The Syndicate Blog
Dr. Yasir Bari
Monday, December 10, 2018
It hasn’t been long since humans have discovered that their very own invention, the allopathic medicine has failed them enough to damage the health in terms of morbidity and mortality via side effects of the harmful and synthetic ingredients found in those medications; that they are now turning to the Mother Nature again. Herbal medicines are once again are being studied in depth and with every passing day new researches are being published on the natural remedies. So one of the nature’s gifts we are discussing today is the magic herb called the Kratom or also known as Biak, Ketum, Kakuam, Ithang and Thom.
Kratom has been in use in the south East Asian countries like Thailand and Indonesia since centuries as a part of their traditional medicine for the treatment of aliments like opioid withdrawal, diarrhea and as a pain killer. Furthermore, it has also been used to increase energy, stamina, and limit fatigue and as a concentration booster. Since its active ingredients were discovered by the scientists Kratom made it’s well established place in the market as an alternative to many allopathic medicines to treat the problems mentioned above. The leaves of Kratom are consumed either by chewing, or by drying and smoking, putting into capsules, tablets or extract, or by boiling into a tea.
Kratom consumption is primarily motivated by its perceived effects that enhance well-being, occupational performance, and social interactions depending on an individual, as well as serving as a natural “home remedy” that is preferred by millions of Americans to conventional medicines. Like everything else, when used in quantities more than the prescribed usual doses it may produce some undesirable effects like nausea, vomiting dryness of mouth and headaches along with some irritability following the next dosage due to perceived dependence on the drug. This was something which was used as leverage against the consumption of the herb as an alternative medicine by the opponents of Kratom, well that we all know who could be; all the big pharmaceuticals who feared that the growing trend of its use may give strong competition to their harmful and addictive NSAIDs and Opioid derivative.
It doesn’t just stop at opposing the use, they somehow managed to do successful lobbying at the state levels, of course due to the hefty budgets at their back supporting their ambitions to pursue FDA and other drug regulating authorities to issue scheduling on the use of Kratom. Not only that, they were also successful to launch campaigns against its use as an addictive and illicit drug. Even the states where cannabis is now legal have banned the use of Kratom.
When we dig deeper into the actual realities and upon studying the reports issued by the scientists, submitted to FDA and other agencies, some of them were made public as well, it became evident that there were undoubted misunderstandings and meticulous ambitions behind all the negative publicity of the herb. As reported by the Washington Post in December 2016, Jack Henningfield, an addiction specialist from Johns Hopkins University and Vice President, Research, Health Policy, and Abuse Liability at Pinney Associates, issued a 127 page report which was developed to determine the appropriateness of CSA scheduling of kratom and/or its alkaloids and derivative products, and if so, the most appropriate schedule for kratom.
It was concluded by the study that kratom’s potential for abuse, tolerance, and dependence is lower than that of many schedule IV and V drugs and is well within the range of many nonscheduled drugs and substances (e.g., caffeine, nasal nicotine spray, fluoxetine, bupropion, and dextromethorphan). Although kratom and its primary alkaloids MG and 7-OH-MG share certain characteristics with controlled substances, as do many nonscheduled substances, there does not appear to be a public health risk that would warrant control of kratom products or their alkaloids under the CSA. It was suggested that Kratom should be regulated as a natural supplement, such as St. Johns Wort or Valerian, under the FDA's Food, Drug and Cosmetic Act.
Furthermore, people who were actually using kratom and were benefiting from its useful effects it was just like an lifesaving drug for them, relieving them from the suffering of chronic pain or helping people overcome their opioid withdrawals and that numbers in hundreds of thousands are likely to be adversely affected and possibly motivated to seek illicit sources if lawfully marketed kratom were no longer available.
Placing kratom into schedule is just like placing it in the same category as heroin, LSD or marijuana, and prevent access for medical research, a concern for many experts, consumers, and advocacy groups. Lack of quality scientific evidence confounds the evaluation of the safety of kratom. So it would be much more effective if the FDA and other agencies first fund the proper research on the product up to the level of their satisfaction and in line with the health standards before completely banning and lifting it from the market.
The purpose of this document is to review the data related to the abuse potential and toxicity of Mitragyna speciosa (also known as kratom) and its primary alkaloids, mitragynine (MG) and 7-hydroxy-mitragynine (7-OH-MG), and the relevance of those data to the doses found in kratom.
We do not recommend scheduling of kratom or any of its specific alkaloids under the Controlled Substances Act. Kratom has a low potential for abuse and a low dependence liability and there is insufficient evidence of personal harm, adverse health effects or detriment to the public health to warrant control under the CSA.
Effectively banning the availability of kratom through scheduling could precipitate public health problems that do not presently exist or are at very low levels, because this would shift the market place from a largely lawful retail market to illicit manufacturers and distributors with no regulated labeling, purity or content standards, or effective ability to remove adulterated products from the market. Appropriate regulation of kratom under the FDCA is the most effective way to protect the public health by ensuring appropriate access and oversight and to sustain the overall very low adverse personal and public health effects associated with kratom consumption.
Full analysis can be found here