Should Kratom Be Banned? Here's What the Experts Say
While lots of people reading this are patiently waiting for marijuana legalization to finally reach their state -- most likely passing the time by smoking marijuana -- lots of others are about to see Prohibition show up at their door for the first time. They are the "kratom" users. That's a plant-based painkiller which some people describe as "herbal heroin." It was, up until now, completely legal. I first used it back in 2009 -- not because I was in pain, but because I wanted to get high without failing a drug test (like many painkillers, you can also take it for fun). Then, a couple of years ago, I introduced kratom to someone who does live with chronic pain -- Cracked contributor Marina Reimann.
She had been on "six 10-milligram Percocet every day" for her pain. Percocet is one of those infamous opioid painkillers which now cause 68 percent of the overdoses in the USA. It came with horrible side effects, and sometimes pharmacists would refuse to fill her prescription, because they tend to assume any young people getting painkillers are jonesin' for a fix. During one of these times, I offered her a glass of kratom (it comes as a powder you can make into tea, or just about anything else). It worked, and kratom soon replaced her daily dose of Percocet. "It's like night and day -- it's like being alive after being dead, forever ... I can't stress how much kratom saved everything I care about."
And then this happened:
Now, The Man doesn't actually take away drugs because they want to ruin our fun; there usually are real dangers at play. So I interviewed a spokesman with the DEA, along with four experts in the field, to find out why a whole bunch of people in Marina's situation are about to become criminals.
The DEA Can Start Drug Wars Without Anyone's Approval
Moving kratom to Schedule I effectively puts it in the same category as heroin and (still!) marijuana. Tens of thousands of users will become criminals overnight as early as September 30th, despite the fact that no one put it to a vote and (as far as we know) no politician was swept into office on the promise of ending the kratom scourge.
"I know Kratom. Bad country. Evil people. Bomb them. Big scourge, yuge scourge."
But Congress has granted the DEA the power to fight drug abuse in America without needing approval for each and every decision -- nobody has to pass a separate law to declare a substance illegal. It's probably not surprising that the DEA spokesman I interviewed, Russ Baer, felt this was perfectly reasonable: "[W]e know that kratom meets the statistical criteria of a Schedule I substance ... there may be ongoing [medical] studies, there may be promising results, but those studies are inadequate at this point. We know that the consumption of kratom individually or with other drugs ... is a serious concern. So the DEA has an obligation to promote and protect the public safety."
Russ also stressed that this was a "temporary" scheduling. The DEA is banning kratom for two years so they can evaluate whether or not it should be banned forever. On one hand, there are examples like the club drug TFMPP -- its 2002 ban was in fact allowed to expire in 2004. On the other hand, we have marijuana, which was recently denied rescheduling once again. We're coming up on 80 years with that one.
Another one of their mandates is to prevent any more Cheech & Chong movies.
At this point, you are likely assuming that there must have been some wave of hospitalizations/deaths related to kratom which forced the government's hand. Or maybe a celebrity OD'd on it? Well ...
We Don't Know If Anyone's Died From Kratom
kratom is mainly grown in Indonesia and Malaysia. It works kind of like a painkiller when you drink a lot of it, and like a stimulant when you drink a little. We spoke with Dr. Darshan Singh, a Malaysian scientist who has dedicated his career to studying it. "People have been using kratom for hundreds of years in Malaysia. It is used in traditional [medicine] ... You can actually see the adult population using kratom to treat diabetes, to treat hypertension ..." He was adamant that, to the best of his knowledge, "No one has died in Asia" of a kratom overdose.
Apparently, 60 percent of the world's population isn't a big enough sample size for some people.
So what's the DEA's justification for the ban? Right now, they cite a "steady increase" in kratom-related hospitalizations. And it is true that "Between January 2010 and December 2015 U.S. poison centers received 660 calls related to kratom exposure. During this time, there was a tenfold increase in the number of calls received, from 26 in 2010 to 263 in 2015."
A tenfold increase sure isn't good. But we're also talking about 660 calls in five years. For comparison, there were four times as many people hospitalized for caffeine overdoses in 2013 alone.
