine in Thai and Malaysian population for centuries. It increases stamina, energy and reduces fatigue. It has been used as a stimulant by workers in Southeast Asia. Its use has been lost in the modern times due to lack of knowledge by the current population. This herbal product has become popular in the United States also.
It has found medical applications in the treatment of diarrhea and muscle pain relief. Kratom has also become useful for the treatment of opiate addiction and withdrawal. Several doctors and medical practitioners have seen the benefits of kratom first hand and have supported the legal use of this plant extract.
An opioid epidemic in the US
Recently there have been reports of misuse of intravenous drug abuse. It has created a public health epidemic in the United States. Driven by heroin, prescription opioids, and other deadly synthetic opioids, there have been 64000 deaths due to drug overdoses in 2016 itself. To put it in perspective, it is more than the total death toll of the Vietnam War.
This opioid epidemic in America started in 1990’s and had started growing in 2000’s when opioids are prescribed for pain by doctors. There were various factors for the crisis to go unnoticed for years including doctors believing that these drugs were safe, aggressive pumping of pills by pharmaceutical companies into the market.
It seemed like a fast, efficient health care system that gives quick fixes. This led to the proliferation of opioid prescriptions. The US became the leading user of these prescription opioids in the world.
When FDA started to regulate these prescription opioids, people began to turn towards heroin. From 1999 to 2008, drug overdose has steadily increased as the sales increased.
As per the DEA (Drug Enforcement Administration), the drug overdose deaths have reached epidemic levels by 2016 causing more deaths than guns or car accidents.
Fentanyl is an extremely potent opioid and is the primary contributor to fatalities. Over half of the overdose deaths were accidental.
At the end of 2016, it became clear to policymakers that urgent action is critical. This opioid crisis has changed the social, moral and cultural resistance to street drug alternatives, e.g., heroin.
In 2017, various states have declared a state of emergency to control the opioid epidemic. It is now considered as one of the biggest medical crisis to be tackled by FDA. In October 2017, President Donald Trump declared United States’ opioid disaster as a public health emergency.
In 2017, the Department of Health and Human Services announced their opioid strategy that has the following five measures:
- Improving access to the prevention, treatment and recovery support services for enabling individuals to recover from the opioid addiction.
- Improving the availability and distribution of overdose-reversing drugs giving the much-needed medication for people in high-risk areas.
- Strengthening public health data reporting and collection thereby improving the quality and timeliness of data.
- Providing support for cutting-edge research that helps in understanding pain and addiction. Any potential new treatments, medicines and effective public health interventions to reduce opioid-related harms.
Advance innovations in pain management to increase access to high-quality pain care that is supported by evidence thus aiming to reduce the burden of pain for patients, families, and society.
Kratom has come under the radar of FDA (Food and Drug Administration) and DEA (Drug Enforcement Administration) owing to increase in reported opioid deaths. This has led to the rigorous monitoring inspection of kratom supplies by FDA citing reasons of overdose deaths due to possible kratom abuse. However, the decision has not been substantiated with any hard evidence.
In 2016, DEA has attempted to criminalize the use and possession of kratom before withdrawing the proposal because of massive public outcry.
Kratom came under the scrutiny when some chronic kratom abuse cases were reported in some of the hospitals. The cases include respiration suppression, seizures and ultimately death. However, there has not been a detailed study into these cases as for how much kratom consumption has led to this issue.
Need for regulation and scientific study of Kratom
Kratom supporters all over the country have expressed their concerns in various forms. They have pointed out the beneficial effects of kratom in reducing pain and opioid addiction. Kratom is a herb that can reduce anxiety and limits mood disorders. There have been substantial scientific studies that show the potential of kratom use in positive mental health.
Scientists have petitioned the FDA, highlighting the benefits of kratom on patients and medical community as a whole. They have pointed out that kratom is the lifeline for countless people who are recovering from drug addiction. If the ban is instituted without proper scientific evidence, then it would be the most significant social injustice to the community.
According to the lead author Marc T. Swogger, Ph.D., associate professor in URMC’s Department of Psychiatry, “kratom studies confirms that there is no co-relation between kratom use and psychosis, suicide, and violence. The public administration does not indicate kratom’s contribution in public health issue”.
Swogger and his counterpart Zach Walsh collated 13 studies about kratom that have been conducted from 1960 to 2017 containing data of over 28,000 individuals.
There needs to be encouragement on the proper scientific study of kratom on the potential benefits. This can help both the government and public in regulating the drug more productively.
Scientific facts can help regulators make informed decisions about the kratom use.
While there are cases of kratom abuse, they are extreme outliers and do not represent the broader population that uses the drug for medicinal purposes. The regulation needs to be based on ground reality taking account of the effects on ordinary people who depend on kratom for their drug addiction treatment and pain relief.
According to most researchers, it is time for rigorous, prospective studies that are well controlled to support a nuanced, sophisticated understanding of the plant.
Various data collected over state populations indicate that kratom has a legitimate use in mitigating effects of opioid dependence. Large quantities of research available today shows that kratom can be a less addictive substitute with milder effects. It is less dangerous than most opioids and the chances of fatal deaths because of kratom is less likely.
