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Conflict over Kratom, a potential opioid alternative

Conflict over Kratom, a potential opioid alternative

The U.S government has attempted 2X to categorize kratom as a controlled substance but public opinion and setbacks from Congress have hindered those attempts.

A W.H.O meeting in the upcoming week could be decisive for the future of kratom, a readily available herbal supplement that works similarly to plywood pain easers, in the U.S. and abroad.

Kratom, a plant indigenous to S. East Asia, yields narcotic-like effects when consumed in smoke, liquid, or pill form. Its supporters claim that the substance is a potentially good replacement for opioid painkillers, helping ease addiction and reliance on those drugs, which have killed almost 70K people in the U.S. in 2020.

The above claims have not been confirmed by experts yet. The U.S. government has attempted twice to limit kratom’s usage by labeling it as a “controlled substance”, claiming that it comes with a high risk of abuse and no proven medical value. However, public backlash and setbacks from Congress have hindered those efforts.

Now, kratom supporters are pointing out that Washington is behind the WHO’s attention–an attempt to bypass the federal legal procedures by taking the global route to complete what it could not achieve nationally.

The WHO’s drug reliance committee will carry out a “pre-trial” or Kraton. The preview could pave the way for the substance to be subject to additional checks by global health policy-makers, potentially placing it on the way to being planned as a controlled drug.

The U.S or WHO planning the drug, according to its advocates’ claims, would place even more barriers to examining it, related to complaints from local cannabis researchers who were only allowed legally to study exclusively “research-grade” marijuana under the supervision of a state-approved unit.

Albert Perez Garcia-Romeu, professor at the Johns Hopkins University School of Medicine has commented that making Kratom an illegal substance is going to trigger people to use more risky drugs.

An FDA representative announced that the agency will public opinion to update the U.S. stance if WHO suggests or imposes global controls on Kratom or another substance under speculation the upcoming week.

She said that it’s premature to consider what acts, if applicable, would be needed before that period.

While the HHS and FDA are keeping off on calling the WHO to plan Kratom, their public comment announcement hinted that their perspective of the herbal substance continues to be murky.

The FDA has said that Kratom is a highly popular psychoactive substance that is directly available on the drug market in the U.S.

The FDA, in particular, has been skeptical of Kratom, cautioning consumers to refrain from using it and seizing all supplements from overseas that contain Kratom. The agency has placed several kratom suppliers under warning for promoting it as a treatment for opioid addiction or pain, medical claims that are not verified.

Both the previous Obama and Trump administrations attempted to prohibit Kratom, only to bow out because of the popularity of the herb and its proponents in the public and some members of Congress.

Ex FDA commissioner, Scott Gottlieb, has emphasized that kratom is just as risky as opioids and that it further fuels the opioid crisis.

Gottlieb’s claim elicited a quick rebuke from Brett Giroir, ex-assistant secretary for health and acting FDA commissioner during the former Trump administration. Giroir turned down the FDA’s suggestion to categorize kratom as a Schedule 1 controlled substance due to an overwhelming lack of data, and a failed attempt to consider general public health. Giroir, in a 2018 memo, abolished the HHS suggestion to ban Kraton and urged for more research and public comment.

After countless hours reviewing the evidence, Giroir shared on POLITICO on Friday that classifying Kratom as a “Schedule 1 Drug” would obstruct research and potentially drive consumers toward more dangerous substances like heroin.

Gottlieb didn’t reply to any calls for comment.

Kratom rose in popularity during the 2000s together with the opioid drug crisis, Garcia-Romeu said, leading the DEA to categorize this as a “drug of concern”. Kratom is currently illegal in Arkansas, Alabama, Indiana, Vermont, Rhode Island, and Wisconsin., while some other states like Utah and Arizona have confirmed acts to regulate it.

Two aspects in Kratom stimulate the brain’s opioid receptors, something that has raised skepticism about whether users may develop addiction over its use.

However, scientists like Garcia-Romeu, claim Kratom’s effects are not the same as those of opioids, noting that the drug doesn’t slow down breathing to the degree conventional opioids do.

Garcia-Romeu characterizes this phenomenon as a double-edge sword that can be abused but also has medical potential.

A study Garcia-Romeu carried out in 2017 involving 2.800 self-claimed Kratom users in the U.S, has found that they are usually male and middle-aged, and use Kratom to treat depression, stress, anxiety, pain, and symptoms associated with opioid withdrawal. 41% also shared using the substance to control or banish their opioid addiction, with more than 1/3rd of the group having weaned themselves off those drugs for more than a year.

Garcia-Romeu has commented that with finds like this, treatment for opioid addiction seems promising.

Mac Haffow, spokesperson of the American Kratom Association supports that his group wants to see a substance that is classified and regulated as a food supplement so that the raw ingredients used to make it are checked for germs and contaminants like salmonella and heavy metals. The enforcement of FDA regulation would also call for better manufacturing procedures and labeling terms, he said.

The FDA has formerly awarded a $2.3M contract to Altasciences in Overland Park, Kan., to examine Kratom dosing to estimate its abuse risk. However, under the regulations of the solicitation, the FDA reserves the rights to all of the sources and documents produced by the conductor who is bound by a confidentiality agreement.

However, Haddow worries that this could enable the FDA to conceal the study’s findings and that he believed science had the responsibility to determine this policy.

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