Is kratom legal? Government regulators are about to decide

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• Government regulators are expected to soon rule on the
  legality of a controversial drug called kratom, a
  representative at the Drug Enforcement Administration told
  Business Insider on Tuesday.
• While federal agencies have called
  kratom a dangerous opioid, advocates say it’s saved their
  lives.
• One thing missing from the debate about kratom:
  hard science on how it works.
• For the first time this summer, a researcher isolated
  kratom’s two key ingredients to see how they affect behavior in
  rats. Although the results were preliminary, they suggested the
  drug
  could hold promise for people with addiction.

A final decision on the legality of a controversial drug is
expected imminently from the US government.

The drug, called
Kratom, has pitted government regulators against
scientists and advocates. The Food and Drug Administration has
called it a
dangerous opioid and sought to ban it by making it a
Schedule 1 drug like heroin or ecstasy. Some advocates say it’s
helped them end their addiction to opioids, and scientists want
to keep exploring its potential as a medical treatment.

Kratom could be banned nationwide or placed in a category similar
to the one used for medicines like popular ADHD medication
Adderall. Or, its two main components could be split and
categorized differently, according to Melvin Patterson, a
spokesperson with the Drug Enforcement Administration. 

“I think there’s just a few remaining in-house things the DEA was
looking at” before issuing a ruling, Patterson said on Tuesday.

Right now, kratom is legal in most states, where it is sold as a
supplement.

The ruling is highly anticipated by both advocates who say the
drug has saved their lives and by scientists who simply want to
learn more about how it works.

“I wish there was some sort of holding box we could put drugs
like this in until more studies could be done,” Scott Hemby, a
professor of pharmaceutical science at North Carolina’s High
Point University who
authored a recent study isolating kratom’s two main
ingredients, told Business Insider on Monday.

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Hemby’s research — the first of its kind — was a preliminary
study looking at how kratom’s two main components affect behavior
in rats. His findings suggested that the chief compound in the
plant could potentially offer therapeutic benefits to people
dealing with addiction, but it’s still early days for the work.

“We’re at the precipice of something promising here,” Hemby said
when the paper came out.

But Hemby worries that the government’s ruling could make
studying the plant and its key ingredients even harder than it
already is, and he’s not alone.

Life saving supplement or dangerous opioid?

Kratom
pills

Psychonaught/Wikimedia
Commons

Frequently ground into a fine powder and taken as pills or tea,

kratom is a psychoactive drug derived from the leaves of an
Asian plant in the coffee family called Mitragyna
speciosa. Kratom advocates swear by the stuff, saying it’s

helped them kick devastating addictions to opioid
painkillers.

But federal regulatory bodies like the FDA and the DEA have

cracked down on kratom and previously tried to
ban it.

“It’s like a cruel joke that I finally found something that works
and the FDA and DEA want it banned,” Bryce Avey, a 26-year-old
California native told Business Insider this summer. Avey said he
took kratom daily as a tea to help him stop using the opioids he
became addicted to after wrist surgery.

The efforts to make kratom illegal culiminated at two recent
points: In 2016, the DEA attempted to ban kratom but
stopped after facing backlash from advocates and members of
Congress. Then in October 2017, the FDA broke out kratom’s two
main components and studied them separately, ultimately
recommending a ban on both of them,
Stat News reported this month. 

That 2017 FDA recommendation was then sent to the DEA, which
began the lengthy process of re-evaluating the drug’s two
components to make a final decision on the legality of each of
them, Patterson said.

Now, a decision on the drug’s two compounds is imminent, he said.
While the FDA focuses on medicinal potential, the DEA looks at
the compounds’ abuse potential. 

Importantly, the agency could choose to rule differently on each
compound, Patterson added. Those include mitragynine
(MG) and 7‐hydroxymitragynine (7‐HMG) — two ingredients that
Hemby calls “the yin and yang of kratom” because while HMG could
be potentially harmful, MG seems like it has a lot of therapeutic
potential.

‘The yin and yang of kratom’

In stark contrast to what regulators have said about kratom, a
growing cluster of physicians and researchers are beginning to
suggest that the drug could have
therapeutic potential. Some have said they understand why
people looking to get off opioids might find the drug helpful;
others have said that new research suggests the plant’s compounds
could have untapped potential.

“It makes sense that this product would mitigate the symptoms of
opioid withdrawal or allow someone to transition from a higher
dose to lower dose, or help get off them off of opioids
altogether,” David
Juurlink, a professor of medicine at the University of
Toronto, told Business Insider this summer.

One big reason is that the kratom plant’s two main
ingredients — which can be thought of similar to how marijuana
contains THC and CBD — appear to have
very different effects on the brain.

Of kratom’s two chief ingredients (MG and HMG), MG is thought to
be the compound with the most therapeutic potential. There’s
about 30 times more MG in Kratom than there is HMG. 

Hemby’s study was the first to use rats to investigate how each
of these two compounds affects the brain. After giving the
animals the chance to self-administer each ingredient by pushing
a dial, they found that the rats quickly took advantage of the
opportunity to give themselves the HMG but were completely
uninterested in MG.

“We stood on our heads to get them to self-administer,” Hemby
said, adding that his team tried upping the doses of MG several
times. “It just wasn’t working. It was almost like it was
innocuous.”

In other words, while one of kratom’s main compounds appeared to
be addictive, the other wasn’t at all — in fact, it appeared to
have the opposite effect.

That could be promising for people who are turning to kratom for
relief from opioid addiction. The drug is known to tap into some
of the same brain receptors as opioids — which spurred
the FDA to officially call it an opioid in February.

But some people believe those characteristics mean kratom could
help treat opioid addiction by staunching cravings and
reducing withdrawal and relapse.

Hemby’s findings also suggest there might be a way to process
kratom to capitalize on this therapeutic potential by heightening
the effects of one compound while minimizing the effects of the
other. Strains of the plant, for example, can be bred to have
differing concentrations of MG and HMG.

That’s something that he and other researchers like him want to
keep studying, he said, so long as government regulators let
them.

“It’s really a rush to judgement to say let’s put the kibosh on
everything,” Hemby said.