October 4, 2016: An update has been appended to this article.
The national debate around kratom—a Southeast Asian plant known for its opiate-like effects—reached its peak in Denver earlier this month, when the Department of Environmental Health issued a public health advisory banning its sale.
The move came on the heels of the Drug Enforcement Administration’s Aug. 30 announcement of its intent to categorize kratom as a schedule I controlled substance, alongside heroin, LSD, and marijuana. About 50 people gathered on the steps of the state Capitol last Friday to protest the ban and impending DEA scheduling. A similar rally took place in Washington D.C. on September 13.
Kratom comes from the leaves of the Mitragyna speciosa tree, which is native to Thailand, Malaysia, and Myanmar, where for centuries it’s been used as a stimulant, depressant, for pain relief, and to wean people off opiates. It’s typically consumed in powder form, dissolved in water or enclosed in capsules, and until now, could be purchased in dedicated stores or headshops. Its leaves “produce complex stimulant and opioid-like analgesic effects,” according to one study.
Some users claim that kratom is nothing more than a harmless herbal tea that provides either stimulation or relaxation. But the DEA says it’s dangerous, addictive, and has no accepted medicinal uses, and therefore should be scheduled under the Controlled Substances Act.
“Having a federal agency make an announcement about the hazard presented by a substance certainly surpasses the threshold where we would be prompted to act,” says Danica Lee, director at the Denver Department of Health, about the advisory. “So on the basis of [the DEA’s] announcement, we acted locally to put a hold on product within our jurisdiction that we were aware of.”
Research on the drug remains scant, but Kratom has grown in popularity in the United States in recent years, even as it has existed in a legal gray area. The Centers for Disease Control and Prevention reported 26 kratom-related calls in 2010, compared to 263 in 2015. The DEA cited this increase to support its intent to schedule the substance, moving it off the Drugs of Concern list, where it’s been for several years.
The Food and Drug Administration, which does not regulate kratom, hasn’t been able to previously restrict its sale because the plant was categorized as a botanic dietary supplement. The agency was able to ban imports of kratom in 2014 on the grounds that it has a high potential to be a harmful substance. But many suppliers, including former Denver retailer Rocky Mountain Kratom, sold packages of kratom with the FDA-required “not for human consumption” label, in order to satisfy U.S. Customs requirements.
The lack of sanctioned research and regulation means kratom users must trust their supplier, which to Lee is enough to warrant its ban.
“From a public health standpoint, we have not met the threshold for what is considered safe using the standards that we use this day in age,” she says. “Normally when we say a product is established as safe, we hope to see some research behind it and have an understanding of the impact it has on the body. Does it have the same impact on people who might be immune-compromised or have different types of health conditions? That body of research isn’t there.”
Lee cited the 2014 death of a Denver man that was attributed to “apparent acute Mitragynine intoxication,” according to the death certificate. (Mitragynine is the active chemical compound found in kratom.) “What I ask myself is, if the worst case scenario were to occur, would I feel OK with what we did,” Lee says. “My concern was, ‘what if we have illness, death cases resulting from kratom products here locally because we failed to act on it before the DEA rescheduling was finalized?’”
The outcry against the ban, both nationally and in Denver, has been loud and swift. Advocates have praised kratom, saying the product reduces harm by keeping them off other substances, like prescription drugs or heroin. At the rally at the state Capitol on Friday, one Rocky Mountain Kratom employee said he uses the plant to manage symptoms associated with Lupus, thus avoiding the side effects of the prescribed medications he’s previously used.
“Kratom saved me,” said one U.S. Navy veteran at the rally, who uses the plant to manage his multiple sclerosis. His prescribed medications, he says, had him hooked, bedridden, and caused episodes he couldn’t remember in which he was verbally and physically abusive to his wife. He says kratom causes no such effects for him.
For some addicts, though, kratom may be too similar to opiates to be safe. The New York Times reported that the drug’s spreading popularity but still-unknown long-term effects might lead recovering addicts to relapse. If deeper scientific understanding of kratom is needed, the DEA classifying it as a schedule I substance would be a tremendous hindrance to research.
As 5280 has reported before regarding cannabis, a schedule I categorization makes broad scientific research all but impossible. That’s why 51 members of Congress have asked the Obama administration to postpone the scheduling decision, calling it “hasty” and “done without any public comment from researchers.” The letter also points out that federal grants from the National Institutes of Health, the National Institute for Drug Abuse, and the National Center for Research Resources led to a patent application for the use kratom in treating symptoms of withdrawal.
Even more, a Whitehouse.gov petition to stop the proposed scheduling currently has more than 137,000 signatures, surpassing the 100,000 signature threshold that warrants a response from the White House within 60 days. But with the DEA scheduling expected to go into effect on September 30, the future of kratom remains uncertain.
Update, 10/4/16: After a slew of backlash from the public and elected officials, the DEA has postponed its plan to classify kratom as a schedule 1 drug. The agency will now allow for a modified public comment period before the final decision will be made. The timing of the comment period has yet to be released. Danica Lee, director at the Denver Department of Health, said on Tuesday that the DEA’s decision doesn’t affect the public health advisory issued by her department, which banned the sale of kratom in Denver. “We’ll stay the course for now, but we will certainly continue to evaluate things as they develop and continue to make changes and adjustments,” Lee said.
Clarification, 9/18/16: This article was updated with more information about research into kratom’s use in treatment of withdrawal from addictive substances. The article also clarifies Rocky Mountain Kratom’s labeling of the product.