KAYSVILLE — Kaysville resident Lora Romney is among a growing number of people seeking viable alternatives to opioids to treat chronic pain. Earlier this year she discovered kratom, a ground-up botanical grown primarily in Southeast Asia.
Romney has a rare disease called atypical trigeminal neuralgia, which she said feels like an “ice cream headache that won’t go away.” Romney found some relief from highly addictive prescription opioids, but those drugs have become more strictly regulated in response to the U.S. opioid epidemic.
“Oxycodone, the drug I’m on, is under quantity limits so I can never get more than three per day,” Romney said. But a dose only lasts four to six hours and over time the body builds up a tolerance to the drug. “So for people trying to control their pain ... it’s not enough for a patient to have any quality of life.”
About nine months ago, Romney gave kratom a try.
“Some people just toss the powder in their mouth and wash it down with water — a practice called ‘toss and wash,’” Romney said. “I put the powder in orange juice and drink it.”
While the taste of kratom — or Mitragyna speciosa — is far from appealing, Romney said she began feeling relief within 15 minutes
“It drops my pain level as much as with an opiate, so I’ve been able to replace most of my opiates with kratom,” Romney said. “I tried everything under the sun, and this has been a miracle for me. I’ve been able to be active again, make plans for the day and not be paralyzed in bed all day because I don’t have enough opiates to take care of my pain.”
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IS KRATOM SAFE?
The federal Drug Enforcement Agency lists kratom as a drug of concern, and in September 2016, announced its intent to classify kratom as a Schedule I controlled substance, similar to marijuana, LSD, heroin and ecstasy. But public outcry paused that effort, and the DEA asked the Food and Drug Administration to evaluate kratom’s scientific and medical merits and recommend its classification.
On Nov. 14, 2017, the FDA issued a public health advisory regarding kratom, acknowledging that people use it to treat pain, anxiety and depression, “which are serious medical conditions that require proper diagnosis and oversight from a licensed health care provider.” The FDA then compared kratom to opioids in terms of effects, saying that it “carries similar risks of abuse, addiction and in some cases, death,” and noted kratom’s association with serious side effects such as seizures, liver damage and withdrawal symptoms.
Also cited in the FDA’s advisory is a 10-fold rise in calls to U.S. poison control centers from 2010 to 2015, as well as 36 reports of death associated with kratom products.
The National Center for Complementary and Integrative Health added perspective to those numbers: 26 calls involving kratom were received at U.S. poison centers in 2010, rising to 263 in 2015 — for a total of 665 calls over the six-year period. More than one-third of those calls came from people who ingested kratom in combination with other substances, including benzodiazepines and narcotics.
The Centers for Disease Control and Prevention said in a July 2016 report that the data suggests kratom is an “emerging public health threat.”
In response to the FDA’s health advisory, the Botanical Education Alliance defended kratom, pointing out that from 2010 to 2014, the total number of calls to U.S. poison control centers averaged 2.2 million to 2.4 million per year. So calls concerning Kratom made up 0.0006 percent to 0.007 percent of that total, depending on the year. Coffee ranked higher, the Alliance noted, at about .2 percent of all poison center calls.
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PENDING STATE LEGISLATION
In light of the opioid overdose epidemic, Utah lawmakers are considering a bill for the general legislative session, which starts in January 2018, that would launch research into various pain management alternatives.
The measure, discussed this month by both the Business and Labor Interim Committee and the Health Reform Task Force, would look at medical food, noninvasive pain management therapies and kratom as alternatives to opioids and possible aids to wean people off those powerful narcotics.
Jack Henningfield, vice-president of Research, Health Policy and Abuse Liability at Pinney Associates, spoke to the Health Reform Task Force Monday, Nov. 27, on behalf of the American Kratom Association.
“The Utah culture has been enormously important in recognizing the value of dietary supplements and giving consumers options other than prescription drugs. And kratom is an example of that,” Henningfield said, noting the plant’s opioid- and caffeine-like effects without depressing respiratory function or inducing euphoria that drives addiction.
“It’s important to realize that thousands of people who were formerly using opioids — either for pain or because they were addicted — have transferred to kratom ... and now are off opioids,” Henningfield said. But at this point many are terrified of losing that lifeline, he added.
In a phone interview Wednesday, American Kratom Association Executive Director Peter Candland said he believes there is enough anecdotal evidence to merit more research of the plant.
“People are choosing kratom over dangerous opioids. If our government bans it, it will create a black market. We’re all for regulations and standards,” Candland said. “We want responsible manufacturers and sellers. But the worst thing they can do is classify it as a Schedule I controlled substance, which would make any future research exponentially more expensive.”
Sen. Curt Bramble, a Provo Republican who co-chairs the Business and Labor Interim committee, said the FDA’s statement caused him to rethink whether state lawmakers should advance legislation involving kratom.
“It may be appropriate at this point for the (kratom) industry to work with the FDA,” Bramble said, adding that he did not personally know anyone who uses kratom but had received emails from people who claim it’s a godsend.