5 ms·

I don't agree with the ban, but it seems like the risks of kratom are not discussed, and in fact even downplayed by saying hey, it's just a plant. To help me b

I don't agree with the ban, but it seems like the risks of kratom are not discussed, and in fact even downplayed by saying hey, it's just a plant. To help me be an informed reader I would like WaPo to mention: 1) If you search kratom withdrawal there are a ton of anecdotal reports that sound pretty unpleasant if not debilitating. 2) What is the frequency of severe side effects, as best as can be known? 3) That "natural" substances or "plants" are not always safe. This misconception is so common and dangerous it shouldn't be used to mock the ban (real logic will suffice). https://web.stanford.edu/~jpc/overture.htm https://web.stanford.edu/~jpc/overture.htm There are plenty of valid reasons to argue against a ban. For example the chill on research, the low rate of fatalities, the likelihood it will make use more dangerous, and the probability a ban would have no net benefits.

cmdrfred 10y ago
In medicine, you have to show a drug is more effective (or as effective) and is as safe as existing drugs for a purpose in order to get FDA approval. Why not take a similar stance on drugs for recreational purposes? If it is as safe or safer than alcohol or tobacco, approve it.
- unethical_ban 10y ago
  Au contraire, a substance should only be banned from consumption if it is shown to be highly addictive, and life-threatening if overconsumed. Or something like that. I don't believe something should be banned until presumed completely safe.
  - slowmovintarget 10y ago
    >>highly addictive, and life-threatening if overconsumed You mean like caffeine or nicotine?
    - unethical_ban 10y ago
      No. 1) Addictive as in, one "normal" dose causes high physical addiction. 2) Lethal, more specifically that it is easy to overdose, or that the difference between "normal" and LD50 is low. You don't get hooked on caffeine after one coke, and it's hard to kill yourself drinking too much coffee.
      - scottmf 10y ago
        Which drugs cause "high physical addiction" with one dose?
      - Broken_Hippo 10y ago
        It is pretty rare for anyone to get addicted to a drug after one dose. Even for things like heroin. I think I've read that at most, there is a 25% chance of addiction. Still high, but still below the thresh hold. But admittedly, it is rather hard to sort out fact from propaganda here. (and heroin does have that second one, I'm guessing).
    - eutectic 10y ago
      Little known fact: pure nicotine is hardly addictive. The Mono-amine oxidase inhibitors in tobacco really ramp up its addictive potential.
  - drivingmenuts 10y ago
    Make them all legal, tax the hell out of it, and put that toward substance abuse programs. The ones who can't handle their addictions will cease to be a problem soon enough.
- csours 10y ago
  I upvoted you for adding to the discussion.
- rms 10y ago
  Tobacco and alcohol are unusually dangerous in the scheme of drugs. I don't disagree with your intention to relax restrictions behind drugs, but if this logic was followed, nearly every drug would be legalized, which is not the goal of the government of the USA.
  - cmdrfred 10y ago
    If that is true, and your end goal is truly safety, why doesn't the FDA and DEA advocate for the criminalization of those drugs as well? I have been told that the argument is that prohibition caused violence and crime, but so does the prohibition of heroin so that logic doesn't seem to hold.
    - alexbecker 10y ago
      Because it would be politically impossible? (I would also argue that the DEA's goal is not safety.)
- deleted 10y ago
  [deleted]
- BurningFrog 10y ago
  If that rule is so great, can we afford not to use it everywhere? Let Pepsi, Toyota and Apple prove they're better than Coke, Ford and Microsoft!
- GordonS 10y ago
  This has been done. Mitragynine and 7-OH-mitragyine (the primary alkaloids in kratom) do not recruit β-arrestin[1], which os what causes typical opioid side effects - including respiratory depression. It is this that kills when you overdose on almost every other known opioid drug. This really is huge deal. Less importantly, but still relevant, it also doesn't cause anywhere near the level of constipation that pharmaceutical opioid drugs cause. It also activates both mu and delta opioid receptors, which is perhaps why I personally find it is so much more effective for neuropathic pain than the more common mu-opiod pharmaceutical drugs. [1] http://pubs.acs.org/doi/abs/10.1021/jacs.6b00360?journalCode=jacsat& http://pubs.acs.org/doi/abs/10.1021/jacs.6b00360?journalCode...
rms 10y ago
