Kratom: Innocuous Pain Reliever or Dangerous Drug?

DEA sees no medical use for tropical plant

Kratom, a relative of the coffee plant, is a tropical tree native to Southeast Asia. According to David Kroll, a pharmacologist and medical writer, farmers and indigenous people have used it for hundreds of years both as a stimulant to increase work output and as a way to relax at the end of the day. The leaves are brewed like a tea; crushed and mixed with water; or pulverized and put into capsules.

In August, the Drug Enforcement Administration (DEA) announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act—the same category as heroin and LSD. According to the DEA, kratom has a high potential for abuse; has no currently accepted medical use in treatment in the United States; and has a lack of accepted safety for use under medical supervision.

In protest to the DEA’s decision, people have uploaded hundreds of videos talking about why they drink kratom concoctions or swallow kratom pills––veterans coping with post-traumatic stress disorder, recovering alcoholics, people with fibromyalgia. A petition on to keep the plant legal has garnered more than 118,000 signatures.

The DEA attributed 15 deaths to kratom between 2014 and 2016. Critics call it a legal heroin, ripe for abuse and addiction.

Kroll, however, said it is going overboard to classify the plant as a dangerous drug. “Kratom being lumped in with other opioids is both unfair and unscientific,” he said. “It glosses over the subtleties of how the main chemical in kratom actually works.”

That chemical is mitragynine. It binds to some of the same receptors in the brain as opioids, providing pain relief and a feeling of euphoria, but, Kroll said, not the same high. And the chemical doesn’t cause the same adverse effects as opioids, such as respiratory depression, he added.

“It turns out mitragynine has a very low risk of respiratory depression,” Kroll said. “It also appears that it’s very difficult to get mice addicted to ‘mitra’—either with the herb or with the pure chemical.”

Kroll worries that a kratom ban could force people back to opioids or alcohol. And, he says, it would obstruct scientists’ efforts to research the possible risks and benefits of the plant.

From February 2014 to July 2016, law enforcement officers encountered more than 55,000 kg of kratom material at ports of entry in the United States, according to the DEA. In addition, another 57,000 kg of kratom material offered for import into the U.S. between 2014 and 2016 are awaiting an FDA admissibility decision. Together, this material is enough to produce more than 12 million doses of kratom.

Sources: Kaiser Health News; September 20, 2016; and DEA; August 30, 2016.