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Kratom: proponents praise its pain-killing properties, but others fear addiction

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Kratom: proponents praise its pain-killing properties, but others fear addiction

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Content 1

Kratom: Proponents Praise its Pain-killing Properties, but Others
Fear Addiction
Haley Ray
Specialized Journalism, The Arts
Masters of the Arts
University of Southern California
August, 2017

2
Table of Contents

Title Page 1
Table of Contents 2
Kratom 3
The Ban 6
Positive User Experiences 9
Kratom’s Dark Side 16
The Research 19
The Economic Impact 25
The Wait 26
Bibliography 28

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Kratom

Amidst the preppy college bars and trendy vegetarian restaurants of Chapel Hill, North
Carolina, a kava bar called Krave opened in March of 2014. Virtually no one knew what
kava and kratom was, or what a kava bar offered its customers. Local newspapers were
so intrigued that they published features about the bar that sold a murky brown kava tea
instead of alcohol.

I wandered in one day out of sheer curiosity after reading a review. The grey exterior
resembled a storage building, or maybe an upscale dive bar. Upon walking inside and
taking a seat, I met the owner, Elizabeth Gardner, who presented a lengthy spiel about
their products that was given to all new customers. She explained that Krave only sold
kava tea, kratom tea, Fiji water, and flavors of yerba mate. No alcohol is sold here, you
can’t bring alcohol inside, and the bartenders will not serve you if they suspect you have
already consumed alcohol. Some bar, I thought.

Although Krave was new to Chapel Hill, many Americans are using these substances for
various ailments. I would later learn that Kratom, especially, has established a
widespread clientele who mostly consume it for pain relief and aiding substance abuse
recovery. During my initial visit to Krave, Gardner said the Food and Drug
Administration (FDA) does not regulate kava or kratom, creating some suspicions around
the products. But the full depth of the controversy surrounding kratom became more
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apparent when the U.S. Drug Enforcement Agency (DEA) announced its intent to
emergency schedule kratom on Aug. 31 2016.
Emergency scheduling means the DEA has the authority to temporarily place said
substance under a Controlled Schedule. In the case of kratom, the DEA was moving to
place it under Schedule I, as a drug that is illegal to manufacture, distribute, dispense or
possess.

The Comprehensive Crime Control Act of 1984 amends the Controlled Substances Act
(CSA) to allow the DEA to emergency schedule a substance in order to avoid “an
imminent public health crisis.” Emergency scheduling permits a faster scheduling of a
drug, while the formal rule-making procedures are conducted.

Gardner continued.

“Kava is a root native to South Pacific islands like Fiji, Hawaii and Vanuatu. The
island Cultures have used it for hundreds of years for ceremonies and everyday
use. They normally crush the root up and brew it into a tea, like we do here. It’s
part of the black pepper family, so it can make your mouth feel a little numb, but
it helps with overall relaxation and anxiety.”

Gardner said the bar serves small portions of kava and kratom. She advised limiting my
intake to one serving my first time to gauge my body’s reaction. Some of the effects I
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might feel from kava included relaxed muscles, an increased sense of well-being and a
mellow mood.

“Kratom is mitragyna speciosa; it’s a tree that is part of the coffee family,” she said. “It is
native to Southeast Asia in places like Thailand and Indonesia, and it can be prepared like
kava. You can also chew fresh kratom leaves, or use a powdered form, but we take the
dried leaves to make a cold tea. Kratom relieves pain, elevates focus and energy levels,
and increases sociability. If you drink it on an empty stomach you might feel nauseous,
so it’s a good idea to eat something before or after drinking kratom.”

In basic terms, kava acts as the “downer” and kratom works as an “upper.” My education
complete, I ordered the Krush, an equal mix of kratom and kava, which Gardner said is
their strongest tea. The light brown, milky looking tea tastes gritty and, quite honestly,
like a handful of dirt.

After a succession of small sips, I feel a tingling, numbing sensation in my mouth. It’s
more pleasant than overwhelming. About 30 minutes pass and I notice a slight elevation
in my mood; it’s comparable to the sensation of a wonderfully strong latte or a sun bath
at the beach. I feel upbeat, energized, and excited to hold long-winded conversations.

