A Dangerous Alternative to Opiates or a Potential Treatment for Heroin? Kratom Debated

A Dangerous Alternative to Opiates or a Potential Treatment for Heroin? Kratom Debated

Mary Ann Lee, KLJ Online Content Editor[1]

Kratom, a plant-based substance that has been used for many years as a stimulant by farmers in southern Thailand, has caught the attention of authorities in the United States.[2] This long-used herbal drug with stimulating and pain relieving properties has created a commotion recently as authorities in six states have banned its sale.[3] However, in the remaining forty-four states kratom remains legal,[4] and users can even buy the product on Amazon for $19.99 (eligible for free shipping through Amazon Prime).[5] Critics of kratom liken the drug to other addictive controlled substances and proponents claim it could be used as a treatment for heroin, methamphetamine, and cocaine addiction.[6]

Kratom is derived from the leaves of the kratom plant, or the Mitragyna speciosa and the effects of the plant come from the alkaloid mitragynine, which targets the same receptors in the brain as morphine.[7] Taken in small quantities, kratom stimulates users and gives them additional energy, similar to caffeine.[8] Ingested in larger quantities, it relieves pain. Initially grown and produced in many Southeast Asian countries as a treatment for stomach aches, diarrhea, or mild pain relief, kratom is now illegal in Thailand, Australia, Myanmar and Malaysia, but remains legal and freely available in the majority of the United States.[9] Kratom is available in powder, pill, liquid extract, leaf resin, processed leaf, and whole leaf forms.[10] It can be ingested through pills, mixed with other foods, or brewed into a tea. Many users obtain kratom from online retailers or in stores where prices start at $6.99.[11] The use of kratom has increased significantly: according to the Drug Enforcement Agency (DEA), there was one report of seized mitragynine, the primary alkaloid in kratom, in 2010, 44 reports in 2011, and 81 reports in the first six months of 2012.[12]

Authorities have begun to consider banning kratom as sales have skyrocketed in the past year, but researchers claim the drug could be used to treat heroin, cocaine, or methamphetamine addiction. On one hand, critics rail against the drug, likening it to salvia, K2, spice and bathsalts, an illicit alternative to addictive and harmful controlled substances.[13] On the other hand, proponents of kratom claim its stimulating properties pose minimal risks and its pain relieving properties could be utilized as a treatment for heroin, cocaine, or methamphetamine addiction.[14]

Researchers at the University of Mississippi obtained a grant from the National Institute of Health to begin studying the effects and potential therapeutic uses of kratom.[15] Animal studies found that isolating the mitragynine compound in kratom blocked all symptoms of morphine withdrawal, working better than methadone.[16] “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,” the lead researcher, Christopher McCurdy, explained.[17] In another related study, researchers discovered rats chose kratom over cocaine, which marked the first time rats chose any drug in this class over cocaine.[18] The mitragynine produced the same effect on the rats, but had no effect on the rats’ other activities: it provided relief from the withdrawal without inhibiting the rats’ behavior or ability to function normally.[19]

Organizations such as the American Kratom Association advocate for kratom to remain legal.[20] The Transnational Institute, or TNI, released a policy briefing to the United Nations advocating for its legalization, describing criminalization as “unnecessary and counter-productive given decades of unproblematic use.”[21] According to TNI, kratom use has existed as a part of Thai culture through religious ceremonies and everyday use.[22]

While there are no known fatal overdoses from kratom, withdrawal and overdose is possible.[23] Emergency rooms have begun to see the number of patients suffering from kratom overdose and withdrawal increase as its popularity increases.[24]  This has prompted the DEA to list kratom as a drug of concern and the Food and Drug Administration (FDA) to issue an alert about kratom, authorizing its agents to detain without physical examination products from a list of known kratom importers.[25] In the alert, the FDA states, “there does not appear to be a history of use or other evidence of safety establishing that kratom will reasonably be expected to be safe as a dietary ingredient” and warns that there is no evidence proving that there is no “significant or unreasonable risk of illness or injury.”[26]

Alabama joined Vermont, Tennessee, Arkansas, Wisconsin, and Indiana in banning kratom on May 10, 2016.[27] Alabama classified kratom as a schedule I drug, the same category as ecstasy and heroin.[28] Other states, such as Kentucky and North Carolina, have introduced legislation to ban the plant.[29] Whether kratom has the potential to help addicts recover from their addictions or states should ban the drug because of its potential for abuse and remains to be seen. Regardless, more research is necessary to determine the effects of kratom and other drug alternatives as their popularity continues to climb.

