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Title: The DEA Thinks All Kratom Use Is Abuse
Source:
Reason
URL Source: https://reason.com/archives/2016/09 ... thinks-all-kratom-use-is-abuse
Published: Sep 5, 2016
Author: Jacob Sullum
Post Date: 2016-09-07 07:44:02 by Deckard
Keywords: None
Views: 1327
Comments: 5
At the end of this month, kratom will be illegal throughout the United States thanks to the Drug Enforcement Administration (DEA), which last week announced that a ban is necessary "to avoid an imminent hazard to public safety." The way the DEA reached that conclusion provides an illuminating window on the prohibitionist mindset, which dresses pharmacological phobias in the garb of science. Kratom is a pain-relieving leaf that acts as a stimulant or a sedative, depending on the dose. But the most important thing to know about kratom, if you want to understand the DEA's reasoning, is that it's not from here. Kratom comes from a tree, Mitragyna speciosa, that is native to Thailand, Malaysia, Indonesia, Myanmar, and Papua New Guinea. It has gained a following in the United States only recently, hawked by online merchants and head shops as an herbal medicine, "dietary supplement," or legal high. As far as the DEA is concerned, the fact that people in other countries have used kratom for centuries to ease pain, boost work performance, and wean themselves from opiate addiction counts for nothing. All the DEA needs to know is that our shores have been invaded by a foreign drug that is increasingly popular among Americans as a home remedy and recreational intoxicant. From the DEA's perspective, that is intolerable, regardless of the drug's hazards or benefits. If you think I'm exaggerating, consider how the DEA decided that kratom meets the criteria for "temporary" placement in Schedule I of the Controlled Substances Act, the law's most restrictive category. The DEA has at least two years to make that designation permanent, which it almost certainly will do after going through a somewhat more elaborate process of bureaucratic self-justification. For the time being, it need only consider three factors: "the substance's history and current pattern of abuse; the scope, duration and significance of abuse; and what, if any, risk there is to the public health." That exercise is easy, because according to the DEA all use of kratom is abuse and the substance has no benefits. That means any hazards associated with kratom pose an unacceptable risk to public health, even if they compare favorably to those associated with legal intoxicants, over-the-counter remedies, and prescription drugs. "Kratom is abused for its ability to produce opioid-like effects," the DEA says. "Kratom is misused to self-treat chronic pain and opioid withdrawal symptoms, with users reporting its effects to be comparable to prescription opioids." So if you use kratom to relax, relieve pain, or get off heroin, that's abuse. "Kratom is an increasingly popular drug of abuse and readily available on the recreational drug market in the United States," the DEA says. So if you use kratom for fun, that's abuse. Any medicinal use of kratom has to be abuse, the DEA figures, because kratom has not been approved for any indication by the Food and Drug Administration. Nor has the government approved kratom as a recreational intoxicant or a utilitarian stimulant (possibly because no such regulatory categories exist for new drugs), so those uses are also beyond the pale. The DEA's blinkered thinking is especially glaring when it frowns on kratom as a substitute for heroin. "Kratom has a history of being used as an opium substitute in Southeast Asia," it says. "Especially concerning, reports note users have turned to kratom as a replacement for other opioids, such as heroin." So if a heroin addict switches to a less dangerous drug, that is "concerning," even if the switch enables him to taper off his drug use and ultimately stop completely. In other words, even using kratom to reduce drug abuse is drug abuse. With logic like that, it's a cinch for the DEA to conclude that mitragynine and 7-hydroxymitragynine, kratom's main active components, have "a high potential for abuse." In the DEA's view, kratom's only potential is for abuse. Since the DEA assumes there is no rational, morally acceptable reason to use kratom, it does not need to muster much evidence that kratom is intolerably dangerous. That's a good thing for the DEA, because the evidence indicates that kratom is less hazardous than drugs that are legally used for similar purposes. "Serious toxicity is rare and usually involves relatively high doses (more than 15 g) or coingestants," says a 2014 article in the journal Pharmacotherapy by clinical pharmacologist Megan Rech and four of her colleagues at the Loyola University Medical Center in Maywood, Illinois. "Fatalities typically involve coingestants…. Withdrawal has been described as less intense but more protracted than with prescription opioids." A 2015 literature review in the International Journal of Legal Medicine offers a similar assessment. "Kratom is considered minimally toxic," write Florida forensic scientist Marcus Warner and two co-authors, although they add that "research evaluating its toxic effects on humans is limited, with the vast majority of studies involving animals." Warner et al. say "withdrawal symptoms are generally nonexistent to mild, even for heavy users" and note that two Florida counties "have deemed kratom not ready for regulation due to the lack of information demonstrating the substance as being unsafe or hazardous." Warner and his colleagues concur with Rech et al. that there's little evidence kratom is lethal by itself. "Although death has been attributed to kratom use," they write, "there is no solid evidence that kratom was the sole contributor to an individual's death. In most documented instances, mitragynine was detected in combination with other drugs." Pascal Tanguay, a program officer for PSI, an international health promotion organization, in Thailand, was more emphatic in a 2013 interview with MinnPost. "There's never been a single death associated with kratom," Tanguay said. "People have been chewing this for thousands of years with no cases of overdose, psychosis, murder, violent crime. Never in all of recorded history." Although the DEA claims there have been "numerous deaths associated with kratom," it does not cite any deaths where kratom was the only factor. The agency cites 14 deaths "reported in the scientific literature," plus 16 others that "have been confirmed by autopsy/medical examiner reports," meaning that "mitragynine and/or 7-hydroxymitragynine were identified in biological samples." It is not safe to assume, as the DEA does, that every person who ever died after consuming kratom died because