Kratom: Is the US trying to ban a drug helping heroin addicts beat their habit?

When Donald Trump became US president a few minority groups took a sharp intake of breath, worried at how the unpredictable businessman might affect them. Perhaps among the least well-known is the community of people who take a drug called kratom.

The drug, also known as mitragyna speciosa, is a member of the coffee plant family, and originates from Southeast Asia. Due to its opiate properties, it has been used by addicts to wean themselves off drugs, including in the US which is struggling to contain heroin and opiate addiction in the population. In 2013, 1.9million Americans were addicted to some for of opiate, whether prescription pain killers or heroin.

In small doses the plant acts like coffee and in larger doses as a relaxant, as it contains both the stimulant mitragynine and opiate 7-hydroxymitragynine.

At the beginning of March, over 26,000 people in the US had signed a petition lead by the American Kratom Assocation (AKA) calling on the President to stop a push by the Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA) to make kratom illegal. A report by the AKA released in November suggested that Kratom is as harmless as nutmeg.

“We are veterans, and lawyers, and factory workers, and school teachers, and health care professionals. We are mothers and fathers and grandparents and senior citizens,” the petition read. "We are the real face of America. Our choice to consume kratom does not make us 'drug abusers' any more than drinking a cup of coffee would."

However, the reality seems a little more complex. On the Kratom Reddit forum users can find how to take kratom - including in capsules, in food and tea - as well as dosing and where to find it. Users celebrate the drug as saving them from opiate addiction, including prescription drugs and alcohol, but also share attempts to wean themselves off. “It's been a great ride, but it's time for me to exchange the kratom crutch for one that is less habit forming,” wrote one user.

“Kratom is an interesting case,” says Hayden Griffin, Assistant Professor in the Department of Criminal Justice at the University of Alabama at Birmingham who is an expert in the drug. “Although the plant has been used for hundreds of years in Southeast Asia, it is relatively new to the United States.

“From the research literature, it is difficult to find any reports of any deaths attributed solely to kratom. Thus, it seems like there is not an immediate need to regulate kratom and the decision by the DEA to emergency schedule kratom, which has since been withdrawn, seemed hasty, especially since this regulatory action would have essentially prohibited medical researchers from conducting studies with kratom.

“Yet, it is hard to imagine that some regulations should not be placed on kratom," he adds. "Clearly, it is a drug and at the very least, there needs to be some regulations to make sure that sellers actually sell kratom free of adulterants."

The issues surrounding kratom become more complex still due to the drug control apparatus in the US, he adds. While it is too early to tell which addiction kratom is most useful for treating, the road to finding out will be likely be a long one. As kratom is a plant and therefore presents patenting issues, it is not appealing to drug companies. As a result, doctors will not prescribe a drug that is not FDA approved, even if it might help serious addiction.

“I think there seems to be potential for kratom to treat people with substance dependency issues, but the system does not seem to encourage or allow this," argues Griffin. But criminalising users seems like a mistake that can and should be avoided, he adds.

"I think there are many things that need to change," he goes on. "Many people who suffer from substance abuse are self-medicating to alleviate varying forms of trauma or abuse. Some people are suffering from physical ailments. Using the criminal justice system alone to combat these problems is inadequate because you are merely punishing the behaviour without better examining why the behaviour exists.

"Also, treatment is not easy. Many people who have serious substance abuse troubles will need time and multiple stints in rehab to treat their problems. Even when the focus is more on rehab than punishment, we need to give many users more than one chance. Additionally, some users who get caught with drugs do not start out as hard core users. Many people will use drugs and then later quit on their own."

Looking at the current issues with harder opiates, lessons need to be learned moving forwards with kratom, suggests Griffin. "It has been used for hundreds of years without great harm, does not seem to pose a great danger especially compared to opiates, and medical researchers should be given an adequate chance to investigate the substance before strict controls are put in place that could inhibit this research. What will happen is difficult to say."