Kratom withdrawal is unpleasant. Debilitating withdrawal is uncommon in people that aren't taking heroic doses to self medicate their addictions to other opiates, therefore punting the withdrawal symptoms down the road. Acute kratom withdrawal is shorter than for long acting pharmaceutical opiates, but post acute withdrawal syndrome (PAWS) can be dragged out because kratom has some poorly documented and poorly understood non-opiate-related antidepressant actions. It has unusually complicated pharmacology with interesting combinations of conflicting, competing, and synergistic mechanisms. https://drive.google.com/file/d/0BwMPT92bOJKdZWM2bzlLeU5DdDg/view https://drive.google.com/file/d/0BwMPT92bOJKdZWM2bzlLeU5DdDg... is the letter from the American Kratom Association to the DEA, which compares the number of kratom related calls to poison control centers to calls related to supplements. Kratom seems to be at about the same level as ginkgo biloba and better tolerated than St. John's Wort. This is surprising, and has resulted in weird errors in literature reviews on kratom, that I've spent dozens of hours trying to unpack during my efforts to improve the Wikipedia article. Kratom seems to have a really surprisingly low incidence of severe side effects. The state of the information out there is weird. Something like someone said "Kratom is a mu opioid agonist and mu opioid agonists cause respiratory depression" in a peer reviewed paper, which then got cited in a medical textbook as "Kratom causes respiratory depression". However, primary research in mice shows that kratom causes dramatically less respiratory depression than poppy derived opioids. No case of kratom related respiratory depression has actually been documented in a human. In my comprehensive review of the literature, there was someone who had a seizure and was intubated but still had respiration in the normal range. Someone else suffered aspiration pneumonia in response to (inhaling?) kratom, but aspiration pneumonia is not respiratory depression. Basically, kratom does have side effects, and real side effects, but when looked at as a population level public health problem, is profoundly safe for how powerful of an effect it actually has.
- darpa_escapee 10y ago
  I, unfortunately, have extensive experience with kratom and kratom extracts. Today, I am 5 years clean of kratom and all narcotics. I bought the "kratom is non-addictive and can improve your life" line fully as a teenager. What ensued was indistinguishable from a full blown opiate addiction. I ended up in in-patient detox to finally quit and, five years later, have not regained all that I had lost during that time. Just because kratom has a high threshold for overdose does not mean it is not an opioid. Edit: Keaton != Kratom
PostOnce 10y ago
A whole bunch of plants can kill you, we haven't banned nightshade, most mushrooms, poison ivy, green potatoes lol. Let's ban poison ivy. Let's ban going outside without sunblock on. Let's ban walking around without a bicycle helmet on. Let's have the govt come into my office every two hours and remind me to get up and walk around and stretch. At some point, people have to take care of themselves. How many kratom addicts have you ever had a problem with? And how many problematic interactions with a drunk? We aren't banning alcohol either.
- toss1941 10y ago
  And there is strong evidence that Kratom curtails alcohol addiction. Kratom is amazing. It has anti-depressive effects that once fully understand I believe will usher in a new and vastly superior wave of anti-depressants. To schedule 1 this plant is beyond insane. Banning it is the bunny brained idea of a lunatic. The DEA is completely out of touch with reality or some special interest is pulling their strings.
  - WhitneyLand 10y ago
    Strong evidence? Citations please.
    - GordonS 10y ago
      On mobile now, so can't give examples, but do a search on Google scholar and you really will find plenty evidence there
      - rms 10y ago
        Really? I tried doing this search and can't find much. I'm pretty up on the state of the scientific literature on kratom, because I'm in the industry, curious, and have been actively working at improving the dreadful wikipedia article. There's this case, http://www.sciencedirect.com/science/article/pii/S0924933811717618 http://www.sciencedirect.com/science/article/pii/S0924933811... , but it's a case of one. There are some cases of simultaneous kratom and alcohol dependence, but that's not the same thing. Even the peer reviewed evidence for kratom working for opiate withdrawal is quite weak, despite boatloads of anecdotal evidence. There are studies in mice and some observational studies, but nothing that meets the standards of an FDA clinical trial. Kratom has just not really been seriously studied. If I'm missing some papers or a body of research, please let me know.
M00n_Sl47r 10y ago
