Could a Tea from Thailand Help Cure Opioid Addiction?

Some See a Cure-all, Others, a Dangerous New Epidemic

The small bar is tucked into the back of a tree-lined parking lot, right off a busy street somewhere in Fort Lauderdale, FL. Even at two in the afternoon, it’s crowded. But this bar isn’t selling alcohol it’s a kava bar but kava isn’t what we came here for today.

The bar’s interior is dark, and it’s low ceilings and high bar give it a narrow, cozy feel, like the inside of a ship’s cabin at night. As we walk up to the counter, my friend asks for it and the bearded bartender passes it toward him in a small plastic bag.

You’re gonna like this he says with a sly smile.

Did we just buy drugs? Well, that depends on your definition the bar is full of former drug and alcohol users most, if not all, in recovery, and many of them say that their secret to sobriety is one of the bar’s hottest products.

It’s not kava, the foul-tasting Polynesian root that gives the bar it’s moniker. Instead, it’s kratom, a light green powder made from the leaves of a tree found in Thailand– and hundreds of thousands of Americans are claiming that it’s allowed them to live pain-free while getting off prescription painkillers like OxyContin and Percocet.Kratom-Tea-Thailand

Even many former heroin users swear by the herb, saying that it helps them get out of bed in the morning with a newfound spring in their step while
avoiding the constant fatigue, constipation, dizziness, and stomach pain so often associated with regular use of opiates. But scientists, doctors, and law enforcement warn of a hellish herb with serious addiction potential and painful,
debilitating withdrawals for those who stop using the substance.

With two sides spouting such contradictory messages, what’s the truth about kratom? Is it a nirvana for former addicts or just a new form of herbal heroin? We’re about to find out.

Kratom growing in popularity, but law enforcement and federal agencies remain wary

In the last two years or so, a handful of kava bars, smoke shops, and gas stations selling the product have sprung up around South Florida so while this kava bar is particularly popular, it’s far from the only one in the area selling the herb which is sold both in small, discrete packets, and more expense prepared drinks often with juice and fruit-flavored syrups to enhance kratom earthy, leafy flavor, which some people undoubtedly find unpleasant.

Despite the herb’s popularity, the DEA had planned to ban the herb in October of last year, but an outpouring of opposition seemingly stopped them in their tracks. Social media platforms and websites like Reddit and Quora exploded with anger about government overreach, while the largest Kratom lobbying group, the American Kratom Association (AKA), lobbied behind the scenes.

The AKA’s connections in congress may well have been enough to halt the ban even without the public’s outraged reaction to the proposed law; the organization is helmed by Paul Pelosi Jr., the son of Democratic house minority leader and California congresswomen Nancy Pelosi. The DEA’s last statement on the matter said the agency is still considering a ban– which could be more likely under President Trump’s new administration.

While some see risk, others see opportunity in a potent plant

With so many people claiming to benefit from the herb, it begs the question: why is the DEA so concerned? The answer is unclear, but it probably has to do with a small, but vocal percentage of people who oppose the drug. The group is mostly comprised of friends and family members of people who claim that kratom worsened their family member’s addictions, causing them irreparable harm and more than a few scientists, researchers, doctors, and law enforcement officials who strongly agree.

In several cases during the last few years, individuals who committed suicide were found to have the plant in their possessions or homes when they died which, while incriminating, isn’t conclusive evidence that the substance contributed to their demise. However, in a few cases, the relationship between kratom and self-harm seems more than circumstantial; in one shocking 2014 incident, a Boynton Beach, FL man with kratom in his system jumped off a highway overpass to his death– one of several incidents that resulted in nearby local and state officials considering a statewide ban on the drug. (The bill went through the Florida legislature in 2015 and didn’t pass.)

In a similar case, a University of Georgia student shot himself with a 45-caliber handgun after writing a note that blamed kratom for his impending suicide. A subsequent investigation found multiple bags of the substance scattered throughout the man’s apartment and his parents have now joined the chorus of those advocating against the drug.