However, vendors are selling different strains with their own names and difficult to understand which strains are for what purpose. It is necessary to have a proper regulation dictating the allowed contents and concentration in kratom drugs. This will help patients and doctors not to fall victim to fake medications that tarnish the image of kratom.
Better and well-guided research can outline the benefits and risks associated with kratom in-depth detail. Only through disciplined scientific analysis, it is possible to find out the truth related to kratom benefits as well as the harm. It will also provide the much-needed information for policymakers, public and healthcare professionals to make informed decisions.
The federal government should make rational decisions backed by sound data to understand the potential effects of kratom on the human body. It is in the interest of consumers to encourage active research and formative regulations on kratom thereby nullifying any adverse effects.
Recent comprehensive review on Kratom
Though the debate is still going on which are the best ways to fight against the opioid addiction in the US, several residents have started using alternate medications for self-treatment.
Kratom is now a legal and readily available substance which has a lower risk of having any side effects and low dependency as compared to any other treatments. Therefore, various users have claimed that it can be used to manage pain and reduces their dependence on using opioids.
With its increased usage, the concerns for any potential risk has also highlighted. After hearing so many terrible things about Kratom in a recent systematic analysis about the potential dangers associated with Kratom. The most comprehensive one, till date is done, wherein all such claims where questioned. Along with that, a blueprint for the future research for the clinical benefits and side effects of Kratom is being submitted.
Dr. Marc. T. Swogger along with Dr. Zach Walsh have stated about their findings that people are using Kratom for various purposes, mainly to help them cope up with the opioid withdrawal. They further stated that in their findings they hadn’t found any evidence which can prove that kratom can cause any negative mental health, such as anxiety, depression or suicidal ideation.
They have provided this finding based on their 57 years of research done on kratom. They say that the plant can help in improving mood as well as relieves symptoms of mild to moderate anxiety. They clearly mentioned that the research supports kratom’s benefits. It is less dangerous than opioids, less addictive, and can’t cause a fatal overdose.
Though the review shows that kratom has few signs of dependency but its mild and might result in symptoms like irritability, headaches or nausea. This is because the plant belongs to the coffee family and might have similar effects which we see with coffee.
The reason behind all the negativity is not kratom, but the less information and more misleading information available about it which doesn’t state explicitly about its risks or benefits. They even said that various claims made by the FDA has no base and there is no reliable source to it.
While concluding they said that more research should be done so that everything can be as transparent as possible. They even said that every painkiller has its side effect, in the same way, kratom can also have some side effects if used for long-term. Therefore, only intense study based on clinical trials over a long haul show its harm as well as medicinal benefits.
Recent Salmonella outbreak in the US is linked to Kratom
Recent salmonella breaks also need regulations. On February 2018, it was reported by the US Center for Disease Control and Prevention that kratom use is the reason for 28 salmonella infections that outbreak in 20 states.
This infection in multiple states has been sudden in which 11 people with severe salmonella infections are being reported. There were no deaths reported in the incident.
There has been no concrete evidence directly linking kratom to the diseases except for the fact that all of them consumed kratom in tea, powder or pills. However, no common distributors have been identified in this case.
This incident needs to be scientifically studied before decided that kratom is the reason for this.
Local media spreading false information about Kratom, calling the supplement potentially “deadly” and dangerous
Because of the opioid crisis, there has been misinformation about kratom being a reason for opioid deaths. There have been media speculations about the potential of kratom to be deadly and dangerous. The allegations of the local media have no substantial proof as they have not done a detailed investigation into the kratom use, in case of overdose deaths.
In the opioid crisis, regulators are looking for a quick fix solution without researching into the statistics of kratom use in the opioid crisis.
Fake news” of Kratom deaths published by a reporter Hannah Lawrence’s of WTVC NewsChannel 9 on October 17, 2017 is one such example.
Another false and misleading story was published by a reporter Bobeth Yates of cbs46 news on Apr 07, 2018. The reporter claimed that Kratom is being “reclassified as a Schedule 1 drug by the FDA, which is totally untrue. Kratom is currently legal in the US except for few states and cities.
The misleading information about kratom has affected millions of Americans who depend on it. Kratomt has been used for drug withdrawal treatments, and the ban would ruin their lives.
Over the past few months, there have been rallying support from the supporters of kratom. American Kratom Association has filed a formal demand for FDA to take back their misleading and unsubstantiated advisory on coffee-like herb kratom.
Leading scientists from all over the country have supported the use of kratom. They have pointed to the hurriedness and inconsistency of the data used by FDA in justifying the false public health advisory.
Kratom has more positive effects and has become an essential drug for many to get relief from pain. Local media is spreading false information about Kratom, calling the supplement potentially “deadly” and dangerous.
Conclusion
Kratom supporters have rallied together seeking better management of the situation with the help of scientific studies rather than blinding banning kratom because of unrelated deaths.
Recently the first Kratom summit has showcased the overwhelming support that is available for the drug. Kratom is essential for millions of drug addicted Americans to come out of it and lead a healthy life.