[1] J.D. expected May 2017.
[2] Melissa Brown, States Ban Kratom Supplement Over Abuse Worries, ABC News (May 20, 2016, 11:32 AM), http://abcnews.go.com/Technology/wireStory/states-ban-kratom-supplement-abuse-worries-39256673.
[3] Id.
[4] Id.
[5] See Amazon.com, search “Kratom” in search bar. http://www.amazon.com/Kratom-K-com-Kava-112-Capsules/dp/B009RCO0LC/ref=sr_1_4?ie=UTF8&qid=1463975267&sr=8-4&keywords=kratom.
[6] Compare Larry Greenemeier, Should Kratom Use be Legal?, Scientific American (Sept. 30, 2013), http://www.scientificamerican.com/article/should-kratom-be-legal/ with Thomas Fuller, A Fading Thai Drug Finds Its Resurgence in a Cocktail, The New York Times (July 23, 2012), http://query.nytimes.com/gst/fullpage.html?res=9E05EFDC103EF930A15754C0A9649D8B63.
[7] Larry Greenemeier, Should Kratom Use be Legal?, Scientific American (Sept. 30, 2013), http://www.scientificamerican.com/article/should-kratom-be-legal/; Barbara Lago, New Hope for Addicts, Ole Miss University of Mississippi News: Ole Miss News Blog (January 25, 2013), http://news.olemiss.edu/new-hope-for-addicts/.
[8] Melissa Brown, States Ban Kratom Supplement Over Abuse Worries, ABC News (May 20, 2016, 11:32 AM), http://abcnews.go.com/Technology/wireStory/states-ban-kratom-supplement-abuse-worries-39256673.
[9] Jon Fernquest, Kratom leaves: Are they really a dangerous drug?, Bangkok Post (Sept. 6, 2015 at 8:07 pm), http://www.bangkokpost.com/learning/learning-from-news/682364/kratom-leaves-are-they-really-a-dangerous-drug-with-video; Larry Greenemeier, Should Kratom Use be Legal?, Scientific American (Sept. 30, 2013), http://www.scientificamerican.com/article/should-kratom-be-legal/; Melissa Brown, States Ban Kratom Supplement Over Abuse Worries, ABC News (May 20, 2016, 11:32 AM), http://abcnews.go.com/Technology/wireStory/states-ban-kratom-supplement-abuse-worries-39256673.
[10] Drug and Chemical Evaluation Section, Drug Enforcement Administration, KRATOM, (January 2013) available at http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf.
[11] http://krakenkratom.com/kratom-powder-leaf-online.
[12] Drug and Chemical Evaluation Section, Drug Enforcement Administration, KRATOM, (January 2013) available at http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf.
[13]See United States Drug Enforcement Administration, United States Department of Justice, Drug Facts Sheets, http://www.dea.gov/druginfo/factsheets.shtml.
[14] See Barbara Lago, New Hope for Addicts, Ole Miss University of Mississippi News: Ole Miss News Blog (January 25, 2013), http://news.olemiss.edu/new-hope-for-addicts/.
[15] Id.
[16] Id.
[17] Id.
[18] Id.
[19] Id.
[20] About Us, American Kratom Association (last visited May 23, 2016), http://www.americankratom.org/about.
[21] Pascal Tanguay, Kratom in Thailand: Decriminalisation and Community Control?, Transnational Institute (May 3, 2011), https://www.tni.org/en/briefing/kratom-thailand-decriminalisation-and-community-control.
[22] Id.
[23] Kari Huss, Asian leaf ‘Kratom’ making presence felt in US emergency rooms, NBC News: US News (Mar. 19, 2012 1:48 pm), http://usnews.nbcnews.com/_news/2012/03/19/10760892-asian-leaf-kratom-making-presence-felt-in-us-emergency-rooms.
[24] Id.
[25] Drug and Chemical Evaluation Section, Drug Enforcement Administration, KRATOM, (January 2013) available at http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf; United States Food and Drug Administration, Import Alert 54-15, (Jan. 22, 2016) available at http://www.accessdata.fda.gov/cms_ia/importalert_1137.html.
[26] United States Food and Drug Administration, Import Alert 54-15, (Jan. 22, 2016) available at http://www.accessdata.fda.gov/cms_ia/importalert_1137.html.
[27] Melissa Brown, States Ban Kratom Supplement Over Abuse Worries, ABC News (May 20, 2016, 11:32 AM), http://abcnews.go.com/Technology/wireStory/states-ban-kratom-supplement-abuse-worries-39256673.
[28] Id.
[29] William R. Toler, Kratom ban could cost N.C. jobs, Richmond County Daily Journal (May 21, 2016), https://yourdailyjournal.com/news/local-news-5/34197/kratom-ban-could-cost-n-c-jobs; John Null, Bill that Would Ban Kratom, Synthetic Opioids Clears Kentucky Senate, WKMS Murray State’s NPR Station (Feb. 19, 2016), http://wkms.org/post/bill-would-ban-kratom-synthetic-opioids-clears-kentucky-senate.