The truth is, any drug which actually does something can make you sick in high enough amounts, as opposed to herbal supplements and homeopathic placebos (trust me -- kratom is no placebo). As Dr. Walter Prozialeck (who reviewed all the available scientific literature on kratom back in 2012) put it, "My view is that if kratom has pharmacologic activity (which it clearly does), it would certainly have potential for toxicity, even serious toxicity." The DEA also cites the deaths of nine people in Sweden who were using a kratom-derived product called Krypton. So case closed, right?
But Krypton isn't straight kratom -- it was adulterated with O-Desmethyltramadol, a more intense version of the painkiller Tramadol. See, this is where things get complicated. Lots of people who take kratom don't take it straight. I asked Dr. Oliver Grundmann (a pharmaceutical scientist who published a report on kratom's toxicology last year) if kratom alone has ever killed anyone. "[I]t cannot be excluded that kratom might have been a contributing factor that made the condition worse, especially in users that use other depressant drugs ... but kratom use, single kratom use alone, has not been attributed to any deaths to my knowledge."
Never trust anything named after a planet where everybody died.
I asked Dr. Singh the same question, and he told me, "You can see all the cases that have been reported to the poison center of the U.S. ... [are] actually not due to kratom alone, because most of the kratom products are adulterated with other substances ..."
But DEA guy Russ Baer, whom I interviewed while sweating heavily and hoping he didn't Google me and realize I wrote a whole book about experimenting with weird ancient drugs, had no question in his mind that kratom has killed people. "The media's not representing the other side. When I get calls from a father who lost his son three years ago from the misuse of kratom ... We're talking about families that have been gravely harmed. We need to not forget that." The father he was speaking of is Dr. Lawrence Fox. I interviewed him as well.
He explained that his son, Alexander, purchased kratom in an attempt to wean himself off of opiates. "He took it on one occasion, and the autopsy report shows that it did contain the adulterant which is marketed as Krypton, which has been responsible for many deaths. Now, as far as I know, he would've been ordering just thinking he was ordering kratom over the internet."
So it's perfectly reasonable to say people shouldn't be giving out free samples of this stuff at the mall -- especially when it's impossible to know exactly what you're getting. Remember, the most loyal customers are those with chronic health conditions, whose systems are already weakened and/or are on other medications kratom may or may not interact with. Still, is there no way to save people like Dr. Fox's son without throwing them in jail and ruining their lives?
Scientists And Users Want Kratom Regulated; The DEA Can't Do That
Even assuming the DEA's kratom death tally is accurate, kratom is roughly as deadly as 5-Hour Energy, a product you can buy in every gas station. Likewise, Acetaminophen (like Tylenol) is the #1 cause of calls to poison control centers nationwide, and kills roughly 458 people with liver failure every year. The obvious counter to that is that caffeine and Tylenol are used by nearly every adult in the country, so in order to translate death tolls to risk, we need to know how many people use kratom. And ... we have no fucking idea. That's because all kratom sold in the U.S. comes from websites like this ...
And you thought Taco Bell was boss at marketing the same damn thing a thousand different ways.
... and the same head shops where Americans buy their bongs, incense, and marijuana leaf flags.
That lack of certainty is a problem for users, too. Dr. Prozialeck pointed out that, "The problem is that when people buy or use 'kratom' products, they are not sure what they are actually getting/using." When we spoke about his son's death, Dr. Fox noted, "one of the problems with knowing how dangerous the drug might be is simply that normal testing doesn't reveal it. So if you give someone a urine screening for drugs, this stuff doesn't show up ... we only found out that this was in [his son's] blood because when I found his body in his bedroom, we found packets labeled 'kratom' ... People in theory ... could be dying left and right as a result of kratom, and we would never know."
So yes, in a perfect world, there would be some middle ground between "SWAT team kicks down your door" and "a totally unregulated market in which the seller might be a front for the Russian mafia selling you the ashes of a murdered informant." This is not a perfect world -- right now, kratom is regulated as a "dietary supplement," which is the same classification as the silver people keep shooting up their butts until they turn blue.
