In this week's paper, I wrote about kratom, an old drug with new popularity in the United States. Its leaves have been chewed or brewed into tea for generations in SE Asia for its mild, opioid-like effects. (Researchers say it interacts with the same receptors in the brain that opium does, but for some reason doesn't seem to have the more pernicious effects of opioids, like the respiratory depression that causes overdose deaths.)
You can read much more more about kratom here. The rush to ban it, led by some extraordinarily ignorant state legislators who can't be bothered to learn the first thing about it—one legislator leading the charge in Iowa called it a "life-threatening" "hallucinogen" with "no medical value" which is three kinds of wrong—is a problem.
Why? Because once a drug is banished into schedule one, it becomes infinitely more difficult to get the grants and DEA permission to study it. And, among other things, kratom has promise as a kind of "herbal methadone," a bridge between heavy opioid addiction and getting clean—perhaps even more potential than methadone or buprenorphine. (And it's a hell of a lot cheaper, and currently available to addicts who don't have medical insurance.)
But legislators want to score easy political points without doing their homework and some of my colleagues in the media play along because they're dim or lazy or both. Let's dissect one example from a news outlet in Sioux City, Iowa.
(For the record: I am not endorsing kratom use or saying it's a panacea. It is simply a potentially useful plant that has been used for centuries in some parts of the world, but hasn't been studied much. What I am opposed to is the idiotic, misinformed dance that journalists and legislators start doing whenever they hear the word "drug." And we can see that knee-jerk prohibition isn't working—not for us and not for the rest of the world.)
Kratom is a narcotic (1) derived from the leaves of trees which grow in Malaysia and Thailand and officials say it has the potential to be the next K2 (2). When used, the drug acts as an opiate in small amounts and a stimulant when taken in large quantities (3). There were twelve emergency room visits due to kratom in 2011 and this year there have already been nineteen (4).
Linda Kalin, the Director of the Iowa Statewide Poison Control Center, thinks this could be a sign of an expanding user base. "I think it has potential for growing in terms of numbers. When something's not made to be illegal hearing from other countries who have banned this substance...it does have that potential (5)."
Kratom can be taken as a tablet, capsule, or consumed like an herbal tea. It is now on the Drug Enforcement Agency's "Drug of Concern" list (6).
(1) This is technically true but a terrible—and terribly biased—word choice. According to the OED, a "narcotic" is a substance that induces drowsiness and aids sleep. You could call chamomile tea a narcotic. But when you say "narcotic," people don't think of chamomile tea. They think of heroin, morphine, and other potentially fatal opiates. So, right off the bat, this writer drawing an implied link between kratom and heroin. Which is foolish and wrong.
(2) This is another false equivalency, tying kratom to recent drug scares over "bath salts," Spice, and K2, all new synthetic drugs that were linked to cases of "psychosis." (Rightly or wrongly—I'm not an expert. Unlike some of my peers, I'm willing to own my ignorance.)
Regardless, those are entirely different substances with different effects. They were cooked up in labs a few years ago and weren't intended for human consumption. (The synthetic cannabis drugs were created to facilitate neurological research with mice.) Point being, saying "the next K2" in relation to kratom is like using the word "narcotic"—it's knee-jerk, scare-tactic rhetoric with no bearing on the facts. It should also be pointed out that prohibition of naturally occurring drugs is what drives this market for new drugs. If the old drugs, in their weakest form, were available (coca tea, opium-poppy tea, marijuana, etc.) a whole wing of the drug economy (dirty cocaine, meth, heroin, newfangled designer drugs) would shrivel up into a tiny, tiny ball. As Sanho Tree, one drug-policy expert, pointed out in an interview for the kratom story, alcohol prohibition in the U.S. turned a nation of beer and wine drinkers into a nation of liquor drinkers. The more banned the drug, the more concentrated (and potentially dangerous) it becomes.
(3) This may be true, but all of those reports, to my knowledge, are anecdotal—and I've seen it reported as the exact opposite (stimulant in small doses, sedative in larger doses). It's just unwise to put out potentially false information with more drug-scare language and pretend like it's established fact.
(4) The whole "emergency-room" meme is interesting—it's shorthand in lazy reporting for "this drug is dangerous and terrible," because when most of us think of emergency room visits for drug use, we think of opiate overdoses, cocaine heart attacks, and people getting their stomachs pumped for booze and/or pills.
But many drug-related emergency-room visits are unnecessary and banal. I recall being in Amsterdam several years ago when the city government was talking about banning pot brownies. The debate wasn't about whether they were actually dangerous, but about how many resources the city was wasting on emergency-room visits from tourists who didn't know what they were doing, got too stoned, and went to the emergency room because they thought they were dying. They weren't dying. They were just freaking out.
In the news stories about kratom (that I've read), emergency-room visits are always by habitual users suffering from mild-sounding withdrawal symptoms. They are typically given a Valium to chill them out and sent home.
(5) I don't know what that sentence means. (Also, quotes from doctors are popular in drug-scare stories, because people presume that all doctors know about everything. Some press-happy doctors like to pretend like they know everything—including doctors quoted in kratom stories who clearly have no idea what it is. Not all doctors know about everything.)
But, to the quote's point: Some countries, like Thailand and Australia, have banned kratom. Both countries are also notoriously prohibitionist about drugs and some freedoms we take for granted, like freedom of speech. In Thailand, it's a crime to insult the king. Last year, a political activist was sentenced to 15 years in prison for the crime. Australia has a bad reputation for censorship. So yes, kratom is banned in some countries. Countries whose legal systems we definitely do not want to emulate.
(6) The DEA's bulletins on kratom largely draw from a seven-page gloss on the plant written in 1975 by a Thai doctor. I write about that in the original story:
The Drug Enforcement Administration (DEA) began putting out warning bulletins about kratom as early as 2005, saying it's used "by young Thai militants... to make them 'more bold and fearless and easy to control.'" The DEA warning also mentions "several cases of kratom psychosis" where kratom users "exhibited psychotic symptoms of hallucinations, delusions, and confusion." The bulletin doesn't cite its sources, but its key data on addiction rates is identical to Dr. Suwanlert's seven-page gloss from 1975. (Suwanlert's study is also the only mention I have found in the scientific literature of "kratom psychosis." He says he observed psychiatric disturbance in five kratom users who wound up in an outpatient hospital: One was a 55-year-old who'd been using kratom for 30 years and was experiencing "clouding of consciousness," and two of the others were schizophrenics.)
Suffice it to say, the DEA's claims aren't based on robust research.
You see how that works? One doctor in 1975 sees five people with mental problems who also happen to use kratom (and most of them, according to his own report, used other drugs as well) and now the DEA is spreading scare stories about a condition called "kratom psychosis" as if such a thing were established fact.
Kratom is an interesting substance for medical and public-health reasons, but it's also an excellent opportunity to watch how our journalists and elected representatives react when they hear about "a new drug." Or, in this case, an old drug that's they've only just heard of.