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About Appeal tribune. (Silverton, Or.) 1999-current | View Entire Issue (Feb. 1, 2017)
Appeal Tribune Wednesday, February 1, 2017 3B Could Oregon ban the herbal supplement Kratom? WHITNEY M. WOODWORTH STATESMAN JOURNAL More than a dozen bills have already been proposed in the upcoming Oregon Legislature dealing with marijuana, but there is also one bill about a lesser- known herb unheard of by many, fierce- ly adored by some and almost banned by the DEA. For millennia, people in Southeast Asia used the leaves from the tree Mitra- gyna speciosa — more commonly known as kratom — to combat fatigue and as a traditional medicine. The herb’s modern proponents claim it can help with opioid withdrawal, pain, fatigue, anxiety and depression. Its de- tractors decry it as an “imminent hazard to public safety,” citing 15 kratom-relat- ed deaths in the United States during a two-year period. Senate Bill 518 would declare an emergency and direct the Oregon Board of Pharmacy to conduct a study to deter- mine whether the plant and its drug de- rivatives should be scheduled as a con- trolled substance. The move has many users and propo- nents of the herb nervous. “It’s a little bit of a surprise,” said Su- san Ash of Portland, director and foun- der of the American Kratom Associa- tion. “We did not think we were going to see a push in Oregon.” Ash said she knows firsthand the life- changing benefits of kratom. She worked for years as an environmentalist and advocate for places like the Audu- bon Society of Portland and as a natural- ist at Bryce Canyon National Park. She left her job after a case of Lyme disease went undiagnosed for eight years, sad- dling her with lifelong fatigue and pain. Doctors prescribed painkillers, and soon she was addicted to opioids. She went to rehab, but nothing seemed to al- leviate the debilitating symptoms of withdrawal. When someone from her Lyme disease support group suggested using an obscure herb called kratom, she dismissed it as nonsense. She soon faced two options: be on the narcotic Suboxone for the rest of her life or have nothing. Ash decided to give kra- tom a try.. “It was like night and day,” she said. “My withdrawal symptoms were totally manageable.” Because her case of Lyme disease was diagnosed so late, it is now a chronic condition, which she has treated with kratom for the past three years. She drinks a tea made from kratom leaves two to three times a day. She describes the effect as “espresso without the jit- ters” and likens the pain relief to taking a strong ibuprofen. Ash formed the American Kratom As- sociation in 2014 with the intent to sup- port and protect consumers of kratom and to educate potential consumers and regulators. She said imports of the substance in- dicate that about three million to five million people in the United States are regular kratom users. It can be brewed in a tea, chewed, smoked or ingested in MOLLY J. SMITH/STATESMAN JOURNAL Kratom is sold in powder or capsule forms in shops including Dizzy’s Smoke Shop. The herb, which some use medicinally for pain relief, is under scrutiny by the Oregon Legislature. capsules. The substance has been on the DEA’s list of drugs and chemicals of concerns for several years. In August, the agency announced its intent to label kratom as a Schedule I controlled substance and deemed it “an imminent hazard to public safety.” With the designation, kratom would join the ranks of heroin, LSD and mari- juana. Agency officials based the deci- sion on the drug’s lack of accepted med- ical use and high potential for abuse. They also cited an uptick in calls to poison control centers and deaths relat- ed to kratom. Between 2000 and 2005, the American Association of Poison Control Centers received two calls related to kratom. From 2010 to 2015, calls skyrock- eted to 660. The Centers for Disease Control and Prevention said kratom abuse can lead to agitation, nausea, hypertension, sei- zures and vomiting. DEA officials said they were aware of 15 kratom-related deaths from 2014 to 2016. After the DEA’s announcement, an outpouring of senators, representatives, doctors, scientists and kratom users con- tacted the agency, imploring it to recon- sider. Sen. Ron Wyden, D-Ore, penned a letter with Sen. Cory Booker, D-New Jer- sey, and Sen. Kirsten Gillibrand, D-New York, urging the acting DEA administra- tor to allow more time for experts and the members of the public to weigh in on the benefits of kratom. “Given that we are in the midst of a drug crisis and there is promising evi- dence of kratom’s potential medical benefits, including the possibility of new, safer medications for the treatment of pain, we believe that placing kratom in Schedule I without adequate time... may have unintended consequences,” the let- ter read. The American Kratom Association organized protesters and a petition gar- nered more than 140,000 signatures. By Oct. 13, the DEA withdrew its intent for scheduling and opened up a public com- ment period. PBS News Hour reported the agency received about 23,210 comments online — an “abnormally high amount.” Dr. Michael Moss , a medical toxicol- ogy fellow and emergency room physi- cian with Oregon Health & Science Uni- versity and Oregon Poison Center, said he is not aware of any local deaths caused by kratom. The poison center, which receives about 60,000 calls a year, has not seen a surge in kratom-related in- cidents. “We have not seen a huge rash of these cases in Oregon,” he said. Moss said he remains wary of the sub- stance. “It’s still a drug. It’s still a chemical,” he said, adding that kratom, which is available in smoke shops and online, is largely unregulated. He said it’s safest to avoid kratom, but if people do seek out the substance, they should exercise extreme caution. “You never know what exactly you’re " "- # #& && '#,& /#+& "- #! VLOYHUWRQDSSHDOFRP +&" & #& /#+& ".* , going to get,” Moss said. Kratom can be a stimulant or pain re- liever depending on the dosage and type of leaf. Ash said she supports making sure kratom is safe for consumers, the dosage is correct, the herb is uncontam- inated and that product with kratom are not advertised to children. The DEA claims of kratom having a “high potential for abuse” are way off base, Ash said. It doesn’t taste good — she compared the flavor to a strong green tea mixed with dirt — and if some- one tries to take enough to get high, they usually just make themselves nauseous. A lot of people lump the substance into the same category as bath salts and syn- thetic cannabinoids like “spice,” but it is completely different, Ash said. Jessica Peterson , manager of Dizzy’s Smoke Shop in Salem, estimated less than one percent of her customers buy kratom to use recreationally. Most people use it to help them break their opiate addictions or for pain man- agement. “I believe it’s a huge benefit,” she said. “We’ve watched people come off opiates and become functional people.” About a year and a half ago, the sub- stance started growing in popularity. Customers shared their stories of recov- ery with Peterson, and she came to be- lieve in its ability to help people. “I look at it differently now,” she add- ed. The store took it off of their shelves after the DEA’s announcement but re- stocked after the reversal. “I had customers on the verge of tears,” Peterson said. Oregon Board of Pharmacy executive director Marcus Watt said kratom was on a list of drugs to make controls on last year, but the board dropped it due to lack of negative feedback. The board works with law enforcement, emergency room personnel and doctors to determine a substance’s impact in the community. They look for drug busts, emergency room visits and overdoses to help deter- mine whether to embark on a study. The board didn’t hear from anyone with strong negative feelings about kratom, Watt said. If ordered by legislators to study the herb, the board would hold public hear- ings and meetings to investigate wheth- er the effects of kratom warrant making it a controlled substance. A normal study and review takes about three to six months. Declaring a public health emer- gency would lead to a quicker, two- month study. Six states, including Vermont, Indi- ana and Alabama, have banned the sub- stance. Ash said she hopes Oregon officials take their time, wait for the DEA to make its ruling and talk to people who’ve bene- fited from kratom use, law enforcement and doctors before deciding its future in the state. “This has a huge potential to help in the nation’s opioid epidemic,” she said. 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