Long term kratom use can cause a dependence, and the withdrawals are very very similar to heroin/morphine withdrawals. regarding your second point, I cant find any hard sources, but my experience has been that unless one is doing WAAYY too much kratom, both per dose and over longer periods of time. Unless you are already an opioid addict trying to use kratom to maintain and kick a harder habit (the well known use is as a transition from dope), you should NOT be doing kratom every day.. unless you're trying to become one of the aforementioned addicts. On 3, definitely, it's a ridiculous misuse of the conception that natural is healthy. What if I told you to go out and do datura (Stramonium, iirc), or nightshade (makes you so pretty!). Both just as natural, arguably moreso considering you have to process kratom leaves, whereas you can go from finding a datura or nightshade family plant to eating it in seconds.
- GordonS 10y ago
  > withdrawals are very very similar to heroin/morphine withdrawals Source please. Anecdotal evidence from those that have gone through both heroin and kratom withdrawals generally say coming off kratom is extremely easy by comparison. It's also worth noting that, anecdotally (and I include myself here), for many people coming off kratom is easier than stopping drinking coffee.
- Stanleymilgram 10y ago
  This is ridiculous! First, please become informed before posting on a subject you clearly know little about. Second, in your "aforementioned" comment, you did not differentiate between uei and plain leaf kratom. This means you are either a "plant", or just a complete m. I know first-hand that coming off daily use of plain leaf kratom is a cakewalk compared to pharmaceuticals like methadone. Kratom is very similar to stopping your daily cup of coffee. You do not have 2 weeks of severe withdrawal nor do you have years in a state of PAWS. Also, if you think man made drugs like methadone are safer than natural substances like kratom, you need to head back to your big pharma office. Kratom is safe when taken in moderation. It will not kill you DEAD because when you take too much, it induces the users to vomit. It does not cause a complete shutdown of your cns! And when used daily for anxiety or other ailments, it is much safer than big pharmas "non natural" poisons. All big pharma concoctions can kill you and "accidental" overdoses occur every minute in the US on a daily basis. You are wrong and I question the sincerity of your comment.
nikcub 10y ago
Most modern nations accept opiate substitution therapy (OST) as the most effective way to treat opiod addiction. The entire premise of OST is that you substitute a bad opiate for a "less bad" opiate - and Kratom is looking like one of the best "least bad" candidates we've ever seen. Nobody is delusional about the effects of Kratom or downsides - all drugs have downsides. I've never seen it mentioned or recommended outside of opiate substitution and for opiate addicts - it has no value as a recreational drug.
- kristopolous 10y ago
  Do you think it's the Subutex and Methodone manufacturers using legal muscle since they can't patent and monopolize this alternative? Reckitt Benckiser, maker of Suboxone has fought hard against generics being available. I will save my criticism of the moral implication of such a position because the English language doesn't provide me enough words to express it.
  - nikcub 10y ago
    Think if Reckitt had any sway they'd want loosening of the restrictions on doctors to prescribe suboxone. Currently only 10,000 of the 800,000 doctors in the USA are prescribing suboxone - wait lists are long and the per-doctor cap is rising very slowly.
    - kristopolous 10y ago
      Yeah, those restrictions are a completely insufficient response to the growing problems. I had a friend fighting heroin addiction live on my couch for a year while I tried using my money and time to help him through. The biggest problems (now we are getting off topic) are * lack of recovery groups for atheists. The conventional twelve step programs claim they'll work for atheists but the act of faith plays such a crucial and fundamental role, that someone who is faithless really won't work in the program. * an unspoken internal conflict of process. Institutions of rehab strongly disagree on methodology and there's this culture where most seem to have one elaborate and very specific process. Using multiple resources can be mutually exclusive and impossible. * rehab in general is structured terribly. The reality is that someone serious about recovery ends up living with a bunch of strangers who may not be. It's like a zombie movie, one bad apple can spoil the bunch. There has to be a better way. * a lack of reliable or convenient access to medication. These people know how to get street drugs. When they have to travel 30 miles and show up between 6 and 7:30 am to get methadone while heroin is an SMS away and gets delivered, there's a problem.
deleted 10y ago
[deleted]