At low to moderate doses (0-5 grams), Kratom produces mild stimulant effects, similar to
what I experienced, according to a study by Dr. Walter C. Prozialeck at the Department
of Pharmacology at the Midwestern University/Chicago College of Osteopathic
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Medicine. Higher doses, at about five to 15 grams, produce the opioid-like effects of
euphoria, analgesia and sedation.

The fine line between stimulant and opioid-like effects has resulted in increased interest
within the scientific community to assess the potential benefits and dangers associated
with kratom. It also resulted in the hasty decision to place the plant under the list of
Schedule I drugs, a move that received enormous pushback.

The Ban
When the DEA announced its plan in August to ban kratom, public advocates were
unsettled that it would be placed under Schedule I of the Controlled Substances Act,
which contains drugs defined as having no medical use and a high potential for abuse.
Heroin, LSD, and ecstasy are among the substances classified as Schedule I.

Six states had already banned kratom before the DEA decision in 2016. Tennessee passed
a bill to make kratom illegal in 2013. Indiana did the same in 2014. Vermont, Wisconsin,
Arkansas, and Alabama also have bans on the substance.

DEA spokesperson Melvin Patterson said the decision to add kratom to Schedule I was
influenced by an increased number of calls to U.S. poison control centers, an alert from
the Food and Drug Administration (FDA), and a lack of regulation.

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The National Poison Data System and the Center for Disease Control (CDC) recorded the
number of phone calls regarding kratom to poison control centers between January 2010
and December 2015. During this period, the number of calls to poison control centers
jumped from 23 in 2010 to 263 in 2015 for a stunning increase of more than 2,600
percent.

The number of calls has continued to grow. In 2016, 480 calls about kratom were made to
poison control centers. A relatively small amount when compared with the more than
190,000 calls received by poison control centers in 2015 about household cleaning
products alone.

After the DEA announced its kratom decision, the public pushed back hard. Patterson
said the agency received more than 23, 200 comments about the substance online, which
is an unusually high amount. A great majority were advocating for its continued legality.

Kratom advocates made calls to their local representatives. In early September, protesters
organized a march from the White House to Lafayette Park in Washington, D.C., and
presented the Obama administration with a petition signed by 120,000 people opposing
the rushed decision to make it illegal.

In response, the DEA withdrew the immediate scheduling and opened the case up to a
public comment period that ended on Dec. 1, 2016.
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“The public pushback didn’t alter the process,” said Patterson. “But it did raise eyebrows
that this isn’t the normal process we go through when emergency scheduling things.”

Patterson said in 2014 the DEA requested an eight-point analysis on kratom from the
FDA in 2014, but it was never completed.

“That kind of helped us pump our brakes in emergency scheduling,” he said. “We
requested another eight-point analysis from the FDA, and we’re going through all of that
right now.”

During the analysis, the FDA evaluates a drug's potential for addiction, scientific
evidence of pharmacological effects, the state of scientific knowledge regarding the drug,
the scope of abuse, and any risk to public health. The final factors of analysis are its
physiological dependence liability and whether the substance is an immediate precursor
of a substance already controlled, meaning it has been formed from, and contains similar
properties of, an illegal drug.

Patterson said more scientific research and clinical studies are needed to assess kratom’s
true potential for addiction, as well as its medicinal potential.

“I think there is a need for some type of regulation. From what I’ve seen from the product
there’s no way to tell what you’re getting. Sometimes you just get leaves, sometimes you
crush it yourself. I think it does need to be regulated just to know that,” he said.
9
No date has been announced for the completion of the FDA’s analysis, but Patterson said
he hopes it comes soon. He also emphasized the need for more research to uncover the
uncertainty surrounding kratom.

“The DEA is ultimately a law enforcement area,” he said. “When we get into that area we
really like to lean on the science community, or the research community. We like to be
able to say we follow the science and let science dictate what we allow to be good
medicine.”

Positive User Experiences
As the U.S. opioid epidemic and death count from overdoses continue to grow, many
kratom advocates worry that a ban would make the situation worse by ridding of an aid to
people in recovery.

A large percentage of people who consume kratom believe it helps them get off
prescription painkillers, or avoid the need for painkillers altogether. This includes
consumers who got hooked on pills from recreational use, as well as patients who
developed an addiction from a doctor’s prescription.