To be fair, have you ever seen a fat Na'vi? No.
Dr. Singh believes that this wild west attitude is why Americans keep getting sick from it. "Most of these internet pharmacies that market kratom, they do not provide clear information to consumers ... in Malaysia, we don't use kratom in powders, kratom in liquid form. It's very safe if it has not been adulterated. Simple as that."
This also creates a problem for those trying to research the benefits of the drug, since scientists essentially have to rely on the same shady websites as people looking for a quick legal high.
"What does 'ultra-enhanced' mean, you ask? Fuck you, that's what it means!"
Dr. Grundmann told me that the medical kratom advocates he's spoken with very much wanted some regulation -- you'd think there'd be plenty of ground for compromise. But the DEA isn't allowed to compromise, because somewhere along the line, we decided our law enforcement agencies should have more rigid programming than the goddamn Terminator.
"The DEA has very limited tools to restrict the access to drugs," says Dr. Grundmann. "Basically, if the FDA says there's no medical indication for that part-plant extract ... the DEA only has one schedule, and that's Schedule I, in which they can put that drug ... so they don't have the tools to fine-tune [their] response to drugs that are a potential health threat." He could've just as accurately have said, "The DEA has a giant hammer and is wearing Nailvision goggles."
The agency which answers to no one and makes its own rules can't add a "1.5" to the rules they make up.
Of course, the DEA argues that regulation is absolutely a possibility. That's why this is only a temporary scheduling -- to give scientists time to study it. But the issue for medical users like Marina is that the government is choosing to ban it while it's being studied instead of letting individuals decide for themselves. It's the same "criminalize until we are 100 percent sure it's safer than oatmeal" attitude that has been stuffing the prisons with drug offenders for about a century now.
But no, damn near 25 percent of all prisoners are American because they're terrible people, sure.
Even though I'm a user, and you can guess my position, this is no doubt a complex issue. I can certainly understand why Dr. Fox supports the move to Schedule I while kratom is being studied. And even he acknowledged that, while his son's death was "obviously coloring" his judgment, "I appreciate very much why people would want the autonomy of being able to order something that would help them with chronic pain." He noted that a big problem here was the lack of a "middle ground" between kratom being completely illegal and people being able to package Murder Pills in a box which says "Kratom" with zero regulation.
"I favor learning everything we can about this drug. Because it may have very desirable properties that absolutely should be exploited," he says.
If they leave it legal while it's being studied, some people will probably get sick from it. Maybe very sick. Some may die. But criminalizing kratom comes also with a human cost, and it's easy to argue that it's much higher. After all, the most serious side effect of marijuana is prison.
The DEA Claims That Research Will Continue; Researchers Don't Believe Them
So if we can't get the DEA to change its mind, then we've got to quickly get a buttload of research together proving that kratom is safe, right? Well, see, there's a problem.
Baer was adamant that kratom's scheduling would have no impact on research into the drug. "We're trying to remove roadblocks. We did it in the case with marijuana, and we're encouraging the scientific medical community to apply for research registrations to move the ball forward." The way he explained it, the only difference between research on Schedule I versus Schedule II-V drugs is that researchers would have to submit a proposal, along with DEA form 225, to get a license. That's this four-page form, which looks pretty much like every other government form:
That all sounds reasonable. But then I spoke to Dr. David Nichols, a scientist who produces MDMA, LSD, psilocybin, and a bunch of other chemicals for legal research. He might be the world's expert on dealing with the DEA in order to study illegal drugs. He seemed to trust the DEA's words about as far as he could throw the agency's headquarters:
"The DEA 225 is the application for a license, and in addition, they will need to submit a research protocol. Plus, they will have to have an inspection of their storage facility, usually requiring a safe of some kind. That will take a minimum of three months (if they already have a safe), and likely will take longer. So I don't know how the DEA can say that [ongoing research will not be impacted]. If you are currently doing research on kratom, you will need to do all the things I mention above ... It will keep all but the most devoted from continuing their research."
On the upside, we might get a Kratom Madness movie.