he consumed kratom. But even if you overlook that logical fallacy, a grand total of 30 "deaths associated with kratom" in the whole world over the course of centuries is hardly "numerous," and it pales beside the number of deaths associated with myriad legal drugs. Alcohol, for instance, is implicated in about 88,000 deaths a year in the U.S. alone, while 28,000 deaths were attributed to heroin and opioid painkillers in 2014. The DEA plays a similar trick when it cites a report on kratom-related calls to poison control centers that the U.S. Centers for Disease Control and Prevention published in July. From January 2010 through December 2015, the DEA notes, "U.S. poison centers received 660 calls related to kratom exposure." It adds that "during this time, there was a tenfold increase in the number of calls received, from 26 in 2010 to 263 in 2015." Reported symptoms included "agitation or irritability, tachycardia, nausea, drowsiness, and hypertension." An average of 110 cases a year may sound like a lot, but it's not. It represents about 0.004 percent of the 3 million or so calls received by poison control centers each year. By comparison, exposures involving analgesics accounted for nearly 300,000 calls in 2014, while cosmetics and personal care products, cleaning solutions, antidepressants, and antihistamines each accounted for more than 100,000. The DEA not only fails to put the number of kratom-related calls in perspective; it does not mention that two-thirds of the cases were deemed "minor" or "moderate," while only 7 percent (eight per year) were described as "life-threatening." The CDC noted a single death in six years, "reported in a person who was exposed to the medications paroxetine (an antidepressant) and lamotrigine (an anticonvulsant and mood stabilizer) in addition to kratom." These numbers are pretty reassuring, especially since the DEA says "millions of dosage units" are imported into the U.S. each year. But the agency draws the opposite conclusion, saying "such alarming quantities create an imminent public health and safety threat." The DEA makes at least one valid point about the risks of using kratom, which is available from many different vendors, some more reliable than others. "Since abusers [i.e., users] obtain kratom…through unknown sources," it says, "the identity, purity, and quantity of these substances are uncertain and inconsistent." Does anyone outside of the DEA think prohibition will take care of that problem? The agency says the psychoactive leaf must be banned because it has never been approved.
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#1. To: Deckard (#0)
https://www.merryjane.com/news/why-are-states-rushing-to-ban-kratom Written on June 30, 2016 by Here's what you need to know about the potent plant. At low doses, it's a stimulant. At high doses, it's an natural opioid-like painkiller. Why would states rush to ban an opioid replacement that's hundreds of times less deadly than synthetic opioids? The void left by cannabis on the list of banned substances is quickly being filled with a new banned plant, kratom. Kratom is one of the few plants, like cannabis, that has inspired its own advocacy movements to keep it legal. The mysterious traditional plant with origins in Thailand and Malaysia is still new in the United States. In 1943, the Thai government banned kratom, fearing it could destroy the opium tax revenue that the nation depended on. Taking cue from Thailand, the United States is poised to do basically the same thing. America's lucrative big pharma opioid powerhouse could take a beating if kratom use gets out of control. Kratom comes in several varieties—red vein, green vein, and white vein. With popular branded capsules with names like Krave already circling abundantly in the United States, it's inevitably led some states to ban the plant. Six states so far have banned Kratom by putting its active ingredients on the controlled substance list. Alabama became the sixth state to effectively ban kratom. Arkansas, Tennessee, Vermont, and Wisconsin have banned the active ingredients in kratom, and Illinois and Louisiana have banned the substance altogether. Alabama District Attorneys' Association Deputy Director Barry Matson said most counties are giving retailers 24 to 48 hours to dump any remaining product. "The last six months in Alabama is when it's really erupted," Matson told Alabama.com. According to the American Kratom Association, anti-kratom legislation is being drafted as we speak in Florida, Georgia, and Kentucky. Senator Arthur Orr (D-Decatur) sponsored Alabama's bill which places the active ingredients, mitragynine and 7-hydroxymitragynine, as Schedule I. Kratom, in its natural form, is harmless. Mitragynine binds to opioid receptors in the brain, the same receptors that react to morphine, heroin, and oxycodone. While kratom is much less dangerous than painkillers or heroin, it does share some “qualities” like withdrawal symptoms and the habit-forming nature that all opioids possess. Mitragynine doesn't bind as strongly as synthetic opioids, but the same idea applies. Extraction artists have made concentrations of the plant, up to 50 times stronger than the plant's natural form. A 50x extract in reality is probably 7 or 8 times the strength of the plant. This creates a problem. There's really only one redeeming quality of extracts this strong — and that's a gateway drug — a gateway to escape opioid addiction. This could be useful to a pill popper or a heroin addict, but there's really no reason to start a new addiction. "It's not as sweet, but it is relaxing, calming," one user, and former addict, told VICE. Still, there's an enormous difference between synthetic opioids and kratom. Kratom has caused very few reported deaths in its entire history. Opioids, on the other hand, has killed 28,647 Americans. Kratom could become a gateway drug out of opioid addiction, as its ingredients are simply not strong enough to stop breathing—which is what kills most opioid addicts that overdose. "Direct kratom overdoses from the life-threatening respiratory depression that usually occurs with opioid overdoses have not been reported," said Oliver Grundmann, clinical associate professor of medicinal chemistry at the University of Florida. Grundmann and his associates studied the effects of kratom in a 2016 study. Written on June 30, 2016 by A Florida native now living in sunny Southern California, Benjamin Adams writes regularly for CULTURE Magazine, Cannabusiness.com and Direct Cannabis Network. He has been seen in SKUNK Magazine, Treating Yourself Magazine and many other cannabis-related publications. After studying Art at the University of Utah, he's written professionally about art, entertainment, and culture for nearly 10 years. Follow Ben on Twitter @benbot11.