Opioid abuse and overdose deaths are a growing problem in the U.S. In fact, drug
overdose is the leading cause of accidental death in America. Of the 52,404 lethal
overdoes in 2015, the most recent figures available, 20,101, or 38 percent were caused by
prescription pain relievers. The National Institute of Drug Abuse also reported that the
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number of opioid prescriptions rose 92 percent from 76 million in 1991 to around 207
million in 2013.

In addition, a study published by the American Society of Addiction Medicine reported
that in 2015, two million Americans had a substance abuse disorder involving
prescription pain relievers, and 591,000 had a substance abuse disorder with heroin.

While a doctor’s prescription may provide a patient with their first painkiller encounter,
medical prescriptions are not solely responsible for the increasing number of addictions
in America. After the medication runs out, some patients illegally seek out the drug or
obtain it from crooked pill clinics. Sometimes referred to as pill mills, these clinics
employee medical workers who freely prescribe or dispense narcotics to patients for non-
medical reasons.

Hugh McCann, a native of Houston, Texas, and a kratom user, has seen the impact of the
addiction epidemic up close. McCann’s positive experience with kratom led him to start
selling it independently online.

“I’ve known the word pain pill since I was 8 years old,” he said. “The opiate problem
where I live is just beyond ridiculous. I’ve dealt with it first hand because of family. My
daughter was almost taken from us because my wife was on pain pills that the doctor
prescribed her. I’ve seen that people will go to multiple doctors to get pain pills. And
people are selling them individually for over $10.”
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He said a bad car accident broke his wife’s leg and ripped open her stomach. She was
given Xanax, Carisoprodol, and Lorcet. McCann said this is a standard prescription for
the Houston pill mills. It’s a diverse prescription, too. Xanax is a popular anxiety reliever,
Carisoprodol, a muscle relaxant, and Lorcet is a form of the opiate-painkiller
hydrocodone.

She began experiencing hangovers from the pills when she woke up, he said. One
morning she was driving their daughter to preschool, and was pulled over and charged
with Driving Under Influence (DUI). This happened three separate times, he said, and his
wife spent two years in prison and rehab while he cared for their daughter. She’s since
recovered, and McCann said taking kratom has helped.

His parents and other immediate family members also faced trouble with prescription
pills, he said. Since introducing his mother, father and aunt to kratom, McCann said they
have been able to wean themselves off various drugs including Suboxone, a synthetic
opiate created to treat addiction and suppress withdrawal symptoms that, like any drug,
has addiction potential itself.

After witnessing the transformation in friends and family, McCann set out to help others
by selling kratom online. His business plan includes a Facebook page with his contact
information, and personally contacting each potential customer to assess their needs.
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“I’ve seen really beneficial side effects, and I’ve seen people try to misuse it,” said
McCann.

Various Facebook groups and online groups for kratom users are filled with people who
share similar accounts. Louis Hauger from the Facebook group Kratom United said she’s
been consuming kratom for almost two years. The 50-year-old mom of two lives in
Kevil, Kentucky, and said her quality of life has drastically improved since she found
kratom.

“It helped me stop taking methadone,” she said. “I have chronic pain that began 16 years
ago and ended up addicted to opiates.”

Kratom may also be beneficial to those using it in recovery. Julie Bolton, a nursing
assistant in Chapel Hill, North Carolina credits her improved health to kava or kratom
bars. At the time of her interview, Bolton was 240 days clean and sober. She frequents
Krave Kava Bar in Carrboro, North Carolina, where she’s found friends and a supportive
community.

Not every bar has a similar community, though. And not every former addict will find
kratom beneficial. Gardner said some local addiction counselors forbid their patients
from visiting Krave, because they view drinking kratom as swapping one substance for
another. But it does work for some people, like Bolton.
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“I’ve met a ton of people who are in recovery,” she said, adding that she was addicted to
alcohol. “It seems as though every time I’m here I meet someone else who is sober and,
you know, practicing NA or AA.”

Bolton said the community at the kava bar has been equally as beneficial as kratom itself,
although not everyone who tries kratom finds this to be true.

“It’s an outlet,” she said. “And it gives me something else to look forward to.
Addicts’ minds are very different, and I mean, it’s possible that I would’ve
relapsed by now. I’m not sure, but I really do think it’s helped.”

