Doctors have long searched for an effective opioid painkiller without the high risk of addiction and debilitating withdrawals that have turned opioid abuse into an epidemic. Dr. Susruta Majumdar, a chemist at Memorial Sloan Kettering Cancer Center, argues that the “holy grail of painkillers would not induce the seductive euphoria of common opioids or their less-pleasant side effects like itching or constipation” (1). In fact, he thinks he might have found such a drug. The drug, Kratom, is derived from the Mitragyna speciosa tree of Southeast Asia and is a natural painkiller with much less severe withdrawals and a lower tendency towards addiction. However, the Drug Enforcement Administration (DEA) is attempting to ban Kratom (classifying it as a Schedule I banned substance) and thus, is putting an end to Majumdar’s and others’ extensive research on the medical potential of Kratom.
The DEA argues that the addictive effects of Kratom (though significantly milder than other opioids) and the fact that it may have been responsible for 15 deaths between 2014 and 2016 (2) are grounds for classifying Kratom as a Schedule I controlled substance. To put things in perspective, other Schedule I drugs include ecstasy, heroin, and other drugs that are considered to be dangerously addictive with no known medical use. However, the conundrum lies in the fact that once Kratom is banned by the DEA, medical researchers like Majumdar can’t prove its medical benefits through lab research without obtaining a special license that allows them to experiment with the controlled substance. That means that if Kratom is banned, current Kratom researchers will have to destroy all their current samples and essentially start over. Furthermore, they’ll have to obtain the Schedule I license (which is very difficult to do) and prove Kratom’s medical benefits within the next two years. After 2 years, the DEA can move to permanently ban Kratom (based on its lack of medical use) at which point any demonstrated medical benefits of Kratom won’t matter.
Consequently, there has been much backlash from protestors and Congressmen, who defend the medical potential of Kratom and do not want to see Kratom research halted. The earliest date that the DEA could have banned Kratom was on September 30th, but they haven’t done so yet. However, the DEA has been very clear that they won’t drag their feet for long. DEA spokesperson Russ Baer went so far as to say, “We have determined that it [Kratom] represents an imminent hazard, so… It's not a matter of if, it's just a matter of when" (3). Several Congressmen, including top-ranking Senator Orrin Hatch (R-Utah), are attempting to persuade the DEA to hold off on banning Kratom until more medical research is completed. Mark Pocan (D-Wisconsin) and Matt Salmon (R-Arizona), who organized a letter signed by 50 House Representatives, stated in their letter that, “The DEA’s decision to place Kratom as a Schedule I substance will put a halt on federally funded research and innovation surrounding the treatment of individuals suffering from opioid and other addictions—a significant public health threat” (4).
On top of being useful as a replacement for addictive opioids, Kratom has also helped many people overcome addiction to opioid painkillers. On September 13th, hundreds of protestors marched down Pennsylvania Avenue with signs that read “Kratom Saved Me.” Andras Varadi, a colleague of Majumdar who is a medicinal chemist at Columbia University and Sloan Kettering, says that Kratom, like other powerful opiates, binds to the body’s mu-receptors, blocking pain receptors and making it an effective opioid. However, it also lowers tolerance and lessens withdrawal symptoms making it a “double whammy” (1). Opioid overdoses were responsible for 18,893 deaths last year in the United States (5), which calls into question why the DEA would ban Kratom over just 15 cases that weren’t definitively tied to Kratom. Alicia Lydecker, a toxicologist at the University of Massachusetts who is not exclusively studying Kratom, said, “In terms of death, we really only get into that issue when it’s combined with other substances” (1). Some Kratom bought in the US was found to be compounded with other, more serious drugs like hydrocodone.
Based on the current research, it seems that the DEA may be acting too hastily in banning Kratom. Many Kratom researchers understand and support the need to regulate Kratom, however, they disagree with the DEA’s classification of Kratom as a Schedule I drug (1). Not only do they feel that it’s an inaccurate classification because of the medical potential they’ve seen for Kratom, but also assigning Kratom Schedule I classification will almost definitely halt important medical research that could help thousands of people.
(1) Chen, Angus. "Kratom Drug Ban May Cripple Promising Painkiller Research." Scientific American. N.p., 26 Sept. 2016. Web. 01 Oct. 2016.
(2) "DEA Announces Intent to Schedule Kratom." Drug Enforcement Administration. N.p., 30 Aug. 2016. Web. 01 Oct. 2016.
(3) Nelson, Steven. "Kratom Will Remain Legal for Days, Possibly Longer." US News. U.S.News & World Report, 30 Sept. 2016. Web. 01 Oct. 2016.
(4) Mole, Beth. "DEA Has Kratom Users Holding Their Breath, Lawmakers Write More Letters." Ars Technica. N.p., 30 Sept. 2016. Web. 01 Oct. 2016.
(5) "Opioid Addiction 2016 Facts & Figures." American Society of Addiction Medicine. N.p., n.d. Web. 30 Sept. 2016.
Image: © Ratree Fuangnakhon | Dreamstime.com - Mitragyna speciosa Korth.
Currently, Olivia is a senior at USC majoring in Biology and minoring in Spanish. She is the President of USC Health Sciences Education Program, a student organization that seeks to inspire young students to pursue careers in STEM and to foster excitement about the sciences among K-12 students. For the past two years, Olivia has been conducting clinical research on sports injuries in conjunction with the Human Performance Lab at USC's physical therapy school, which is where her interest and experience in biomedical innovation comes from. In her free time, she loves reading about new medical technologies, volunteering at schools around USC, and cheering on the Oklahoma City Thunder (her hometown team). After graduation, Olivia plans on going to medical school and eventually becoming an orthopedic surgeon.