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FDA Declares Kratom an Opioid

By David Jenison on February 9, 2018

In 2016, the Drug Enforcement Administration (DEA) added the medicinal plant kratom to its list of Schedule I prohibited substances. This category—reserved for dangerous and addictive drugs with no medical value—currently includes mushrooms, LSD and cannabis, which shows how little law enforcement seems to know about medical value. The kratom prohibition sparked a public outcry and motivated a 51-person bipartisan coalition of U.S. House members to petition the Obama administration to reverse it. The DEA eventually rescinded the kratom prohibition, but a new ruling by the Food and Drug Administration (FDA) might change that. 

Earlier today, the FDA officially declared kratom an opioid. 

"Scientists at the FDA first analyzed the chemical structures of the 25 most prevalent compounds in kratom," the agency said in a statement. "From this analysis, the agency concluded that all of the compounds share the most structural similarities with controlled opioid analgesics, such as morphine derivatives."

The analysis suggested that 22 compounds (out of 25 tested) bind to opioid receptors in the central nervous system, and the potency of the receptor binding is comparable to prescription opioid drugs. 

"Kratom compounds are predicted to affect the body just like opioids," the statement continued. "Based on the scientific information in the literature and further supported by our computational modeling and the reports of its adverse effects in humans, we feel confident in calling compounds found in kratom, opioids."

Kratom (Mitragyna speciosa) is a Southeast Asian plant from the coffee family. Though traditionally chewed in Asian cultures, many Americans take the drug via capsules filled with a powdered form of the plant. Before today's announcement, kratom was not considered an opioid because it's not derived from the same opium poppy as heroin and prescription painkillers (e.g, hydrocodone uses codeine and/or methylated morphine, oxycodone uses thebaine, etc., which are all opiate alkaloids). Kratom, which is now essentially a non-opiate opioid, does produce opioid-like analgesic effects that cultures have used for centuries to reduce chronic pain. In more recent years, people utilized kratom to treat opioid withdrawal syndrome.  

Many advocates argue that kratom helps people recover from opioid addiction with fewer risks than those associated with other withdrawal drugs like methadone. To date, the FDA has received 44 reports of deaths associated with the use of kratom, while methadone accounts for thousands of overdose deaths each year, per the Centers for Disease Control and Prevention (CDC). Moreover, the University of Mississippi announced clinical findings in 2013 that claim kratom successfully treated opioid withdrawal in mice more effectively than methadone, and a drug rehabilitation center in Maine currently utilizes cannabis and kratom to treat opioid addiction.

What about other studies? A 2016 study in the Journal of American Chemical Society found that kratom does bind to and activate opioid receptors, but it does so with less potency and fewer negative side effects than traditional opioids. Likewise, a Journal of Ethnopharmacology study in 2017 described kratom as "a pharmacological tool to mitigate withdrawal symptoms." That same year, Human Psychopharmacology looked at kratom use in Southeast Asia and noted, "Studies based on self-reports suggest that prolonged kratom use does not result in serious health risks or impair social functioning."

Then there's this case report from 2008. A study in Addiction looked at an opioid-injecting 43-year-old who successfully self-treated withdrawal symptoms by drinking kratom tea four times per day. "The patient attributed substantial pain relief to kratom as well as improved alertness," the researchers noted. "[Afterwards,] the patient abruptly ceased use of kratom and sought the care of an addiction specialist. He described a period of withdrawal considerably less intense but more protracted than that from prescription opioids.... The patient currently reports adequate pain control, and follow-up urine screens for drugs of abuse have remained negative."

Many believe that bureaucrats seek to prohibit kratom because corporations can't patent it and Big Pharma sees it as a threat to its gigantic opioid profits. While this might sound like a conspiracy theory, keep in mind that these same bureaucrats currently claim cannabis compounds like cannabidiol (CBD) are highly addictive, dangerous and devoid of any medical benefits whatsoever. They don't even acknowledge the medical cannabis benefits for which the U.S. government currently holds patents. At present, DEA scheduling treats crack cocaine and crystal meth as safer and healthier than non-psychoactive CBD, and the FDA told the DEA not to reschedule cannabis to allow medical use in 2016. 

In other words, some conspiracies certainly seem to have merit when it comes to the DEA and FDA. Even though the DEA reversed course on its previous kratom prohibition, the FDA announcement gives the DEA cover should it try to schedule kratom again, which you can fully expect it to do. Kratom may indeed involve risks and require regulation, but many would argue that these agencies are prone to put Big Pharma profits and lobbyist pressure ahead of personal freedoms and public health. They certainly have with cannabis. 

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