Musician Ken Cannon is another frequent patron of Carrboro’s Krave, and is recovering
from an alcohol addiction. He stops in almost every day for a Krush, a drink with equal
parts kava and kratom. He said he first tried kratom in the capsule form and wasn’t
impressed, but decided to give it another shot when he heard a kava bar was opening
locally.

“It definitely knocks some of the anxiety off, to have a kava,” he said. “It’s nice to have a
place that I can go to that’s not a bar and still hang out with friends, people my age,
people of all ages really. But most people my age are concentrated in bars, and that’s not
really an option for me. Having an option that I can come to, that’s healthy and supports
my sobriety, I’m a big fan of.”

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The kratom bar scene doesn’t cater solely to those in recovery. During my own visits to
Krave, I observed and talked to a wide variety of customers. Students from The
University of North Carolina at Chapel Hill, just a few miles from the kava bar, go to
study or socialize if they need a break from the college bar scene.

Artists sit at the bar to draw, and to later display their work on the walls. Hipster types
enjoy the alternative social vibe. The variety of people, and the kratom increasing
customer’s talkativeness, results in an unconventional bar environment where some find
it easier to cultivate friendships and community. Cannon is one customer who vouches
for the kratom social scene.

“Some of the subjects I’ve been able to talk about here have been a lot deeper than at
normal places,” he said. “I remember one time sitting at the bar here, and talking about
some spiritual things and then kind of branching off into extraterrestrial stuff and things
like that. You know, just crazy crazy stuff. And there were three or four strangers at the
bar who just chimed right in and where right there with me. That was really cool.”

Marine veteran Anthony Choueiry is another user who attributes an improved lifestyle to
the substance. After two deployments with the marines, Choueiry was prescribed Zoloft
and similar drugs to treat his Post Traumatic Stress Disorder (PTSD). He says he wasn’t
fond of taking multiple prescription pills, so he turned kratom as an experiment of sorts.
While he was initially uncertain of its effects, he said it’s been a great help in managing
his anxiety and depression, as well as PTSD.
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Choueiry buys his kratom in pill form online, since there aren’t many bars or stores
selling it near where he lives in Los Angeles, California. Two kilos usually lasts four
months and taking it in pill form makes it easier to take the right dose, he said.

“I tried drinking it when I was younger,” he said. “It was the most disgusting thing I’ve
tried in my life. And I can handle disgusting things.”

Choueiry, who has recommended kratom to friends and other veterans, says he hasn’t
seen anyone abuse it or develop problems.

“I don’t know how you could abuse it, personally. You could take a lot everyday to the
point where you’re always dizzy and throwing up. But you can’t really overdose on it,
and no one will want to get to that point anyway,” he said. “People just want to take a
dose that helps them. I’ve been taking it for six years straight, and nothing negative
happened to me. It helped me stay motivated and I became a helicopter pilot after the
marines. So it just really depends on the person.”

He said a ban is unnecessary, but more testing should be done. To Choueiry, the main
motivation for the DEA to schedule kratom is because it’s causing pain medication
prescriptions to decline.

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Kratom’s Dark Side
Despite the abundance of glowing reviews that many kratom drinkers report, the potential
for abuse exists. As with any mind-altering substance, there can be too much of a good
thing.

On the surface, a tea derived from a root appears benign enough, especially in an era
where medical marijuana is becoming increasingly accepted. The seemingly harmless
nature of kratom could be a downfall, leading uneducated consumers to misuse it.
Because it does contain many similar properties and effects to opioids, kratom users with
a propensity to addiction can find it problematic.

It is possible to become addicted to kratom, although most studies and accounts of
kratom abuse include simultaneous addictions to other substances. Kratom is a partial
agonist, meaning it activates certain opioid receptors in the brain. Heroin is a full agonist
opioid, activating all receptors. Ali Kagoura is one former user who has an unpleasant
history with kratom.

Kagoura heard about kratom early on in 2009, before its popularity rose. He sought it out
after he got his wisdom teeth out at 16 and was prescribed painkillers. He said he
immediately liked the high from painkillers, but knew experimenting with pills was risky.
Instead, he used kratom as an alternative, since the high from a heavy dose was similar to
that of a painkiller.
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“The thing with kratom is that it’s a partial [chemical that produces a biological
response],” he said. “So in the beginning, when my tolerance was low, I actually
preferred it to an opiate. It has more active alkaloids [than opioids], so I enjoyed that it
made me even more social and talkative. So over the years, as what happens with drugs,
it stopped working. I found myself taking tablespoons of powder all day. This was after
six to seven years. I abused the hell out of it. I was always tired and in a brain fog. At the
end I felt gritty and burned out. It sucked my energy.”

