Thousands Say Kratom Cured Their Addiction, Government Says It’s Another Opioid | Hacker News Reader

Thousands Say Kratom Cured Their Addiction, Government Says It’s Another Opioid

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116 pointspmcpinto133 comments

It bothers me that in all the hype about Kratom the fact it does produce dependence is obscured.

I know a few folks who have had a terrible time getting off of Kratom. Only one of which is totally free of it.

All of their cases were similar, going from a small brew a day the first week to doing 6-10g a day within weeks.

People I know who still take it regularly remind me of addicts to other substances - claiming they can quit at any time but since they aren't having a problem they don't choose to quit.

Yet they also constantly crave Kratom and freak out when they can't get it.

Of course there are a lot of legal addictives - like a whole range of mood altering drugs like Xanax, Prozac, etc. - which are far worse long term.

That still doesn't excuse the unrelenting hype that Kratom is safe and that it isn't addictive.

It does produce dependence if taken often enough.

However, compared to the harm caused by illicit opioids (or even prescription opioids) doesn’t this seem like a low priority?

So someone is spending $100 or $200 per month on their kratom. They aren’t committing crimes to pay for it, they aren’t overdosing and dying in the street and they aren’t getting diseases by sharing needles.

It doesn’t seem like a major health cocern.

Kind of like tobacco without the second hand smoke or lung cancer. Sure it would be better if people didn’t do it, but that’s true of a lot of things.

You would see the same level of harm reduction if other opiates were legal. My guess is that what makes kratom less harmful is the legal status.

False. Kratom (mitragyna speciosa) is unique in that it does not seem to trigger respiratory depression. So it’s not just the legal status.

However it is true that drugs like heroin (when pure) are quite safe overall - aside from the respiratory depresssion overdose scenario.

Does Kratom have other undesirable side effects? How is it on the liver? If the population present opiate users switched to Kratom, what would we see?

Instant end to opiate overdose deaths, for one.

I've heard it causes pretty significant constipation in some cases. I guess that's undesirable.

It does cause some constipation, but it's nothing compared to that caused by even 'weak' opioids like tramadol or dihydrocodeine.

Wikipedia explicitly mentions respiratory depression as a side effect of kratom: https://en.wikipedia.org/wiki/Mitragyna_speciosa

I haven't checked their sources, though.

It may be a side effect of taking huge amounts of extract, but is not possible when consuming the leaves, as far as I know. I’ve known people who claim to take an ounce (28g) of leave per day without issue. (I take btw 2-8 grams in a day myself so I can’t speak to higher doses)

In general taking excessive amounts triggers vomiting, similar to when you eat too many psilocybin mushrooms (well, some say it’s ideal to vomit shroom-wise, but I’m not a fan). So mitragyna speciosa is incredibly safe.

Unfortunately Wikipedia’s treatment of the topic could be improved, but there is very little existing literature out there. I read one review study I was pretty happy with but I’m not on a laptop so i can’t go dig up the link unfortunately

I take a muscle relaxer that is non drowsy, yet it’s listed side effects include the same statements of drowsiness seen on all muscle relaxers. They slap the same side effects on drugs of the same class.

> They slap the same side effects on drugs of the same class

They spend billions on developing and promoting these, and they can't figure out the side effects for a specific drug? Maybe they should spend just a little bit more.

Somewhat true, but that's only part of the picture. An extremely significant distinction is that, much like with cannabis, it is pretty much physically impossible to overdose to death on mitragyna speciosa by itself. It will make you feel terrible to the point of being non-functional, but it almost certainly will not kill you.

So it’s a painkiller that works as well as an opiate with a maximum dose that dwarfs the opiates. Sheesh. That alone should be enough to research its use for pain management

Back when the potential kratom ban was scaring everyone, I remember seeing a sign advertising clinical trials for those dealing with opioid addiction. The cynic in me wondered whether the trials were for some medication that mimicked kratom or any individual alkaloid

I don't think it has the same binding affinity as more powerful opiods which reduces it's addictive potential, as well the risk of overdose.

It activates mu-opioid quite strongly but not the other receptors as much (I forget their names).

Interestingly, it has a mix of opioid antagonists and agonists. I’m not sure if that specifically is why tolerance doesn’t build aggressively, or if it’s some other MoA like nmda receptor antagonism

> You would see the same level of harm reduction if other opiates were legal

We see huge harm from legal opioids which are widely mis-prescribed. They cause addiction and fail to treat the pain for which they are prescribed.

No particular opinion on kratom, but the problem historically with other drugs that produce a dependence is the dependence can exceed the amount someone can afford. The politician argument is that this will make them steal, etc

So I’d be careful with “only $x a month” as an argument.

Anyway if it is addictive it’s hard to imagine it being more addictive than oxycodone and that is totally legal and aggressively pushed by companies that know exactly how addictive it is, so mostly this goes back to the standard government motto of only making drugs legal if large companies can make a huge profit off it. Anything that can be easily grown by average consumers (like weed) doesn’t meet that requirement and so tends to be illegal.

My understanding was that kratom was more useful for harm reduction, rather than curing addiction, as it's still addictive but much less harmful than heroin.

It's similar to vaping or nicotine gum in that respect.

Nicotine gum actually uses a different metabolic pathway to uptake the nicotine which is less addictive than inhaling nicotine.

More precisely, there is a theory that nicotine becomes highly addictive in the presence of an MAOI which are naturally present in tobacco smoke, but not added to nicotine gum.

I was actually referring to inhalation vs ingestion; specifically how inhalation has a 10-20 second lag before the effects are noticeable whereas ingestion takes much longer - resulting in less behavioral reinforcement.