cmdrfred 10y ago

In medicine, you have to show a drug is more effective (or as effective) and is as safe as existing drugs for a purpose in order to get FDA approval. Why not take a similar stance on drugs for recreational purposes? If it is as safe or safer than alcohol or tobacco, approve it.

unethical_ban 10y ago
Au contraire, a substance should only be banned from consumption if it is shown to be highly addictive, and life-threatening if overconsumed. Or something like that. I don't believe something should be banned until presumed completely safe.
- slowmovintarget 10y ago
  >>highly addictive, and life-threatening if overconsumed You mean like caffeine or nicotine?
  - unethical_ban 10y ago
    No. 1) Addictive as in, one "normal" dose causes high physical addiction. 2) Lethal, more specifically that it is easy to overdose, or that the difference between "normal" and LD50 is low. You don't get hooked on caffeine after one coke, and it's hard to kill yourself drinking too much coffee.
    - scottmf 10y ago
      Which drugs cause "high physical addiction" with one dose?
    - Broken_Hippo 10y ago
      It is pretty rare for anyone to get addicted to a drug after one dose. Even for things like heroin. I think I've read that at most, there is a 25% chance of addiction. Still high, but still below the thresh hold. But admittedly, it is rather hard to sort out fact from propaganda here. (and heroin does have that second one, I'm guessing).
  - eutectic 10y ago
    Little known fact: pure nicotine is hardly addictive. The Mono-amine oxidase inhibitors in tobacco really ramp up its addictive potential.
- drivingmenuts 10y ago
  Make them all legal, tax the hell out of it, and put that toward substance abuse programs. The ones who can't handle their addictions will cease to be a problem soon enough.
csours 10y ago
I upvoted you for adding to the discussion.
rms 10y ago
Tobacco and alcohol are unusually dangerous in the scheme of drugs. I don't disagree with your intention to relax restrictions behind drugs, but if this logic was followed, nearly every drug would be legalized, which is not the goal of the government of the USA.
- cmdrfred 10y ago
  If that is true, and your end goal is truly safety, why doesn't the FDA and DEA advocate for the criminalization of those drugs as well? I have been told that the argument is that prohibition caused violence and crime, but so does the prohibition of heroin so that logic doesn't seem to hold.
  - alexbecker 10y ago
    Because it would be politically impossible? (I would also argue that the DEA's goal is not safety.)
deleted 10y ago
[deleted]
BurningFrog 10y ago
If that rule is so great, can we afford not to use it everywhere? Let Pepsi, Toyota and Apple prove they're better than Coke, Ford and Microsoft!
GordonS 10y ago
This has been done. Mitragynine and 7-OH-mitragyine (the primary alkaloids in kratom) do not recruit β-arrestin[1], which os what causes typical opioid side effects - including respiratory depression. It is this that kills when you overdose on almost every other known opioid drug. This really is huge deal. Less importantly, but still relevant, it also doesn't cause anywhere near the level of constipation that pharmaceutical opioid drugs cause. It also activates both mu and delta opioid receptors, which is perhaps why I personally find it is so much more effective for neuropathic pain than the more common mu-opiod pharmaceutical drugs. [1] http://pubs.acs.org/doi/abs/10.1021/jacs.6b00360?journalCode=jacsat& http://pubs.acs.org/doi/abs/10.1021/jacs.6b00360?journalCode...

