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I am Ram

The FDA seems to be getting ready to crack down on kratom

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Background: Kratom is a SE Asian tree that is related to the coffee plant. The main psychoactive compound is mitragynine. Kratom has mild simulating and opioid-like effects. Withdrawal symptoms mimic opioid withdrawals but seem generally mild compared to "real" opioids. Kratom is legal in many countries (including most of the US) and has been around for thousands of years, yet very few clinical studies have been published. In recent years, kratom has become increasingly popular. People use it recreationally for its stimulating and relaxing properties, and medically to treat chronic pain, anxiety, and - most importantly - as a substitute for more potent opioids.

What happened so far: In 2016, the DEA tried to pull a surprise dick move and attempted to emergency-schedule kratom, citing an imminent danger to public health. The scheduling would have made kratom a schedule 1 drug (bad, bad, bad with no accepted medical benefits) - the same as heroin. There was a massive public backlash, and several members of Congress from both sides of the aisle came out in support of kratom. In an unprecedented move, the DEA pulled back, opened a public comment period and put the scheduling on ice. 

What's happening now: Now the FDA has decided to take up the fight against the evil herb. They have released a detailed statement, citing a number of deaths allegedly associated with kratom and "hundreds" of calls to Poison Control. They use the same strategy as the DEA, essentially equating kratom with drugs like heroin and presenting it as an imminent public health crisis.

Why this is a terrible idea: There is overwhelming evidence that kratom is a relatively safe drugs with stunning medicinal properties. It's abundant, cheap, and very hard to overdose on its own (Unlike many other drugs, with kratom, more doesn't mean better. There is a pretty low ceiling above which the effects don't get any stronger.) The public comments contain tons and tons of reports of people who were able to break their opioid addiction cycles by switching to kratom and folks who were able to wean themselves off of handfuls of pain meds they used for chronic pain. (I suspect the latter part is what the FDA dislikes most about kratom.) Kratom has long stopped being an obscure niche product and is a real factor these days. No drug is risk-free obviously, and there is a desperate need for further study. But that's not going to happen if a ban goes into effect. We are about to lose one of our potentially most useful weapons in battling the opioid crisis in America.

Here is a good write up. Yes, it's HuffPost, but they tend to do a pretty good job when it comes to reporting on drugs. I encourage you to read it. https://www.huffingtonpost.com/entry/fda-kratom-regulation_us_5a0b465be4b00a6eece4c9e0?section=us_healthy-living

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15 minutes ago, thelawlorfaithful said:

How buzzed can this get me?

Not very. Imagine a strong coffee combined with a small dose of oxycodone or something like that. It's not spectacular by any means, but it's pleasant. It does have some potential for addiction even though some of the greatest (and blindest) enthusiasts deny that.

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1 hour ago, I am Ram said:

Not very. Imagine a strong coffee combined with a small dose of oxycodone or something like that. It's not spectacular by any means, but it's pleasant. It does have some potential for addiction even though some of the greatest (and blindest) enthusiasts deny that.

So a poor man's speedball?

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22 minutes ago, Stealthlobo said:

I can't find anything in the medical literature showing Kratoms benefits outweighs the risk. I read it has proven addiction qualities as well which I'd rather stay away from.

What risk? Does it pass the alcohol test?

Remember that every argument you have with someone on MWCboard is actually the continuation of a different argument they had with someone else also on MWCboard. 

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17 minutes ago, happycamper said:

What risk? Does it pass the alcohol test?

https://www.ncbi.nlm.nih.gov/m/pubmed/28484399/?i=2&from=/26511390/related

 "kratom can cause intrahepatic cholestasis, seizure, arrhythmia, impair memory function, coma, and death". Read it in a few pubmed articles. I'm just sick of dealing with patients on drugs that cause addiction.

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16 minutes ago, Stealthlobo said:

https://www.ncbi.nlm.nih.gov/m/pubmed/28484399/?i=2&from=/26511390/related

 "kratom can cause intrahepatic cholestasis, seizure, arrhythmia, impair memory function, coma, and death". Read it in a few pubmed articles. I'm just sick of dealing with patients on drugs that cause addiction.

So... not really from what I'm reading. I have a hard time accepting outright bans of many substances when alcohol and nicotine are legal (especially when it seems like they have at least any therapeutic properties). The bar to "new" or at least infrequently used drugs to enter is so high I doubt that caffeine would make it in. 

That said, sure, regulate and tax the bejeezus out of 'em like we do with booze and nicotine. 

Remember that every argument you have with someone on MWCboard is actually the continuation of a different argument they had with someone else also on MWCboard. 

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3 minutes ago, happycamper said:

So... not really from what I'm reading. I have a hard time accepting outright bans of many substances when alcohol and nicotine are legal (especially when it seems like they have at least any therapeutic properties). The bar to "new" or at least infrequently used drugs to enter is so high I doubt that caffeine would make it in. 

That said, sure, regulate and tax the bejeezus out of 'em like we do with booze and nicotine. 

Oh and don't care if its legal or not, I just don't want to see it used therapeutically with the info we have right now. I don't want to see pain pts on it. Recreationally? Doesn't affect me so I don't care.

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24 minutes ago, Stealthlobo said:

https://www.ncbi.nlm.nih.gov/m/pubmed/28484399/?i=2&from=/26511390/related

 "kratom can cause intrahepatic cholestasis, seizure, arrhythmia, impair memory function, coma, and death". Read it in a few pubmed articles. I'm just sick of dealing with patients on drugs that cause addiction.

This assessment is based on the review of the scarce literature that exist on kratom I happen to be somewhat familiar with the study that discusses arrhythmia. This was an in vitro study on one of the active compounds in kratom, mitragynine, in isolation. It found that based on the behavior of that compound, there might be a potential link between it and torsade de pointes (something, something, potassium channels, repolarization bla, bla, not a medical expert). Not even the researchers suggested anything beyond this potential link. Millions of people use kratom every day, many of them in combination with SSRI, some of which have been confirmed to prolong QT and yet are prescribed by doctors all over the world. Again, I'm not an expert, but I think if there was a significant risk, we would know by now. All kratom deaths I am aware of involved other drugs. The worst case was a headshop product that actually had some form of tramadol mixed in and killed a bunch of people in Sweden.

As I said, further research is needed, but if it's banned, especially as schedule 1, we can forget about that. 

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28 minutes ago, happycamper said:

So... not really from what I'm reading. I have a hard time accepting outright bans of many substances when alcohol and nicotine are legal (especially when it seems like they have at least any therapeutic properties). The bar to "new" or at least infrequently used drugs to enter is so high I doubt that caffeine would make it in. 

Only if you could patent it and allow one company to have the monopoly on it for 20 years. "One coffee, sir? Certainly, that will be 10 euros in Europe or 500 dollars if you are in the US."

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