The MAOI theory is interesting, there are a lot of alkaloids in tobacco. Apparently nicotine uptake across alveoli membranes is very pH dependent - the ionic form won't cross the barrier. Cigarette smoke is cured at a high temp and has a low pH, pipe tobacco is cured at room temp and has a high pH. [0]

It seems that cigarettes are processed to specifically give a minimal dose per volume inhaled that quickly delivers nicotine as a way to maximize reinforcement behavior. I would be interesting to test the pH of commercial vaporization solutions.

[0]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953858/

Super interesting. Thanks for taking the time to clarify.

So because some people are idiots others should have to suffer? Kratom literally saved my life. I was hopelessly addicted to opioids and went from shooting heroin to ingesting plant matter. I agree that the opiate naive shouldn't stupidly throw themselves into opiate addiction but the idea that because some people can't handle themselves I should have to suffer is ridiculous.

Just to be clear -- heroin is processed morphine, which comes from poppy sap. Cocaine is processed coca leaves. Nicotine is primarily extracted from tobacco leaves. Belladonna, strychnine and digitalis... just because something is made from a plant doesn't make it less of a drug or less dangerous.

The most dangerous drugs aren't really comparable, though. They tend to be processed concentrates of the plant, and in those cases the plant itself is much less harmful than the concentrate.

Consuming plant matter directly with minimal processing is quite a different thing from isolating the active ingredients as much as possible, creating dosages much higher than found in nature and simultaneously removing buffering material such as fiber and other nutrients.

Are you saying kratom is as dangerous as heroin? If not why post this?

They are saying just because it grew out of the ground doesn't mean it is safe. I found that pretty clear.

And how does that relate to what I posted? I clearly was not saying any plant is safe, I was comparing heroin and kratom.

I appreciate the concrete experience described in your comment, but please don't do this:

> So because some people are idiots others should have to suffer?

It degrades discussion and encourages worse from others. And since it was obviously not what the commenter was saying, it breaks the guideline which asks you to respond to charitable interpretations, not weak ones: https://news.ycombinator.com/newsguidelines.html.

Also, you've gotten into flamewars about drugs on HN before, and we had to ask you to stop. I get that you have reason to feel strongly about this topic, but that doesn't make it ok to bring sharp elbows into the conversations. If you can't be respectful, including to people who seem completely wrong, then please don't post.

Thanks dang.

I agree with this; I have witnessed Kratom aid people in quitting opioids, and when used properly as a quitting aid, it could help a great many people, should not be made illegal or placed under regulatory capture, and should be studied and brought into formal treatment. I personally keep some around in the rare instances where I would take ibuprofen or something similar.

In a similar vein, the generic drug tianeptine, prescribed for over 30 years in other countries for depression & anxiety, is now a schedule 2 controlled substance in Michigan (https://www.usnews.com/news/best-states/michigan/articles/20...), one of the major base states for the Johnson & Johnson corp, which studied the substance (https://adisinsight.springer.com/drugs/800039841) entering clinical trails for release here, but was dropped with no reasoning. Before some talking-head chimes in that tianeptine is a μ-opioid receptor, read the atypical part and addiction data in countries where it has been prescribed widely. It is the only drug which effectively treats my depression and anxiety, it is generic so large drug companies cannot make an exorbitant profit off of it, and they are keeping it from the US through media scare-tactics, like Kratom, to ensure their profitability and the reception of their patented drugs like https://en.wikipedia.org/wiki/Esketamine. We should stop them.

Tianeptine is a lot different than kratom though. I know it works really well for some people, but its abuse potential is far higher than kratom. I could never have it around, no matter how well it treats depression, because as a former opiate addict having something cheap and legal that feels pretty much the same as oxycodone (in massive doses compared to its therapeutic dose) is a recipe for disaster.

If only tianeptine could be made available in the correct (12.5mg) doses, prescribed by a doctor, maybe I could use it. But as it stands, buying powder by the gram would lead to my demise.

Thank you for that input; yes, the solution is a narrow bridge that has to balance the needs of people who use it as medicine with the potential for addiction (especially in the case of previous opiate dependency). This balancing act, though, gets severely unbalanced in the presence of profit incentives, leading to the media maximization of the addiction potential (or any negative really).

> Of course there are a lot of legal addictives - like a whole range of mood altering drugs like Xanax, Prozac, etc. - which are far worse long term.

I’m not quite sure it’s fair to lump all those drugs under addictive... Xanax is a benzodiazepine, but Prozac is an SSRI. Both can cause withdrawal symptoms if you stop too quickly, but neither are really classified as addictive.

Some of these drugs also profoundly impact people’s lives for the positive as well as actually save lives from severe depression. The constant idea that these drugs are somehow dangerous does much more harm than good to those who need it.

For some reason people have no issue with drugs like Nexium for heartburn (which can also cause dependence) but if it’s a drug that effects your brain... it’s labeled as evil.

And to clarify, addictive substances are not defined simply as something that causes withdrawal. Lots of things cause withdrawal... Tylenol can cause rebound headaches, heartburn medicine can cause intensified heartburn, etc. True addictives on the other hand also cause reward and reinforcement behavior. The strong reward stimulus effects molecular transcription factors that result in reinforcement behavior, which drives the addiction (not fear of withdrawal)

https://en.m.wikipedia.org/wiki/Addiction#Mechanisms

https://en.m.wikipedia.org/wiki/Benzodiazepine_dependence

Benzos cause dependence, and your link says this.

Dependency is different than addictive behavior.