Every single researcher I spoke with shared Dr. Nichols' concerns. Dr. Grundmann told me, "I completely agree [with] Dr. Nichols with this regard ... I know what a challenge that can be ... to get a DEA Schedule I license. There are significant costs there, and an additional time commitment, and in my opinion, it will no doubt burden the scientific process of doing research on kratom." Dr. Prozialeck also worried that moving kratom to Schedule I would slow research. "As an example, the federal regulations regarding marijuana have made it extremely difficult for American [researchers] to conduct research on potential therapeutic effects."
In fact, the U.S. government has a long tradition of banning drugs and setting back research by decades. This recent analysis of several studies on LSD and alcoholism suggest that, in addition to inspiring most of the best progressive rock, acid could be a hugely powerful tool for treating addiction. But all those studies were originally conducted back in the 1960s; the U.S. ban on LSD all but shut down research for decades after that point.
Sorry, lushes. It's poorly funded, barely functioning detoxes, or nothing.
Likewise, there are early studies which show that may kratom effectively stop the withdrawal symptoms of heroin and other opioid use (which would be huge if true, considering prescription opioids kill more Americans than any illegal drug). Yes, the patient can wind up addicted to kratom, but kratom withdrawal seems to be mild. This is on top of the painkilling effects which make it a lifesaver for people like Marina.
Thousands Of Sick People Are About To Become Criminals Overnight
When I asked Agent Baer whether or not moving kratom to Schedule I was effectively the start of a new drug war that could imprison thousands, he told me, "I can tell you from an enforcement perspective ... our priorities are going after the biggest, baddest drug traffickers in the world. We're going after the traffickers that are responsible for ... heroin, methamphetamine, fentanyl ... we will continue to focus our resources on those cases. I don't anticipate us actively seeking out and trying to investigate a person who has a teabag quantity of kratom ..."
But kratom's illegality will mean the only way for users to get it will be via drug dealers. With drug dealers come drug busts, and cartels, and all the shit we've seen with every other drug the DEA's ever banned. There will be a black market -- especially as more people find out how effective it can be. I feel like we've been down this road before.
Mexican discount drug depots do too, and they are licking their chops.
To people like Marina, who are currently using kratom for pain management, Agent Baer says, "We do realize that a lot of people are self-medicating. And the message that we need to send is that self-medicating is not a good idea." That may be sound medical advice, but is a prison term and a criminal record the only way to deliver it? Even he acknowledged that the DEA has received far more phone calls about their decision to schedule kratom than their last refusal to reschedule marijuana. Those included lots of personal stories like Marina's.
Like with every other aspect of kratom's use and abuse, there's not much research into how well it works for chronic pain (something that's incredibly difficult to study anyway, thanks to the placebo effect), but the research which does exist suggests that kratom's stimulant effects make it preferable to the "zombification" many opiate users experience. kratom's ability to get people to choose it over prescription opioids -- which, again, absolutely do ruin lives -- is measurable. Just ask Marina.
"Before I tried kratom, I was on six 10 mg of Percocet every day -- every day -- of my life ... I couldn't type. I couldn't hold things without dropping them. I couldn't work. I was more or less bedridden for a year and a half, which is terrible. But heavy-duty medicine will do that to you ... feeling like you're chained to a pill bottle sorta takes the fun out of living."
Not all prisoners wear jumpsuits.
And Dr. Grundmann told me, "From my personal discussions with people who are using kratom, it's definitely not a junkie kind of scene ... it's mainly middle-aged women who suffer from chronic pain that is not adequately relieved, or who suffer severe adverse effects from opioid treatment ... It's my understanding that most of these folks really benefit from kratom."
All of those people now have a choice to make: Break the law, go back to opioids, or live every day in excruciating pain. "It's like there's an ax over my head," says Marina. "I remember what it was like before I knew about kratom, and those were bad days. I don't want to go back to that."
If you'd like to call the DEA in support, or opposition of the ban, you can reach them at 202-353-1555. If you do not support the ban, there's a Whitehouse.gov petition here.
Robert Evans just wrote a book about how many of the DEA's least favorite drugs helped build civilization.
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