rms 10y ago

Kratom withdrawal is unpleasant. Debilitating withdrawal is uncommon in people that aren't taking heroic doses to self medicate their addictions to other opiates, therefore punting the withdrawal symptoms down the road. Acute kratom withdrawal is shorter than for long acting pharmaceutical opiates, but post acute withdrawal syndrome (PAWS) can be dragged out because kratom has some poorly documented and poorly understood non-opiate-related antidepressant actions. It has unusually complicated pharmacology with interesting combinations of conflicting, competing, and synergistic mechanisms. https://drive.google.com/file/d/0BwMPT92bOJKdZWM2bzlLeU5DdDg/view https://drive.google.com/file/d/0BwMPT92bOJKdZWM2bzlLeU5DdDg... is the letter from the American Kratom Association to the DEA, which compares the number of kratom related calls to poison control centers to calls related to supplements. Kratom seems to be at about the same level as ginkgo biloba and better tolerated than St. John's Wort. This is surprising, and has resulted in weird errors in literature reviews on kratom, that I've spent dozens of hours trying to unpack during my efforts to improve the Wikipedia article. Kratom seems to have a really surprisingly low incidence of severe side effects. The state of the information out there is weird. Something like someone said "Kratom is a mu opioid agonist and mu opioid agonists cause respiratory depression" in a peer reviewed paper, which then got cited in a medical textbook as "Kratom causes respiratory depression". However, primary research in mice shows that kratom causes dramatically less respiratory depression than poppy derived opioids. No case of kratom related respiratory depression has actually been documented in a human. In my comprehensive review of the literature, there was someone who had a seizure and was intubated but still had respiration in the normal range. Someone else suffered aspiration pneumonia in response to (inhaling?) kratom, but aspiration pneumonia is not respiratory depression. Basically, kratom does have side effects, and real side effects, but when looked at as a population level public health problem, is profoundly safe for how powerful of an effect it actually has.

darpa_escapee 10y ago
I, unfortunately, have extensive experience with kratom and kratom extracts. Today, I am 5 years clean of kratom and all narcotics. I bought the "kratom is non-addictive and can improve your life" line fully as a teenager. What ensued was indistinguishable from a full blown opiate addiction. I ended up in in-patient detox to finally quit and, five years later, have not regained all that I had lost during that time. Just because kratom has a high threshold for overdose does not mean it is not an opioid. Edit: Keaton != Kratom

PostOnce 10y ago

A whole bunch of plants can kill you, we haven't banned nightshade, most mushrooms, poison ivy, green potatoes lol. Let's ban poison ivy. Let's ban going outside without sunblock on. Let's ban walking around without a bicycle helmet on. Let's have the govt come into my office every two hours and remind me to get up and walk around and stretch. At some point, people have to take care of themselves. How many kratom addicts have you ever had a problem with? And how many problematic interactions with a drunk? We aren't banning alcohol either.

toss1941 10y ago
And there is strong evidence that Kratom curtails alcohol addiction. Kratom is amazing. It has anti-depressive effects that once fully understand I believe will usher in a new and vastly superior wave of anti-depressants. To schedule 1 this plant is beyond insane. Banning it is the bunny brained idea of a lunatic. The DEA is completely out of touch with reality or some special interest is pulling their strings.
- WhitneyLand 10y ago
  Strong evidence? Citations please.
  - GordonS 10y ago
    On mobile now, so can't give examples, but do a search on Google scholar and you really will find plenty evidence there
    - rms 10y ago
      Really? I tried doing this search and can't find much. I'm pretty up on the state of the scientific literature on kratom, because I'm in the industry, curious, and have been actively working at improving the dreadful wikipedia article. There's this case, http://www.sciencedirect.com/science/article/pii/S0924933811717618 http://www.sciencedirect.com/science/article/pii/S0924933811... , but it's a case of one. There are some cases of simultaneous kratom and alcohol dependence, but that's not the same thing. Even the peer reviewed evidence for kratom working for opiate withdrawal is quite weak, despite boatloads of anecdotal evidence. There are studies in mice and some observational studies, but nothing that meets the standards of an FDA clinical trial. Kratom has just not really been seriously studied. If I'm missing some papers or a body of research, please let me know.