If you read the whole page, it goes into more detail:

“Addiction, or what is sometimes referred to as psychological dependence, includes people misusing or craving the drug not to relieve withdrawal symptoms, but to experience its euphoric or intoxicating effects.”

Also if you read the link on addiction you’ll note that benzos are not listed as drugs that elicits true addictive behavior.

Can you become dependent on benzos... yes that’s possible. But people typically don’t seek out ever increasing doses to get high, which is an important distinction. And people who abuse them are often self medicating due to untreated anxiety disorders rather than to party or get high.

Stigmatizing medicine like SSRI and Benzodiazepines as addictive like opiates is misleading and harmful.

Benzodiazepines, if used under a doctors supervision and for limited duration, almost never cause dependence. Opiates on the other hand, even short term doses, can lead some individuals to become quickly addicted and start drug seeking behavior.

Doesn’t mean benzos are totally safe all the time, but it’s just not fair to compare it to opiates or Kratom.

I’m not in a position to argue the deeper details here, but superficially this thread has a tone that is pretty uncritical about benzodiazepines.

For persons scanning the conversation and absorbing the ambient folk opinions here on various substances — it is crucial to know that benzos are in fact very treacherous. You can die from them, they are highly abused, and they have a big tolerance effect as well as interactions (esp w alcohol) that can get folks in big distress or danger.

Not attempting to be uncritical of benzodiazepines, they can indeed be dangerous. Just trying to specify that they are not addictive in the same way. My understanding is that when they are abused in the sense of getting high, it’s usually in conjunction with opiates or other illicit drugs.

This is perhaps a more critical review, but still specifies the difference between physical and psychological dependence.

https://pro.psychcentral.com/benzodiazepines-are-bad-or-are-...

And so do video game addicts.

Just because something is dependence inducing doesn't mean it should be ever illegal.

If Kratom addicts start robbing convenience stores and offering blowies for Kratom cash i'll believe it.

> If Kratom addicts start robbing convenience stores and offering blowies for Kratom cash i'll believe it

This has very little to do with the properties of a drug itself, and more to do with the demographics (poverty, unemployment, overall disenfranchisement, environmental factors like urban density and access to services) of people who use other drugs; specically, that usage of these substances often correlates with such disenfranchisement.

In other words, the people currently using Kratom may not be the same people using other drugs, and their circumstances may be different.

(Not a comment on Kratom, which I don't know much about, besides its popularity in some websites)

Yeah. And even then, that would have to be a result of both addiction and the state drug war. Without the latter, the stuff is extremely affordable. I was curious if it would help with anxiety so I ordered about $8 of it, which was about 2 sandwich bags stuffed full of it! It made me feel physically nauscious for the entire morning and I took a very small amount. But I don’t think I would have been impaired driving. Drivers on opioids frighten the crap out of me.

> Drivers on opioids frighten the crap out of me.

Is there any reason you personally feel that way or is it more of "opioids are strong and dangerous so I figure people driving on them is dangerous"?

We know that opioids impair ability to drive.

Actually, it looks like opioids are not associated with vehicle accidents

https://www.ncbi.nlm.nih.gov/pubmed/14650448

I'm not too sure that the data in that 2002 study is relevant today. opiate use has skyrocketed since then and it's reasonable to believe that things have changed. In my career as a paramedic, i've probably encountered more vehicle accidents where someone admitted that they have taken opiates (oxy/norco/etc) than anything. Yet it's not going to go down as a cause in many cases because while a blood test would show positive for opiates, it's difficult to pin it down. Alcohol is much easier to pin on drivers.

Of course, but it's obviously going to depend on the dose and the person's level of tolerance.

A few years ago the UK revised their regulations regarding driving while using prescribed opioids, taking an approach that essentially allows the driver to decide if they are too impaired to drive.

> Drivers on opioids frighten the crap out of me

I don't mean this in an offensive way, but that's just because you're ignorant of the effects.

I suffer from chronic pain and use opioids every waking moment, but they do not impair my ability to drive safely.

Of course "being on opioids" isn't a binary thing; my medicinal dose is very different from a recreational one.

Prozac/SSRIs are not like Xanax or even Kratom. They are very useful for withdrawal periods. Just don't take them for years at a time...

Anecdote: about 2-3 years ago I was using about 10g/day kratom and 1gm/day caffeine to deal with chronic fatigue and muscle pain.

I was dependent on both for about 12 months just to function (without them I had a hard time getting out of bed or anything done). But the combo helped to finally get regular exercise, which helped with sleep, which helped me to heal.

The caffeine was _much_ harder to kick than the kratom. A full week of headaches and fatigue due to caffeine withdrawal.

When people talk of kratom being bad because it produces dependency, why don’t they talk of caffeine in the same way? What real negative effects does the kratom have if used long term? My experience says there is none. And all this handwringing is simply due to lack of familiarity.

1g of caffeine? That's like 25 cups of espresso. Have you had a cardiologic exam beforehand?

Its high, but it’s really not that excessive over the course of a day: https://cspinet.org/eating-healthy/ingredients-of-concern/ca...

TIL Starbucks coffee has a ton of caffeine. This explains why I'm super jittery every time I get Starbucks even though I drink (non-Starbucks) coffee every day.

So yeah, two freaking massive 20oz pours of highly caffeinated coffee will get you to around 1 gram.

But FWIW the daily recommended dose is 400mg. 1g is a ton of caffeine and way beyond what you would get to by sipping on coffee throughout the day (it's 10+ cups of drip).

