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Drug Research Studies

What is kratom and should it be regulated? – Las Vegas Sun

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A leaf of Mitragyna Speciosa, also known as kratom.

The trees grow in Asia. They reach about 50 feet in height, and their leaves have traditionally been used as a stimulant and as medicine. The humidity and soil of their native environment mean they aren’t equipped for the desert life of Nevada.

The leaves, though, are popular here and elsewhere in the U.S. as a self-administered pain relief and addiction treatment. Some states have made it illegal. Nevada has not.

It’s called kratom. Let’s take a look at what this plant is, what it does and what the debate around it entails.

What is kratom?

Consumption

Chewing on the leaf itself is rare in the U.S. because the plant does not grow here naturally. It’s available in capsule form and as a powder, which consumers can use to make tea or add to other food. The plant has a bitter flavor and takes effect about 30 minutes after consumption.

Mitragyna Speciosa is a member of the coffee family, an evergreen tree that contains opioid properties. Commonly referred to as kratom, the plant’s leaves are traditionally chewed to produce stimulant effects. Think of it as a shot of espresso in plant form.

Chewing too much, too quickly, or taking a large enough dose in another way can make the plant’s opioid properties kick in.

Opioid properties

Where does it come from?

Southeast Asia—Thailand, Malaysia and Indonesia are the plant’s indigenous homeland. Kratom is illegal in Malaysia and Myanmar and only allowed for medicinal use in Thailand, but since the trees are native, stopping consumption is difficult. It has been used for millennia by rural workers to increase productivity, reduce pain and, in some cases, as a poultice on wounds. In the U.S., people use it as a painkiller and as a self-administered addiction cure. “A lot of people come into kratom as an off ramp to addiction,” Dunn said.

Opioids and opiates are different. Opiates are derived from the opium plant. Opioids are anything else that triggers the same brain receptors as opiates.

But not all opioids are created equal. Cheese contains casein proteins that stimulate those receptors, the same exact ones as morphine, though at an extremely reduced rate. Fentanyl is also a synthetic opioid. See the range?

Kratom is much closer to the cheese level of opioid receptor stimulation than the fentanyl level. Doses of more than 15 grams can have a more pronounced opioid affect, but Kelly Dunn, owner of Urban Ice Organics in North Las Vegas, said the natural form of the plant is very mild. Extracts, which Urban Ice does not produce or sell, can have more of an effect, he said. Dunn has an issue with calling it a “high.”

“[It’s] similar to caffeine. Can you get high on a cup of coffee? Yeah, but you’re not going to be impaired,” he said.

Is it addictive?

Addiction centers and kratom acolytes disagree on this topic.

Research around kratom is lacking, and anecdotal reports show that many users have not had addictive experiences with the drug.

The Mayo Clinic says it’s not effective in treating an opioid addiction because of its own addictive effects, while other studies and organizations stop short of calling the drug addictive outright. In other words, more research is needed.

Rebecca Gasca, a lobbyist with the American Kratom Association, said the plant is not addictive.

Assemblyman Jim Wheeler, R-Minden, who sponsored a kratom-related bill in the past legislative session, said the plant is reported to help with addiction.

How is the plant regulated?

On the federal level, kratom is not regulated.

The Food and Drug Administration warns against consuming kratom in any form until further research is done.

In August 2016, the DEA tried to temporarily ban kratom by using its emergency scheduling powers to define the plant as a Schedule I drug.

Thousands signed petitions to stop the scheduling and won.

Six states and Washington, D.C., have banned the plant. As of now, there are no regulations on the books regarding kratom in Nevada, but that may soon change.

Wheeler and Assemblyman Steve Yeager, D-Las Vegas sponsored a bill—passed by both legislative houses and sent to the governor for signing—that would require vendors to make sure the product is not mixed with another substance to the point of being “injurious to a consumer.” It would also ban sales to minors.

Wheeler said the bill is about consumer protection and to ensure buyers get what they’re paying for.

“What we do in this building is watch out for Nevada,” he said.

Is it dangerous?

Most deaths associated with kratom also are associated with other drugs, and the FDA came under fire in early 2018 for associating kratom with such instances.

Gasca said taking large quantities of kratom is not advised, but not dangerous. “If you take it in large quantities, you’re going to get a stomachache. That’s probably going to be the biggest physical response that you experience,” she said.

Kratom mixed with other products can be dangerous because consumers don’t know what they’re consuming. It’s an issue Dunn is passionate about, and says that buyers should have the right to know what they’re getting.

“The industry needs some guidelines. We need some regulations,” he said. “We need some enforcement, too.”

Dunn said minors shouldn’t consume kratom, which he compared to other readily-available products like energy drinks. “I feel the same way about 5-Hour Energy, Monster Energy,” he said. “I cringe at the idea that we have kids and teenagers buying those.”

This story originally appeared in the Las Vegas Weekly.