The DEA says it will put kratom, a leaf indigenous to Southeast Asia, on its list of most severely prohibited drugs. But scientists and users — who say kratom has helped them kick opioid addictions — think that’s a mistake.
Maybe you’ve never heard of kratom — a plant from Southeast Asia with large, green leaves that are dried, powdered and taken as a drug with mild, opioid-like effects.
Kratom has been used in Asia for generations — usually chewed or brewed into a tea — as a tonic, painkiller and an aid for people weaning themselves off opium. It can be bought in powder or capsule form at smoke shops across the country.
But dedicated kratom users might want to stock up. As soon as Friday, the federal Drug Enforcement Administration (DEA) says it will classify kratom as a Schedule I substance, putting it in a class of drugs — along with heroin, peyote and marijuana — that, per U.S. government policy, have “no currently acceptable medical use.” The Schedule I designation will make kratom illegal to possess or sell and more heavily restricted than cocaine or oxycodone.
Kratom and its chemical compounds, said DEA Special Agent Jodie Underwood, “pose an imminent hazard to the public safety.”
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The DEA’s announcement has created consternation among scientists who study its effects and their potential medical benefits. This week, more than 50 members of the U.S. House of Representatives — including 28 Democrats and 23 Republicans — sent a letter to the DEA arguing its “hasty decision” to schedule kratom “will put a halt on federally funded research and innovation surrounding the treatment of individuals suffering from opioid and other addictions — a significant public-health threat.”
Washington Reps. Adam Smith and Denny Heck signed the letter.
“In the end, this is a disservice to science,” said Christopher McCurdy, chairman of Biomolecular Sciences at the University of Mississippi, which has been on the forefront of research into kratom as a non-opium-based painkiller and an herbal alternative to methadone or suboxone. For decades, the University of Mississippi also had the only contract with the DEA to grow marijuana for medical research.
“I don’t think Schedule I is the right thing at this moment because we don’t have the science yet to speak to potential medical benefits — and we think there are medical benefits.”
McCurdy, who has been studying kratom for more than a decade, says a Schedule I designation means there will be “a lot more hoops to jump through” to have access to the plant, including more security, licenses that can be tough to obtain, new levels of bureaucracy, special safes and scheduled in-person visits from DEA agents. “I know people with Schedule I licenses,” McCurdy said, “and it’s much more lock-and-key.”
After his team heard about the DEA’s plans, he said, they’ve “been frantically trying to figure out how to get our latest research out the door and into the literature.”
McCurdy said his research on mice revealed “promising data” that kratom could be used to help people transition off opioids, though his research hasn’t been extended to humans.
Robin Moore, who works at Holy Smoke on Capitol Hill, said a “huge percentage” of his kratom customers are people who say they’ve used the leaf as an alternative to opioids — either because they’re in chronic pain but don’t like opioid side effects or are in opioid-recovery programs.
“Some say that without kratom, they’d just go back to heroin and wind up dying,” he said. “Saying kratom has no medicinal use is crazy. I get customers who take it for anxiety, depression, alcoholic addiction, painkiller addiction.”
The U.S. Food and Drug Administration banned the import of kratom in 2014, describing it as “a botanical substance that poses a risk to public health” that can lead to nervousness, agitation, aggression, loss of libido, skin hyperpigmentation and rare instances of clinically acute liver injury.
Underwood said the DEA “has not encountered kratom [problems] in the Pacific Northwest,” but it’s “aware of 15 kratom-related deaths (across the country) between 2014 and 2016.”
DEA Special Agent Melvin Patterson said that only one of those deaths was “solely attributed to kratom” and that “all the others were poly-drug overdoses.” He added that he didn’t know whether that single death was similar to the respiratory-failure overdose deaths common in opioid fatalities, or from some other cause.
According to a local Opiate Addiction Task Force, 229 people died of opioid overdoses in King County during 2015.
Washington state’s opioid-overdose crisis continues to be a slow-moving car crash — overdoses have overtaken traffic wrecks in many states as the No. 1 cause of accidental death — but, for some, it’s a lucrative one.
State Attorney General Bob Ferguson recently joined 34 other states and the District of Columbia in a suit against two pharmaceutical companies, which make the opioid-treatment drug suboxone, for violations of the Sherman Anti-Trust Act. The suit accuses the companies of conspiring to keep generic, less expensive alternatives to the drug off the market.
“Our whole hope was to look at pharmacological regulation for kratom as a botanical alternative to methadone or suboxone,” McCurdy said. But he’s not sure the DEA or the Food and Drug Administration “even understand the science — and to be honest, even us basic scientists don’t fully understand the science yet.”
That, he added, is why the DEA’s move to put kratom on the Schedule I list, and further from the reach of researchers like him, is worrisome. “Once the DEA goes down these kinds of paths,” he said, “it’s hard to reverse their course.”
Moore, at Holy Smoke, was more direct. Without kratom, he said, “some customers who’ve gotten off heroin say they’d be destroyed without it.”
The experts simply say they need more science.
Caleb Banta-Green, senior research scientist at the University of Washington’s Alcohol & Drug Abuse Institute, said “it’s hard to measure” the effectiveness of something like kratom for opioid-abuse treatment “when it’s outside the formal health-care and treatment system … While people may feel like kratom is a ‘natural’ solution, it’d be good for them to be able to make a fully informed choice.”