I don’t know where you got 400mg/day. Last I checked it’s 160 mg/day.

https://health.gov/dietaryguidelines/2015 mentions that 400mg/day is the upper bound for moderate caffeine consumption but provides no citation.

I cannot find where the number originates, but there is at least one study @ https://www.sciencedirect.com/science/article/pii/S027869151... which explicitly claims "vidence supported consumption of ≤400 mg/day in adults is not associated with overt, adverse effects."

1g of caffeine is high, but with tolerance it doesn't seem _that_ high. I currently use 600mg/day to help with OCD[1], and it doesn't really effect me - heart rate barely moves, and I don't feel noticeably different. I've tried 1g, and it made me feel _slightly_ jittery, but that was about it.

[1] Counter-intuitive I know, but it seems to help - it makes the intrusive thoughts easier to ignore

Something to consider is that your experience may not be representative of the norm.

There's no real reason to go cold turkey from caffeine. I've gotten to over 600mg/day. Not quite 1000mg though. :) Even so, when I have cut back (which I've done, multiple times) I just reduce my usage over 1-2 weeks and it's fine.

People I know who still take it regularly remind me of addicts to other substances - claiming they can quit at any time but since they aren't having a problem they don't choose to quit.

Is it worse than coffee?

>going from a small brew a day the first week to doing 6-10g a day within weeks.

At small doses Kratom is somewhat of a stimulant. 6-10G is where opiate effects start kicking in, so I'd say doing 6-10G is perfectly normal for Kratom usage.

> Of course there are a lot of legal addictives - like a whole range of mood altering drugs like Xanax, Prozac, etc. - which are far worse long term.

Xanax is a benzo and is addictive, but Prozac is an SSRI. SSRIs are not addictive, and aren't even interesting recreationally because they don't make you feel anything good.

> SSRIs are not addictive, and aren't even interesting recreationally because they don't make you feel anything good.

And are distinctly unpleasant at higher doses.

They can be addictive though: https://en.wikipedia.org/wiki/Antidepressant_discontinuation... (at least in that they can cause withdrawal when stopped).

Check its legal status in Malaysia and Thailand. [1]

Furthermore, some drugs such as khat, betel nut, or coca are mildly stimulating and used heavily in certain cultures throughout the world.

[1] https://en.wikipedia.org/wiki/Mitragyna_speciosa#Regulation

Kratom can ease opioid withdrawal it binds to the same receptors.

Opioid addicts use it to "get by" when they can't their drug of choice. It is also used to "boost" the high by combining it with other opioids.

It gives you the same euphoria as taking an opioid. In my opinion anything that gets you high is not a legit treatment for opioid dependence.

What worked for me when I finally kicked opioids a few years ago was to taper off using suboxone quickly over about 2 weeks to get past opioid withdrawal, and then over about a year you have to train your brain to be high on life instead of substances. Easier said than done, the 27th try was a charm. Clean for 2.5 yrs now.

The thing with Kratom is that it's very dose-limiting. It tastes terrible, causes bad nausea, and makes you jittery. So let's say you have a dose of Kratom that you enjoy and you want more. You double it and you either puke it up before it all hits or it makes you so miserable you think twice before taking it again.

The real danger is in the so-called extracts, which distill and purify the active ingredient(s). But regular powdered Kratom is, IMHO, less harmful than marijuana and should be legal.

Interesting historical note about Kratom: it's traditionally used in SE Asia as a productivity drug. Farmers would take it to help them get through long days in the field. Much like how coca is used in the Andes.

Yes, the extracts are where you end up eventually.

It's true, being high on opioids increases productivity massively while you are high. I remember being able to code 12-18 hours a day, be excited to mow a 2 acre lawn with a push mower, etc. The problem is when you run out of money and are in withdrawal productivity drops to zero, it's hard to even get up to take a pee.

I have personally seen an entire friend group abuse buprenorphine recreationally. It doesn't produce the traditional opiate euphoria, but for people with little opioid tolerance it can be a very strong intoxicant.

From my experience, kratom is noticeably less euphoric than most opiates and doesn't cause as bad of side effects such as nausea and constipation.

Considering that difference and the big differences in price and availability (eg for people that lack access to healthcare), I believe there is a significant portion of people that could viably use kratom in lieu of buprenorphine, and ESPECIALLY in lieu of methadone.

I genuinely believe that the debate about kratom is framed squarely by those who seek to control the profits in addiction treatment.

For reference I am 7 years clean, and have "babysat" over a half dozen people through various stages of withdrawal from opiates, amphetamines and alcohol.

I have to agree with you on the debate being framed by the addiction treatment lobby. I don't have any direct proof, but I have heard scores of stories about "treatment salesmen" connecting to peoples mothers and grandfathers to offer help with their addicted relative. All to shuffle feet through specific treatment centers doors.

With that going on, I wouldn't doubt if it was the old "budweiser lobbying against weed" dealy.

The big difference with kratom is the much lower lethality of kratom vs. other opioids. There are virtually no uncomplicated kratom fatalities. The closest thing to a kratom death I can find is this probable suicide attempt (combined with two antidepressants and DPH -- an opioid synergist):

https://academic.oup.com/jat/article/39/2/152/763622

That's not to say there aren't downsides:

http://journals.sagepub.com/doi/abs/10.1177/2324709618765022

I'm willing to accept that there's some complexity in the regulation of substances people use for medicinal purposes, whether they come out of the ground or a lab. The DEA is an abhorrent institution, though. And while it's clear the writers of the article swing one way about it, the DEA and FDA seem to be acting like they want any excuse to ban the stuff.

When they start locking people up for selling Kratom, and then a year later big pharma comes out with "Kratolizine" at 50x the price, I won't be surprised.

