JUNE 1, 2017 Effects of kratom Kratom is a relatively new drug to the United States and Europe. It has been used for many years in Southeast Asia as an anti-diarrheal medicine, a painkiller and a recreational drug. Kratom is the popular name for a tree and the drug comes from its leaves. The drug may be bought in leaf form, but in this country it is more likely to be purchased as a capsule filled with powdered leaf material or a chopped form of the leaf that can be used for tea or smoking. Most people ingest the drug. The effects of kratom come on rather quickly and last between five and seven hours, although high doses can last longer. Kratom is heavily promoted as a legal, undetectable, safe drug that can be used to come off stronger drugs. It is not yet illegal in the United States, but the breakdown products of kratom can be detected with some drug tests. Because of its legality, the drug tends to be more popular among young people who cannot yet buy alcohol and who may be concerned about being arrested with weed or other drugs. Kratom is included in a newly-defined class of drug called “New Psycho- active Substances,” so-named by the United Nations Office on Drugs and Crime. In the 2013 World Drug Report, kratom is on this list along with khat (another plant, this one from East Africa), salvia divinorum (a plant that is widely available in the United States) and synthetics ketamine, mephedrone and others. Many of these drugs are not yet illegal in the United States and Europe, despite their dangerous and addictive effects. A person using this drug may not expect or want the following unde- sirable effects: 1. Edginess, nervousness; 2. Vomiting (can be severe and prolonged); 3. Nausea (can be severe and prolonged); 4. Sweating; 5. Itch- ing; 6. Constipation; 7. Delusions; 8. Lethargy; 9. Respiratory depression; 10. Tremors; 11. Aggressive or combative behavior; 12. Psychotic episodes; 13. Hallucinations. Grand Ronde Health & Wellness Center Optometry Effective July 1, 2017, Tribal spouses on the Shasta Skookum Health Assistance Program will be required to pay overages above the Skookum Health Assistance Program limitations, as well co-pays when receiving optometry services at the Health & Wellness Center. S moke S ignals 27 June is National Safety Month Injuries are a leading cause of disability for people of all ages, and they are one of the leading causes of death for Americans ages 1 to 44. The good news is everyone can get involved to help prevent injuries. This June, we encourage you to learn more about important safety issues like prescription painkiller abuse, transportation safety and slips, trips and falls. • Prescription painkiller abuse: Prescription painkiller overdoses are a growing problem in the United States, especially among wom- en. About 18 women die every day from a prescription painkiller overdose — more than four times as many as in 1999. • Transportation safety: Doing other activities while driving, like texting or eating, distracts you and increases your chance of crashing. Almost 1 in 5 crashes (17 percent) that injured someone involved distracted driving. • Slips, trips and falls: One in 4 older adults fall each year. Many falls lead to broken bones and other health problems. You can make a difference. Find out ways to help reduce the risk of these safety issues. For more information visit http://www.nsc. org/act/events/Pages/National-Safety-Month-Free-Materials.aspx Come check out our National Safety Month table from 2 to 4 p.m. Wednesday, June 21, in the clinic atrium.