More concentrated forms of kratom may offer new dangers to users

While these cases may paint kratom in a bad light, neither of them involved a more dangerous kind of kratom– a class of
products known as extracts. Unlike the regular powdered leaf, which is taken from the plant, dried, and ground up, extracts
are liquid concentrations of the plant, some which can be hundreds of times stronger per gram than powdered leaf.  In addition to posing a greater risk for addiction than regular kratom, extracts may cause additional side effects–and could seriously impair users while driving or doing other potentially risky activities.Kratom-Tea-Effects-Infographic

However, extracts, while more dangerous than powdered kratom, are unlikely to be deadly in their own right. A more serious problem is when a liquid is marketed as kratom extract, but instead contains synthetic opioids with unknown side effects. Several cases of deaths in Northern Europe have been reported resulting from these types of incidents– cases in which deceptive marketing can have a deadly result.

Whether a user consumes regular powdered leaf or extracts, one thing is for sure kratom withdrawal can be a serious affair. While it’s true that some users report little to no withdrawals, others report nearly heroin-like withdrawal symptoms. Even online message boards, many of which sing of the drug’s benefits, are filled with horror stories about terrible kratom withdrawal symptoms; former users often claim to experience panic attacks and severe depression when trying to get off the leaf.

In some cases, ER doctors have even had to turn to drugs like Valium in order to calm trembling, sleep-deprived, and highly anxious patients who come to the emergency room after developing surprisingly powerful kratom withdrawal symptoms. Unsurprisingly, many medical professionals are advocating against the legality of the substance– and an increasing amount of kratom-related ER visits  haven’t helped the drug’s reputation among the medical community.

Patients may simply be replacing one addiction for another, but does it matter? Many say yes.

Much like many of the arguments for marijuana legalization and decriminalization, most users say kratom is keeping them away from harder, illegal drugs and prescription medications like benzodiazepines, opioids, amphetamines, SSRIs, all which can have serious short and long term side effects. Advocates often reason that if a doctor is allowed to prescribe them a drug that might have terrible long-term side effects,  a patient should be able to use natural, herbal remedies like kratom that may be able to mitigate their conditions even if it does have some side effects.

On the other hand, experts leaning toward prohibiting kratom suggest that it may be instructive to look toward Thailand, the plant’s home, where it has been banned for decades due to serious social problems arising from addiction to the plant. Some reports indicate that 60% of drug addiction patients in Thailand say that they abuse the herb, many of them mixing it with codeine and Coca-Cola in order to form a home-brewed drug concoction colloquially referred to as 4X100.

Long-term Thai users of the herb often report side effects including yellowing of the skin and sometimes even liver damage, and one historical study from the 1970s suggested that long-term users of the drug were prone to both physical and psychiatric disturbances that, over time, seriously reduced their ability to fulfill career and family obligations. One study of a Thai poison control center even reported that a baby suffered serious kratom withdrawal symptoms due to his or her mother’s addiction. The same study also reported that individuals who experienced kratom poisoning suffered side effects that included seizures, palpitations, insomnia, fatigue, and chest pain.

Some addicted to kratom find help in rehab, while others continue to consume the plant, undeterred by potential risks

Back in America, Kratom-addiction based admissions to drug and alcohol rehab centers seem to increase by the day and psychiatrists suggest that for those who can’t quit on their own, addiction rehab may be the best option for those who want to avoid potential short and long-term risks of the herb. While statistics about rehab for kratom users in America is sparse, Thai studies suggest that long term outcomes for kratom addiction patients in rehab are overwhelmingly positive.

Ultimately, due to a lack of long-term studies, we can’t yet confirm kratom causes yellowed skin, seizures, insomnia, or other risky long-term side effects. For now, advocates for and against the drug wait as laws, regulations, and the ultimate fate of kratom all hang in the balance. In the meantime, users seem to be enjoying the newfound sense of calm and freedom that they say the plant gives them, regardless of any long term consequences it might have for their health, safety, and sanity.  

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