https://www.dea.gov/divisions/hq/2016/hq083016.shtml DEA Announces Intent to Schedule Kratom SE Asian drug is imminent hazard to public safety AUG 30 (WASHINGTON) - The Drug Enforcement Administration (DEA) today announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act in order to avoid an imminent hazard to public safety. Mitragynine and 7-hydroxymitragynine are found in kratom, which is a tropical tree indigenous to Thailand, Malaysia, Myanmar, and other areas of Southeast Asia. The announcement was made in the U.S. Federal Register and can be found by following this link. Kratom is abused for its ability to produce opioid-like effects and is often marketed as a legal alternative to controlled substances. Law enforcement nationwide has seized more kratom in the first half of 2016 than any previous year and easily accounts for millions of dosages intended for the recreational market, according to DEA findings. In addition, 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. These three factors constitute a Schedule I controlled substance according to the Controlled Substances Act passed by Congress in 1970. Kratom has been seized by law enforcement in various forms, including powder, plant, capsules, tablets, liquids, gum/resin, and drug patch. Because the identity, purity levels, and quantity of these substances are uncertain and inconsistent, they pose significant adverse health risks to users. From February 2014 to July 2016, over 55,000 kilograms of kratom material were encountered by law enforcement at various ports of entry within the United States. Additionally, another 57,000+ kilograms of kratom material offered for import into the United States between 2014 and 2016 are awaiting an FDA admissibility decision. Together, this material is enough to produce over 12 million doses of kratom. The FDA has also warned the public not to use any products labeled as containing kratom due to concerns about toxicity and potential health impacts. In addition, FDA has issued and updated two import alerts related to kratom products. Kratom has been on DEA’s list of drugs and chemicals of concern for several years. The American Association of Poison Control Centers identified two exposures to kratom from 2000 and 2005. Between 2010 and 2015, U.S. poison centers received 660 calls related to kratom exposure. The Center for Disease Control (CDC) found that kratom abuse leads to agitation, irritability, tachycardia, nausea, drowsiness, and hypertension. Health risks found in kratom abusers include hepatotoxicity, psychosis, seizure, weight loss, insomnia, tachycardia, vomiting, poor concentration, hallucinations, and death. DEA is aware of 15 kratom-related deaths between 2014 and 2016.
The CSA doesn't define abuse, much less potential for abuse, and DEA documents do show them conflating use and abuse, e.g., www.deadiversion.usdoj.go...s/2001/fr0418/fr0418c.htm A government strong enough to impose your standards is strong enough to ban them. https://www.merryjane.com/news/why-are-states-rushing-to-ban-kratom Extraction artists have made concentrations of the plant, up to 50 times stronger than the plant's natural form. A 50x extract in reality is probably 7 or 8 times the strength of the plant. This creates a problem. There's really only one redeeming quality of extracts this strong — and that's a gateway drug — a gateway to escape opioid addiction. This could be useful to a pill popper or a heroin addict, but there's really no reason to start a new addiction. The CSA has not told you clearly enough how habit forming opioids that create withdrawal symptoms could possibly have even a potential for abuse. Beauty is only skin deep, but stupid is to the bone.
Move those goalposts - the DEA claim was a HIGH potential for abuse. A government strong enough to impose your standards is strong enough to ban them. Why Are States Rushing to Ban Kratom?
Ben Adams
Ben Adams
#2. To: Deckard (#0)
August 30, 2016
Contact: DEA Public Affairs
(202) 307-7977
#3. To: nolu chan, Deckard (#2)
a high potential for abuse
#4. To: ConservingFreedom (#3)
The CSA doesn't define abuse, much less potential for abuse, and DEA documents do show them conflating use and abuse
While kratom is much less dangerous than painkillers or heroin, it does share some “qualities” like withdrawal symptoms and the habit-forming nature that all opioids possess. Mitragynine doesn't bind as strongly as synthetic opioids, but the same idea applies.
#5. To: nolu chan (#4)
could possibly have even a potential for abuse.
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