Your post's content is the crux of the problem from my POV. The powers that be and the bodies that make decisions about the legality of substances and scheduling of them seem much more interested in general profit and preventing the average citizen from using any sort of alternate route or remedy to combat their addiction. If they focused even a slight percentage of their energy and efforts into actually helping these people or offering real alternatives in terms of addiction care / help I'd be much more willing to believe things they are doing and saying but as it stands everything just seems like a smoke screen or straw man to allow them to continue conducting business as usual.

I'm curious what the state of affairs is in Europe wrt Kratom, or do they tend to coincidentally come to the same policy conclusions as the FDA?

"In Europe, as of 2011, the plant was controlled in Denmark, Latvia, Lithuania, Poland, Romania and Sweden.[15] In the UK, since 2016, the sale, import, and export of kratom are prohibited under the Psychoactive Substances Act."

My wife has an as yet undiagnosed neurological condition with symptoms that include severe nerve pain, “electric shocks” in her head, and skin pain. She’s seen one of the best neurologist in the state, regularly sees another neurologist, and has bi-monthly appointments with a rheumatologist.

For six years the best thing they could come up with was pumping her with 16 high dose caplets of Gabapentin, 8 doses of Tramadol, and a dose of Symbalta at night. I’ve watched her struggle with that for six years, helpless. And on top of that, none of the symptoms really went away. And if for some reason she ever had to go without Tramadol, you’d think she was detoxing from heroin.

A few months ago she decided to stop taking all of it. She cold turkeyed the Gabapentin and stepped down off the Tramadol. Then she cold turkeyed the Symbalta. It was utter and complete hell.

Now she occasionally takes a Tramadol on her worst nights. But she’s free of the overall effects. Except who knows what the long term effects of that many chemicals did to her.

These were all “approved” treatments. Prescribed by some of the most highly educated and accomplished physicicians in the country. And they very nearly killed her, at best, and at worst made her want to kill herself.

The American pharmaceutical industry and the American “health care” industry are the same industry. They own the medical schools. Which at this point are just cheap sales colleges. Doctors in the United States are licensed drug dealers with absolutely no motivation in treating causes, only in receiving kick backs from their PharmaCo handlers.

And the fight against Kratom may be justified. But from my perspective whenever the FDA or any other government org in the US says something is inherently dangerous I can’t help but feel high levels of distrust.

These are the same organizations that let Monsanto take over the food supply and make decisions based not on science, not even on what they think or can prove is good for the people, but on what increases their boss’s bottom line a fraction of a point.

Has your wife ever taken an antibiotic similar to Ciprofloxacin? It is commonly prescribed for UTIs.

[1] https://en.m.wikipedia.org/wiki/Ciprofloxacin

[2] https://en.m.wikipedia.org/wiki/Fluoroquinolone

Sounds like trigeminal neuralgia or some other nerve impingement.

effects from coffee / prescription anti-inflammatory are good indications towards that

Just thought I'd chime in for this. After my cochlear implant surgery I had all these symptoms.

I was put on the same medications. After a while I started having seizures. Over time, I managed to stop the tramadol, and the others only leaving the gabapentin. Seizures still happened. (the electric shock thing I used to encounter, was probably related).

One day I come across side effects for it and one of the big ones was "causes seizures". So, trying to stop that gabapentin was one of the hardest things I've ever done, such extreme withdrawals, far worse than any tramadol, oxycontin etc.

As soon as I had stopped the gabapentin, all my symptoms disappeared, and I've not had another seizure since.

What we think happened was I had an infection, that had caused the aforementioned pain and shocks, so we went with the medications which obviously masked a lot of the symptoms. However it wasn't until I was free of the meds, that things were actually better, and it was very easy to pinpoint what was causing havoc with me.

When reading about Gabapentin/Pregabalin all over the internet, some people have had such bad experiences with it - and on top of that, doctors give it out like candy in New Zealand as a fix-all, because it's marketed as a very safe drug.

I hope your wife is feeling better these days mate! :)

It's not just another opioid - mitragynine doesn't recruit beta-arrestin, the pathway associated with tolerance build up and side effects like respiratory depression.

I'm certainly not convinced it does cause dependence, especially not to the same degree as most opioids. As a sample size of 1, I was always able to stop taking kratom without suffering any kind of withdrawal, and there are plenty of other similar anecdotes on reddit (to be fair, there are plenty that do talk of cold-like symptoms when stopping it)

As a sample size of 1, and a person who has used a lot of different substances (alcohol, cigarettes, amphetamines, psychedelics, marijuana flowers and extracts), been addicted to quite a few of them, and kicked all of them, Kratom has been by far the hardest drug to stop. After reading online about the potential benefits and mildness of Kratom, I started taking it occasionally, and slowly had to ramp up usage frequency because I would start feeling cold and uneasy when not on it, I pretty soon I had to take it consistently to stay at my baseline level.

I managed to taper off down to a manageable level (about half a coffee spoon every 5 hours), but going beyond that was impossible without feeling the withdrawal effect pretty much full force, I decided it was best to bite the bullet and stop cold turkey.

Extremely cold feeling coming from inside on a very hot day, awful restlessness (which made it impossible to sleep more than 2 or 3 hours a night for the first week, before I had to give up and go on sick leave), the most intense feeling of being devoid of energy both physically and psychologically, and pretty much all the symptoms of a strong cold. The extreme sleepiness and impossibility to fall asleep because of the restlessness is one of the most frustrating combos I've ever experienced, but I'm sure that's all too familiar to opioids users.