Kagoura eventually went to rehab to treat his kratom addiction, as well as multiple other
substance abuse issues, including prescription pills, which he would seek out during the
few periods he wasn’t using kratom. Kagoura met one other person in rehab who had a
similar experience with kratom, but he said bad accounts have become more common in
recent years. The physical withdrawal symptoms are starkly similar to that of opioid
withdrawals, he said.

“With kratom, it takes a lot longer to get to the point of addiction and withdrawal,”
Kagoura said. “But once you’re there the physical withdrawal is just as bad as an opiate. I
had restless legs, insomnia, runny nose, nausea. It was really bad.”

Kagoura has been clean and sober for more than a year and a half, and now studies
Cognitive Neuroscience and Research Psychology at school in San Diego.

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Professional rehabilitation programs for kratom have started popping up in recent years in
response to its growing popularity, while still relatively rare. Ocean Front Recovery in
Laguna Beach, California offers a recovery program specifically tailored for kratom
addiction. Ocean Front declined to comment for this story, but its website addresses some
of the issues surrounding kratom use:

“Kratom creates a psychoactive opiate-like high in people. It is actually legal in some
American states, which creates the illusion among many people that it is safe. The most
common users are teenagers, as well as young adults and former addicts. They justify
their use of the drug by saying it is organic, but it is important to realize kratom can be
dangerous and addictive, and kratom rehab is challenging. In low doses, kratom can
actually provide a person with energy. However, it is then a slippery slope to the high
doses, and the high becomes similar to that produced by an opioid, like heroin.”

Lighthouse Recovery Institute, located in Boynton Beach, Florida is another facility that
specifically treats kratom abuse and offers help with kratom withdrawal. Ryan Johnston,
an addiction treatment specialist at Fort Lauderdale’s Cornerstone Recovery Center,
discussed the danger of people substituting one drug for another while recovering from
substance abuse.

“[Kratom’s] a minor mood-altering substance,” he said in an interview with PBS. “So our
clients are not permitted to use it. What we find, is that it leads them back to the
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behaviors of what surrounds them when they’re using, let’s say, opiates, and oftentimes
leads them further down back to their drug of choice.”

Kagoura recognizes that not everyone who drinks or ingests kratom will develop abusive
habits.

“Addiction is a psycho-social disease,” he said. “So kratom itself isn’t evil. Just like a bag
of heroin isn’t evil if no one is using it. Even though I’ve had a bad experience, I would
never want to ban it. Because people do legitimately use it for pain. It’s up to the
individual person and their body type.”

Not everyone has the same rosy outlook. Huntington Beach Kava bar owner Avi
Hoffman will never sell kratom. He said it’s a dangerous substance that people justify
using because it’s natural and derived from a plant.

“Just because it’s from the Earth doesn’t mean it’s good for,” he said. “If that was the
case, we could smoke blunts all day and drink crude oil. You’re not putting poison ivy in
your spring green salad. That’s what it boils down to, the education. People are not
getting the right education.”

In his opinion, kava bars that also sell kratom aren’t transparent enough with their
customers about what kratom really is. Although he has only ever sold kava, he makes
sure customers who come in requesting kratom receive the proper “education.”
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Hoffman has owned kava bars in both Florida and New York before opening one in
California. He said he has seen kava bar owners put kratom in people’s kava without
telling them, and kids trying to sneak kratom into their drinks at other bars.

He has witnessed kratom’s addictive qualities firsthand, from kids selling it like a street
drug in Asheville, North Carolina, to a young man pawning his music equipment in New
York to obtain a small amount of kratom.

“One day I saw a kid sell his Marshall half stack, a bass guitar, the peddles, the
microphone, the mic stand, the cases, everything for $150 so he could buy a bag kratom
at the head shop. I saw it with my own eyes. It’s disgusting,” he said.

Hoffman supports the DEA’s move to ban kratom. Although he doesn’t think it should be
available for anyone to use, he said it does have the potential to be highly regulated for
medicinal use.