M00n_Sl47r 10y ago

Long term kratom use can cause a dependence, and the withdrawals are very very similar to heroin/morphine withdrawals. regarding your second point, I cant find any hard sources, but my experience has been that unless one is doing WAAYY too much kratom, both per dose and over longer periods of time. Unless you are already an opioid addict trying to use kratom to maintain and kick a harder habit (the well known use is as a transition from dope), you should NOT be doing kratom every day.. unless you're trying to become one of the aforementioned addicts. On 3, definitely, it's a ridiculous misuse of the conception that natural is healthy. What if I told you to go out and do datura (Stramonium, iirc), or nightshade (makes you so pretty!). Both just as natural, arguably moreso considering you have to process kratom leaves, whereas you can go from finding a datura or nightshade family plant to eating it in seconds.

GordonS 10y ago
> withdrawals are very very similar to heroin/morphine withdrawals Source please. Anecdotal evidence from those that have gone through both heroin and kratom withdrawals generally say coming off kratom is extremely easy by comparison. It's also worth noting that, anecdotally (and I include myself here), for many people coming off kratom is easier than stopping drinking coffee.
Stanleymilgram 10y ago
This is ridiculous! First, please become informed before posting on a subject you clearly know little about. Second, in your "aforementioned" comment, you did not differentiate between uei and plain leaf kratom. This means you are either a "plant", or just a complete m. I know first-hand that coming off daily use of plain leaf kratom is a cakewalk compared to pharmaceuticals like methadone. Kratom is very similar to stopping your daily cup of coffee. You do not have 2 weeks of severe withdrawal nor do you have years in a state of PAWS. Also, if you think man made drugs like methadone are safer than natural substances like kratom, you need to head back to your big pharma office. Kratom is safe when taken in moderation. It will not kill you DEAD because when you take too much, it induces the users to vomit. It does not cause a complete shutdown of your cns! And when used daily for anxiety or other ailments, it is much safer than big pharmas "non natural" poisons. All big pharma concoctions can kill you and "accidental" overdoses occur every minute in the US on a daily basis. You are wrong and I question the sincerity of your comment.

nikcub 10y ago

Most modern nations accept opiate substitution therapy (OST) as the most effective way to treat opiod addiction. The entire premise of OST is that you substitute a bad opiate for a "less bad" opiate - and Kratom is looking like one of the best "least bad" candidates we've ever seen. Nobody is delusional about the effects of Kratom or downsides - all drugs have downsides. I've never seen it mentioned or recommended outside of opiate substitution and for opiate addicts - it has no value as a recreational drug.

kristopolous 10y ago
Do you think it's the Subutex and Methodone manufacturers using legal muscle since they can't patent and monopolize this alternative? Reckitt Benckiser, maker of Suboxone has fought hard against generics being available. I will save my criticism of the moral implication of such a position because the English language doesn't provide me enough words to express it.
- nikcub 10y ago
  Think if Reckitt had any sway they'd want loosening of the restrictions on doctors to prescribe suboxone. Currently only 10,000 of the 800,000 doctors in the USA are prescribing suboxone - wait lists are long and the per-doctor cap is rising very slowly.
  - kristopolous 10y ago
    Yeah, those restrictions are a completely insufficient response to the growing problems. I had a friend fighting heroin addiction live on my couch for a year while I tried using my money and time to help him through. The biggest problems (now we are getting off topic) are * lack of recovery groups for atheists. The conventional twelve step programs claim they'll work for atheists but the act of faith plays such a crucial and fundamental role, that someone who is faithless really won't work in the program. * an unspoken internal conflict of process. Institutions of rehab strongly disagree on methodology and there's this culture where most seem to have one elaborate and very specific process. Using multiple resources can be mutually exclusive and impossible. * rehab in general is structured terribly. The reality is that someone serious about recovery ends up living with a bunch of strangers who may not be. It's like a zombie movie, one bad apple can spoil the bunch. There has to be a better way. * a lack of reliable or convenient access to medication. These people know how to get street drugs. When they have to travel 30 miles and show up between 6 and 7:30 am to get methadone while heroin is an SMS away and gets delivered, there's a problem.

deleted 10y ago

[deleted]