If you're trying to kick off an existing opioid addiction (or maybe have some sort of pain where the usual pain meds channel are not available?), this might make it more manageable I'm sure, but all the analogies to coffee or tea as "Just a thing you can take if you wanna calm down a bit" can be extremely dangerous to people that have essentially no need for it, and particularly people with an addictive behavior.

We all have our weaknesses I guess. For me, nothing was harder to quit than pot. I've regularly used opiates, kratom, and even tobacco and I can pick them up and put them down with ease and lack of noticable side effects (short of a few depressed days). Weed took weeks of dealing with lack of sleep, agression and obsessive thoughts before I broke free, and that was after many failed attempts.

I have personally seen several friends kick regular pill habits with kratom and they got off it OK. We should discuss the downsides but from what I've seen the folks with kratom problems just took way too much(as addicts will do, I guess).

Everyone's body reacts a bit differently to different substances, legislation should seek to inform people of the possible downsides rather than banning it completely because some people react poorly. This is well understood with other psychological pharmaceuticals, but with recreational drugs it is frequently overlooked.

Pot would definitely be second in my list. It's at the complete polar opposite of the addiction spectrum in my experience, and I had no physical symptoms beyond having a harder time falling asleep (incomparable to my experience with Kratom though) but the psychological addiction was the strongest out of all of them. Of course Kratom didn't cause any sort of substantial psychological addition in me, the feeling of warmth and general "feel goodness" I got from it was comparable and probably milder than a cup of coffee after having been off of it for a couple days, and subsided quite quickly after daily use.

Thing is, using your tea and coffee analogy, it really was much harder quitting caffeine for me - a week of awful headaches from caffeine withdrawal vs nothing after stopping kratom.

It really is strange the way many people have negligible or no withdrawal symptoms, and others report that they do. One theory is that you didn't just take kratom - there are known cases of it being sold mixed with synthetic opioids (o-des-tramadol is one such, from memory).

I don't think the product I bought was unpure, I got it from different, generally reliable, sources (and tried all the shades Kratoms came in at the time).

I fully accept that different people have different experiences coming off of a drug. I should have mentioned in my case that was about 8 months of daily use, although the withdrawal symptoms shown themselves very quickly (less than a month after I started taking it regularly).

I personally feel sluggish the first days if I stop coffee for a while, but even after drinking coffee every day for a comparable period of time, I don't instantly feel the withdrawal creep up on me as soon as caffeine (mostly) leaves my bloodstream.

For added context, at the peak of my consumption I would take about a teaspoon every 4-5 hours (consistently as this was the time it took to feel the cold symptoms again) through tossing and washing (just swallowing it down with some water). I've no experience with Kratom pills and no amount of sugar can possibly overcome the intense bitterness of Kratom tea at that dosage (and I like bitter).

I stopped cold turkey after taking it for over a year, 3.5g 4x a day, and had no adverse effects at all (well, other than the chronic pain I was taking if for coming back to the fore).

I wonder if perhaps there is some kind of genetic factor.. it's very strange in any case.

> been addicted to quite a few of them,

If you know this about yourself, maybe don't start taking opioids. There is certainly a subset of the population who, like yourself, seem to have addictive personalities regardless of the substance. That shouldn't really inform policy on any particular substance.

I also kicked all those habits. I'm curious and I was a bit of psychonaut.

This isn't me defending myself as not having an addictive personality, I'm sure I do, but I managed to stop smoking, coffee, alcohol and marijuana, some of those at the same time. Addiction is a problem that still plagues pretty much every country but even then I wouldn't say I'm necessarily in favor of banning kratom.

My original comment was only to point out that it clearly isn't as benign as a wide range of people make it seem. Of course if you go on the kratom subreddit you'll see addicts praising its benefits and rationalizing all sort of life improvements in the short term, as well as legitimate "success" stories, but most people who kicked the addiction don't repeatedly frequent and post there. I'd think this massive bias to be fairly obvious, but it might be worth repeating (this isn't aimed at your comment specifically).

Congress isn’t just considering banning it “just because”. There’s certainly a ton a lobbying money (ie bribes) by big pharma to make sure this un-patentable drug can’t cut into their own profits on painkillers. Kratom simply doesn’t have the lobbying power to make it a legal drug.

I wonder how much of its effectiveness in moderating addiction comes from the fact that the active ingredients have not been isolated and available in concentrated form. Already, people seem to be studying different strains. Is it only a matter of time before it becomes abused?

Having no first-hand experience with addiction, opioids, or kratom, I am skeptical since many of the article's subjects remain daily kratom users, often with increasing supply. Keeping it affordable with more socially mild symptoms allows these people to live functional lives. But it seems that the goal is not to attempt abstinence. Why?

Abstinence for its own sake is frankly not all that useful to society. Harm reduction is a much more important goal.

Millions of Americans are hooked on coffee and have withdrawals if they don't drink it, but nobody's up in arms about our caffeine dependence, precisely because it has very little in the way of social harms associated with it. If we can convert drug use with huge social harms (e.g. heroin, oxycontin) into drug use with negligible social harms (e.g. kratom), that would basically solve the opiate crisis.

In my mind the goal isn't to stop people from using opiates-- it's to stop them from dying, committing crimes, and running their lives into the ground due to opiates.

A positive step, to be sure. It sounds like further study is warranted, especially once the active ingredients in kratom are isolated and concentrated. The coca leaf was used for millennia, but became socially harmful in its concentrated form.

Some might say the same thing about refined sugar without the naturally occurring fiber it always occurs alongside in nature.