“They may say it’s helping them off, which it might be, but you’re getting addicted to
something else,” he said.
Kagoura doesn’t believe any regulation of kratom is necessary, other than an age
requirement. He said he also recognize its potential medical use.

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“It could be regulated in a similar way to Suboxone, and Suboxone is incredibly easy to
get,” he said. “I just don’t want addicts who might overdose who can’t get kratom, and
then have to lie or try to explain to a doctor why they need it…. But I’d rather see it stay
legal.”

The Research
Kratom has garnered attention from numerous universities and members of the scientific
community. Eager to research kratom’s potential medical uses, many doctors echo the
worry that a ban on kratom will significantly hinder future research efforts.

Dr. Oliver Grundmann, a pharmacologist at the University of Florida, is among those
interested in kratom’s fate. In 2016 he conducted a survey designed to evaluate the use
and health impact of kratom in the United States.

Grundmann said that the majority of users in the study reported using the substance for
pain relief and increased energy. Eighty two percent of the 9,550 participants had at least
some level of college education, 28 percent had an annual income of $75,000 or higher,
47 percent had insurance through an employer, and 30 percent had insurance through
self-employment or Medicaid.
Grundmann said he is still in the process of gathering information from previous research
to compare with his findings. One study he has used was published in 2014, and
evaluated prescription opioid abuse.

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“The study reached the conclusion that higher income and male gender were associated
with a higher odds ratio of opioid abuse,” Grundmann said. “Obviously this comparison
is lacking in my regards since I did not analyze potential misuse signs and symptoms yet,
although that is part of the survey.”

More information needs to be gathered and analyzed before a kratom ban is put into
place, he said. Dr. Marc Swogger at the University of Rochester Medical Center who
researches psychopathy and substance abuse, agrees with Grundmann.

Swogger conducted a study through Erowid.com, a well-known forum website where
users can submit first-person accounts of their experiences with different drugs. Swogger,
along with his colleagues, combed through the 286 user-submitted reports detailing
kratom experiences. Similar to Grundmann, Swogger found that most users had
experienced pain relief and a sense of wellbeing. Some chose kratom to help get off drugs
they didn’t want to be on, including antidepressants. Negative side effects were also
disclosed.

“Some people experienced vomiting and dizziness,” he said. “There are reports about
kratom in relation to death. There are about 15 reports of them, but they can be
misleading. These are instances in which the person took kratom and later died, but
there’s no data to prove it was caused by kratom.”

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According to the National Institute on Drug Abuse (NIDA), kratom alone has no record
of fatal overdose. However, some commercial forms of the drug can be laced with other
substances that have led to death and overdose.

Swogger said that although kratom does seem less addictive than opiates, there is
addiction potential. But to him this is not enough to justify an outright ban, especially
with the lack of clinical studies and concrete evidence. He said it could be justifiable to
regulate it, much like alcohol and tobacco.

“I think that right now there are a lot of people - hundreds, maybe thousands of people -
in this country taking kratom to relieve their pain, maybe taking it to get off drugs they
don’t want to be on,” he said. “The DEA saying they want to make it illegal is dangerous.
What will these people do? If kratom isn’t available will they become addicted to
opiates? Will they just have to endure their pain? I think it’s a dangerous thing to tell
people who have been relying on a plant to tell them they can’t use that plant because we
don’t know what the unintended consequences will be.”

Scientists have documented the similarity between kratom and opioids and how they
interact chemically in the brain, specifically with the opioid receptors. In moderate to
high doses, kratom binds to the mu and delta opioid receptors, reported the pharmacology
study conducted by Prozialeck.

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University of Florida Medicinal Chemistry Professor Christopher McCurdy is one of the
leading scientists researching kratom. He has conducted a National Institutes of Health
Centers of Biomedical Research Excellence-funded study of the substance. He and his
team were interested in testing how kratom operates on brain receptors and its potential
use in relieving opioid withdrawals.

McCurdy, who worked at University at Mississippi at the same time of the study, and his
colleagues tested it in mice habituated to morphine. The group isolated mitragynine, the
plant’s most active alkaloid and tested the pure compound on the mice.

“What we’ve seen is a clear medical potential for this to treat opiate addiction and
withdrawal,” McCurdy said in an interview with PBS. “Mitragynine completely blocked
all withdrawal symptoms and could provide a remarkable step-down-like treatment for
people addicted to hardcore narcotics such as morphine, oxycodone or heroin.”