Kentucky General Assembly Passes Heroin Bill, Leaves Questions Open

Kentucky General Assembly Passes Heroin Bill, Leaves Questions Open

Max Fuller, KLJ Senior Staff Editor[1]

After struggling to find common ground, the Kentucky General Assembly managed to reach a compromise on an anti-heroin bill on March 25.[2] The forty-one-page bill passed the Senate with a vote of 34-4 and passed the House with a 100-0 vote. The bill includes both tougher penalties for trafficking offenses, a needle-exchange program that local jurisdictions may opt in to, and provisions to eliminate barriers to treatment.[3]

Undoubtedly, heroin addiction and abuse has become an increasingly large problem in the Commonwealth. In 2013 31.9% of drug overdose deaths autopsied by the Kentucky Medical Examiner were linked to heroin. This number is almost double the 19.6% of drug overdose deaths that were linked to heroin in 2012, and over ten times the 3% of drug overdose deaths that were linked to heroin in 2011.[4] But will the General Assembly’s bill be effective? Heroin’s rise has been, in many cases, linked to tougher laws and regulations on prescription narcotics such as OxyContin. In 2014 Attorney General Jack Conway noted that “the state’s pill crackdown ‘played some role, but [was not] the whole story,’” and that “sometimes, it feels like a game of Whac-a-Mole. You get one drug under control and another pops up.”[5] With an emphasis on treatment placed in this bill, hopefully a crackdown on heroin will not lead to the rise of another drug.

There are also questions to be raised about whether or not tougher penalties are the answer to the heroin problem. The bill, which went into effect as soon as the governor signed it, requires offenders found with more than two grams of heroin and more than one item of “paraphernalia” to serve at least 50% of the sentence imposed. While there are many proponents of laws that are directed towards traffickers, there is substantial data that suggests other methods are more effective at reducing drug abuse rates than increasing incarceration rates. [6]

Will a solution that combines both increased treatment and increased penalties work to eliminate the rising heroin problem? Only time will tell.

[1] J.D. expected May 2016.
[2] Mike Wynn, Heroin bill passes with needle exchange, The Courier-Journal (Mar. 25, 2015), http://www.courier-journal.com/story/news/politics/ky-legislature/2015/03/24/heroin-bill-gov-steve-beshear-urges-kentucky-legislature-pass-legislation/70376936/.
[3] 2015 Kentucky Senate bill No. 219, Kentucky 2015 Regular Session.
[4] Heroin deaths keep rising in Kentucky, The Courier-Journal (Aug. 2, 2014), http://www.courier-journal.com/story/news/local/2014/08/02/heroin-deaths-keep-rising-kentucky/13504281/.
[5] Laura Ungar and Chris Kenning, Heroin surges as Kentucky cracks down on pain pills, The Courier-Journal (May 16, 2014), http://www.courier-journal.com/story/news/investigations/2014/05/16/heroin-surges-kentucky-cracks-pain-pills/9123285/.
[6] See, e.g. A drug policy for the 21st century, The White House (2014) https://www.whitehouse.gov/ondcp/drugpolicyreform; Maia Szalavitz, Drugs in Portugal: Did Decriminalization Work? Time (Apr. 26, 2009), http://content.time.com/time/health/article/0,8599,1893946,00.html.

Good Intentions Gone Wrong: Does an Attempt to Bring Awareness to Dangers of Heroin Abuse Give Rise to a Claim for Libel?

Good Intentions Gone Wrong: Does an Attempt to Bring Awareness to Dangers of Heroin Abuse Give Rise to a Claim for Libel?

Felisa Sue Moore, KLJ Staff Editor[1]

Eva Holland posted a photo on Facebook with her children and their deceased father, Mike Settles, in an open coffin.[2] Holland’s proclaimed purpose for the post was a seemingly noble one; she wanted to inform Facebook users of the “cold hard truth that heroin kills.”[3] Holland stated that she was certain the photo would make others feel uncomfortable, but the purpose behind the photo “was to show the reality of [heroin] addiction.”[4] The message was widely received by many Facebook users; as of this writing, Holland’s photo has been shared 250,000 times and has received 100 comments.[5] Continue reading

Not for Human Consumption: How Inept Legislative Policy Proliferates the Synthetic Drug Problem

Note | 103 KY. L. J. ONLINE 3 | Feb. 22, 2015

Todd J. Weatherholt[1]

The “war on drugs”[2] is facing a new opponent, one that is sophisticated and dynamic, but unfortunately whose dangers go widely undocumented.[3] As if there were not enough problems with other classes of drugs for authorities, a new “underappreciated” category – synthetic drugs – has gained tremendous momentum within the last few years in the United States and around the world.[4] These substances, although widely eradicated in neighborhood gas stations and head shops, remain easily obtainable over the internet.[5] The industry, which targets drug-naïve teenagers and young adults through the combination of shiny packaging with familiar cartoon characters and vibrant names such as Ivory Wave, Spice, and Cloud Nine, generates an estimated $5 billion dollars annually.[6] Unfortunately, the synthetic drug enigma facing our nation is not merely the result of these products’ accessibility, but likewise due to their easily manipulative characteristics, which help manufacturers circumvent existing laws.[7] As authorities identify specific chemical components to outlaw, rudimentary chemists simply modify existing drug compositions slightly to escape the law.[8] Continue reading