The Kratom Controversy
For those who follow the news surrounding substance misuse and recovery, kratom might not be a new topic. For others, particularly laypeople, kratom might be entirely unfamiliar. No one with a vested interested in the recovery community can afford to remain unaware of the plant, it’s drug classification status, and the drama surrounding its production, distribution, use, and abuse.
Formally known as Mitragyna speciosa, kratom is derived from a tree that grows in Southeast Asia. Its psychoactive properties are paradoxical: in high doses it has a sedating effect, but in smaller amounts it is a stimulant. Kratom affects the same areas of the brain impacted by opiates, though it has a lesser risk of respiratory depression than other drugs in that category, making some users believe it to be a low-risk alternative. However, kratom carries its own problems; namely, liver toxicity, anxiety, seizures, and psychosis, depending on the dose. This has led enthusiasts to claim that, while opiate-like, kratom itself is not an opioid, as it is not derived from nor related to the same chemical family. Nevertheless, the FDA classified kratom as an opioid last month and it will now be subject to a number of regulatory efforts.
While users advocate for the “natural” and “safe” aspects of kratom, the FDA and DEA remain unconvinced, and since 2012 have worked to minimize the importation and distribution of kratom and its active materials. Proponents of kratom say that it is so unlike other opiates that it can be used to assist those with substance misuse disorders in safely withdrawing from more dangerous opiates. In the early 19th century kratom was used for this purpose in Malaysia and Thailand, where it grows in profusion; however, little reliable data has been made available on the efficacy and side effects of this process. Furthermore, since the production of kratom is not done in a methodical, controlled situation, it is far too easy for users to be unaware of the potency, contaminants, or adulterants in the product. A recent salmonella outbreak affecting at least 87 people in the US was tied back to kratom being sold as an unregulated dietary supplement.
As it stands now, the FDA has taken a clear stance by declaring kratom an opioid. This announcement from last month will have a multitude of effects, one being the restriction of indiscriminate sale, and another the incentivization for scientists to study more carefully the effects and risks of the plant and its derivative chemicals.
Kratom is not a “safer alternative” to opiates. It can absolutely be tested for via both urine and blood tests. It can be misused, lead to dependence, and cause serious – even fatal – side effects. Whether the FDA made the right classification decision or not, there is no responsible need for this substance to be widely available, over the counter or through illicit measures.
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