Susruta Majumdar, a chemist at Memorial Sloan Kettering Cancer Center, is also curious
about kratom. He collaborated with Columbia University medical chemist Andras Varadi
to study the compounds found in the substance.

Although all three molecules in kratom were binding to the mu-opioid receptors,
researchers found that the binding occurred in an unconventional way. Rather than
activating both negative and positive effects of a typical opioid like heroin, they reported
25
that kratom activated most of the beneficial effects, such as pain relief, and left behind
the unsavory side effects.

Members of the scientific community interested in kratom hope to continue more in-
depth research and clinical trials, but they worry a ban will greatly hinder these efforts.
While revealing studies have been conducted, more information is needed to understand
the full extent of kratom’s chemistry and effects.

DEA spokesman Patterson said the process to approve research would become a much
lengthier process if kratom were listed as a Schedule I substance.

“Basically you would have to become a registrant with the DEA, and then you’d have to
submit protocol to the FDA,” he said. “It’s pretty expensive: $3,000 annually. Once you
have your protocol approved you can start the research.”

The Economic Impact
Placing a ban on kratom has the potential to affect the U.S. economy, as well as the
health of many Americans. In 2016, the Botanical Education Alliance (BEA) performed
an economic impact report and found that the total combined revenue of businesses that
sell kratom exceeded $1.13 billion. The report had 157 respondents, who estimated their
collective revenue would decline more than $200 million if the DEA goes through with
scheduling.

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The report estimated that 10,000 kratom vendors in the U.S., and 2,426 people are
employed by companies in the industry. The BEA data shows that it has evolved into an
increasingly in-demand product, able to operate within its independent industry.
However, a bill to ban kratom reintroduced by Florida State Rep. Kristin Jacobs (D)
stated that banning kratom in Florida would not have any impact on state or local
government revenues. The bill also states a ban will not have a direct economic impact on
the private sector.

With 18 bars, mostly concentrated in West Palm Beach, Florida has one of the most
vibrant kratom and kava cultures in the nation. The popularity has slowly spread up
North, as far as New York. And kava bar owner Hoffman predicts that Southern
California will soon be a hotspot for kava and kratom bars.

The Wait
With the DEA still waiting on a complete analysis from the FDA, it’s unclear when
kratom’s fate will be decided, and what exactly that fate will be. Although it could be a
long wait, various organizations are staying committed to keeping kratom out of
Schedule I.

The American Kratom Association (AKA), which was “formed to organize and represent
a community of responsible consumers,” continues to rally kratom supporters to take
action. Most of their work consists of contacting local senators and state representatives.

27
The American Coalition of Free Citizens (ACFC) is another organization dedicating time
and money to stopping the kratom ban. Formed in May 2016 as a result of the kratom ban
in Alabama, the organization is teaming up AKA to spread information and maintain
their right to consume kratom.

As Patterson said, the widespread public pushback from medical professionals and users
alike, is an alert that this may not be the typical DEA scheduling process.

“Emergency scheduling is ridiculous,” said Kagoura, a former user of kratom. “I don’t
believe in the war on drugs in general, with any substance. I think it would be a really bad
thing. If kratom isn’t there, people are still gonna do opioids. But they’re going to
overdose.”

Kratom proponents await the DEA’s final verdict, continually working to spread
awareness on the substance and prepared to deliver another hefty push back if the
decision turns out unfavorable. For the mean time, people are able to legally enjoy
kratom in most states. And Gardner expanded Krave to a second location in Greensboro,
N.C.

28
Bibliography
Bergen-Cico, D., & MacClurg, K. (2016). Chapter 89 - kratom (mitragyna speciosa) use,
addiction potential, and legal status. In V. R. Preedy (Ed.), Neuropathology of drug
addictions and substance misuse (pp. 903-911). San Diego: Academic Press.
doi://dx.doi.org/10.1016/B978-0-12-800634-4.00089-5

Boyer, E. W., Babu, K. M., Adkins, J. E., McCurdy, C. R., & Halpern, J. H. (2008). Self-
treatment of opioid withdrawal using kratom (mitragynia speciosa korth). Addiction,
103(6), 1048-1050. doi:10.1111/j.1360-0443.2008.02209.x

De Melker, Saskia, and Melanie Saltzman. "If kratom helps opioid addicts, why might
DEA outlaw it?" PBS NewsHour, January 15, 2017. Accessed January 20, 2017.