> but nobody's up in arms about our caffeine dependence, precisely because it has very little in the way of social harms associated with it.

Caffeine is associated with reducing the amount of sleep[0], which is associated with almost all illnesses [1].

[0] https://www.psychologytoday.com/intl/blog/sleep-newzzz/20131... [1] https://www.npr.org/sections/health-shots/2017/10/16/5580588...

Well, and uh, the part where it's an opioid that can be addictive that is wholly unregulated and being sold by any number of vendors online that are sourcing the product from god only knows where and selling it as a safe supplement.

I have heard the same, and it's sickening.

You are absolutely right. If they do ban it, isn't it just going to go the way of pot and be grown in basements, etc.? I don't know if this is harder to grow than pot or not.

This is just my personal experience, maybe because I take it in lower doses but I really do experience it like tea only more so. There are such sharply diminishing returns on the effects that I doubt this story about high addictivity.

My guess is that people do a lot because of the diminishing returns. Which you could argue is just another facet of addiction but I would disagree.

It is an opioid, that many people get quite dependent on. Methadone is an opioid that helps people get off heroin, it also has people that get addicted to it.

Just because something, when used a certain way, has positive benefit doesn't mean it should just be sold to anyone that wants some.

One twist to the equation is that Kratom isn't that pleasurable to people who aren't already addicted to opioids.

I bought a pack after I had surgery- I never finished it and never expect to take it again. In a large way it feels gross and unpleasant, completely unlike codeine/vicodin/oxycodone. (I don't feel like I ever got addicted, despite taking it daily for a couple weeks, and haven't taken any opioids in the 8 months since the pain stopped interfering with my life)

That's true of many addictive things though. Problem is, the stuff is unregulated and coming from all sorts of sources most of which probably have zero quality control and then it's readily avialable to buy for anyone with access to the internet and a credit cad.

Sure, people can also go on a DNM and with bitcoin they bought with a credit card order as much cocaine or heroin to their door as they want but most people see cocaine and heroin as bad and would never do that.

However, when you have people on podcasts and YouTube going on and on about how great kratom is, how kratom makes their anxiety better, how kratom helped their friend's cousin's room mate's girlfriend get off heroin, then people are like "oh shit, I'm gonna order this panacea" and you have people that likely would never have tried some random opioid ordering the substance and consuming it.

People will try something if it becomes part of a (their) culture or when someone they put trust in talks well of it (podcast host, YouTuber they follow). Look at when people discovered hacking productivity with Modafinil, you had domestic and foreign websites popping up like crazy selling real modafinil, fake modafinil, super harsh on the liver pro-drug versions of modafinil, to anyone that had a credit card all because a few tech journalists reported on how some in silicon valley were using it to hack their productivity.

Look at 'k2' and similar synthetic cannabinoids that popped up several years ago. People were all 'hey man, it's legal and like weed!' and within months it was for sale in every headshop and even many independently owned gas stations. And whoops, once you had a bunch of people trying it turns out it wasn't exactly like weed and people were having basically bad trips and even seizures from mild to moderate comsumption and then state after state quickly started making it illegal.

Then 'bath salts'.

Go back 20ish years and kids were fucking around with freon and dying because it quickly entered certain cultures as a free way to get high at home.

We live in a world where ideas are highly contagious. While kratom does seem to have benefit in some cases when used correctly and does have a traditional use, it just shouldn't be something that John Q Public can hop on the clearnet and order for self-medicating.

Kratom has a long history of widespread use, so it's not really like anything you're trying to equate it to.

Nowhere near the levels it is now nor in the quantities it's being consumed by individuals.

K2 and other synthetic cannabinoids only exist because of prohibition - people would much rather have real cannabis.

That's the same as heroin. People need to learn how to use it.

I was going to post something about methadone. I saw the same parallel, but see it the opposite of you maybe. To me, if people are taking kratom and it's helping them, why take that out of their control and use it to pad the pockets of middlemen like physicians, pharma etc.? If they want that level of oversight, or a judge thinks its necessary, go that route, but I generally think people should be in control of their own bodies.

I see regulating kratom as just a chance for healthcare and pharma to take a cut of a substance that's in demand, by controlling the market for it.

Step 1: see substance in high demand because it actually has physiological effects.

Step 2: identify potential harms.

Step 3: claim that because of these potential harms, only highly credentialed people are allowed to administer the substance.

Step 4: profit.

The hypocrisy with regard to alcohol and common household chemicals should immediately dispel any arguments about harm reduction being the driving factor in drug regulation. Not to mention substances that have publicly been identified as harmless (or at least, within the ability of every day citizens to self-administer) in the scientific literature, but are still regulated because of concerns that deregulating them will "set a precedent" and "trigger demand for more deregulation." (https://www.ncbi.nlm.nih.gov/pubmed/9524840)

From the article, it seems like the government wants to ban the plant in fear of a new opioid crisis—all while opioid class drugs are relatively accessible. It’s amazing how large of a grip big pharmaceutical companies have on the US government.

Why is there still a prevalent knee-jerk attitude towards some drugs (or external catalysts that affect the body)?

Are the lawmakers uninformed on the real effects the drugs have?

Do they know but they can't take a 'pro sense' stance because of (irrational) fears that they'd get booted by their constituents?

Are they influenced (lobbied) by powerful players to resist pouring more money towards research or being more open to moving towards legalization?

Do they actually know but don't care?

Are the lawmakers uninformed on the real effects the drugs have?

Maybe to some extent.

Do they know but they can't take a 'pro sense' stance because of (irrational) fears that they'd get booted by their constituents?

Perhaps. If so, it would be the result of decades of successful propaganda. See below.