Hassan, Z., Muzaimi, M., Navaratnam, V., Yusoff, N. H. M., Suhaimi, F. W., Vadivelu,
R., . . . Müller, C. P. (2013). From kratom to mitragynine and its derivatives:
Physiological and behavioural effects related to use, abuse, and addiction. Neuroscience
and Biobehavioral Reviews, 37(2), 138-151. doi:10.1016/j.neubiorev.2012.11.012

House Bill 12 Senate Bill 48, 108th General Assembly Cong., 1-6 (2013) (enacted)

House Bill 73: Controlled Substances, H.R. 73, Florida Senate Cong., 1-6 (2016)
Johanson, Chris-Ellyn, Cynthia L. Arfken, Salvatore Di Menza, and Charles Roberts
Schuster. "Diversion and abuse of buprenorphine: Findings from national surveys of
treatment patients and physicians." Drug and Alcohol Dependence 120, no. 1-3 (January
1, 2012): 190-95. doi:10.1016/j.drugalcdep.2011.07.019.

Lauren Silverman. (2016, Sep 12,). Kratom advocates speak out against proposed
government ban. Npr Retrieved from http://www.npr.org/sections/health-
shots/2016/09/12/493295493/kratom-advocates-speak-out-against-proposed-government-
ban

Philipp, A. A., Meyer, M. R., Wissenbach, D. K., Weber, A. A., Zoerntlein, S. W.
Zweipfenning, P. G. M., & Maurer, H. H. (2011). Monitoring of kratom or krypton intake
in urine using GC-MS in clinical and forensic toxicology. Analytical and Bioanalytical
Chemistry, 400(1), 127-135. doi:10.1007/s00216-010-4464-3 PO1-50 kratom and
alcohol dependence: Clinical symptoms, withdrawal treatment and pharmacological
mechanisms - a case report ().

Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012a). Pharmacology of kratom: An
emerging botanical agent with stimulant, analgesic and opioid-like effects. The Journal of
the American Osteopathic Association, 112(12), 792. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/23212430

29
S Suwanlert. (1975). A study of kratom eaters in thailand. Bulletin on Narcotics, 27(3),
21-27. Retrieved from https://erowid.org/plants/kratom/kratom_journal3.shtml
Singh, D., Müller, C. P., & Vicknasingam, B. K. (2014). Kratom (mitragyna speciosa)
dependence, withdrawal symptoms and craving in regular users. Drug and Alcohol
Dependence, 139, 132-137. doi:10.1016/j.drugalcdep.2014.03.017

Success stories. Retrieved from http://www.americankratom.org/success_stories

Swogger, M. T., Hart, E., Erowid, F., Erowid, E., Trabold, N., Yee, K., . . . Walsh, Z.
(2015). Experiences of kratom users: A qualitative analysis. Journal of Psychoactive
Drugs, 47(5), 360-367. doi:10.1080/02791072.2015.1096434

Unknown. "Kratom Legality Map." Speciosa.org. April 19, 2017. Accessed December 16,
2016. http://speciosa.org/home/kratom-legality-map/.

Unknown. Economic Impact of Kratom Scheduling. Report. Botanical Education Alliance.
1-7. https://www.botanical-education.org/wp-content/uploads/2016/09/BEA-Economic
Impact-Report_V3-1.pdf

Abstract (if available)

Abstract Article exploring kratom user experiences and scientific studies in relation to the pending kratom ban initiated by the Drug Enforcement Agency.

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Asset Metadata

Creator Ray, Haley (author)

Core Title Kratom: proponents praise its pain-killing properties, but others fear addiction

School Annenberg School for Communication

Degree Master of Arts

Degree Program Specialized Journalism (The Arts)

Publication Date 07/06/2017

Defense Date 07/02/2017

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag ban,DEA,kava,kratom,OAI-PMH Harvest

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Castaneda, Laura (committee chair), Cole, K. C. (committee member), Murphy, Sheila (committee member)

Creator Email haleyera@gmail.com,hray@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c40-393005

Unique identifier UC11265353

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Legacy Identifier etd-RayHaley-5478.pdf

Dmrecord 393005

Document Type Thesis

Rights Ray, Haley

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

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