Are they influenced (lobbied) by powerful players to resist pouring more money towards research or being more open to moving towards legalization?

Yes.

There's a neo-prohabitionist streak that most boomers (which most politicians are and also most voters) have. Consuming any mind altering substance that isn't culturally ingrained (i.e. alcohol or tobacco) is morally wrong, and therefore should be regulated and banned if possible.

A lot of them seem to be under the impression that if recreational drugs were legal, everybody would spend their waking hours high and no work would ever get done. My boss recently claimed that they shouldn't legalise recreational cannabis because everyone would be high all the time, yet somehow people manage to avoid being drunk all the time, or at least most of us do.

Why is it so hard to say that both sides can be right? Kratom definitely helps many people, much the same as cannabis, amphetamines, and other opioids. It has a clear medical purpose and maybe even a recreational purpose. We have not seen a huge epidemic of kratom-related deaths after all. Yet it is still an addictive drug at the end of the day, and anyone who argues that it isn't (or that weed isn't) is just hurting our ability to have rational conversations over these things. Alcoholism is a thing, yet it's clear that blanket bans of alcohol do far more harm than good. As much as people try to paint kratom as a magical cure for every disease under the sun, it's irrational to argue that it has no harmful effects. Getting to the point where we can accept this type of nuance is necessary if drug policy reform is a serious goal of ours. Simply trying to shut out the other side with phony pseudo-science juju shit about cannabis reversing the effects of smoke inhalation and being some magical gateway into another realm is just reinforcing their beliefs.

Of the two sides, to me the FDA is the one exhibiting the most phoniness, their blatantly dishonest stance on marijuana being a perfect example.

In this article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670991/) there is a dude who was pretty heavily addicted to opiods and used Kratom to manage his withdrawal symptoms when trying to quit. Unfortunately he went a bit overboard and had a seizure. So he abused Kratom a lot and also opiods. After that he understandable quit the Kratom and had minor withdrawals.

My takeaway here was that quiting Kratom is not like quiting opiods, and Kratom could be useful in allowing people to quit opiods more easily.

I certainly think it's worth studying more, and to do that you don't want to ban it.

Well, no argument it is an opioid (or probably a couple different opioids). That said, it has at least three significant advantages over black market heroin (IMO):

1. It is extremely inexpensive! Even grey market production, shipped halfway around the world, sold in small quantities across the internet, is just extremely cheap. Almost anything you would cut or adulterate it with is more expensive and thus adulteration is not as economically viable.

2. Dose (quantity). It's much less concentrated than heroin.

3. Dose (method). Taking drugs orally doesn't provide the same immediate gratification feedback loop that injecting (especially) or smoking does. (And as other commenters note, it tastes bad. It's like drinking dirt tea.)

Kratom is not an opioid...

https://erowid.org/plants/kratom/kratom_journal2.shtml

>By 1940 three alkaloids in addition to mitragynine had definitely been characterized viz. mitraphylline from the bark of M. rubrostipulata (Michiels and Leroux 1925), rhynchophylline from the bark of M. stipulosa (Larrieu, 1930) and rotundifoline

It does not contain any opiate alkaloids. It has zero morphine, thebane or codeine in it.

It binds to mu opioid receptors and the compounds are largely unstudied. So while maybe not technically an opioid, that doesn't magically mean it's good to go.

What it is, and what it does are two different things.

Saw your edit.

If it quacks like a duck and quacking is what matters...

Either we respect the chemistry, or we don't.

Kratom does not contain alkaloids from the opium family.

Which is it?

Secondly, classifying the overall effect of Kratom as opiate like is, frankly ignorant.

There is some minor league overlap, but not enough to justify the current moves to ban.

Now, that degree of overlap may well prove a reason to monetize.

And that looks a lot like the dynamics of THC too.

The conversation should be honest, and most of it really isn't on that front. That, coupled with uninformed discussion on effects, potentials, makes for far more negative impact on the public than is warranted.

This attempt to frame kratom into schedule 1 or even 2, based on very shallow, mostly anecdotal, and or dishonest representations of danger, is deplorable.

Rabid too, where potential monetization is concerned.

We can and should do much better.

That could start with the chemistry, and history, frankly.

...or not, and that path is hardly respectable.

A young child quacking, when quacking matters, would be the analogy to break yours down, in simple terms.

It's an opioid. (Or rather, contains opioids—more than one, by the way!)

Every purported "non-addictive opioid substitute" in history has turned out to be an opioid. If it acts like an opioid and quacks like an opioid, assume it is one.

> https://erowid.org/plants/kratom/kratom_journal2.shtml

Try:

https://erowid.org/references/refs_view.php?ID=7348

(linked from https://erowid.org/plants/kratom/kratom_basics.shtml)

A deciding rule to tell whether some chemical or plant is an addictive opioid: if people are using it to "lessen their withdrawal symptoms from opioids".

>Every purported "non-addictive opioid substitute" in history has turned out to be an opioid.

I thought Naloxone was non-addictive (and clearly an opioid)? Or am I misreading? https://en.wikipedia.org/wiki/Naloxone

Naloxone binds to the same receptors, but it is an antagonist, so has the opposite effect.

It's not an opiate. It absolutely is an (or is made up of at least one) opioid.[0]

> Opioids are substances that act on opioid receptors to produce morphine-like effects.

> ...

> Opioids include opiates, an older term that refers to such drugs derived from opium, including morphine itself. ... Opiate is properly limited to the natural alkaloids found in the resin of the opium poppy although some include semi-synthetic derivatives

[0]: https://en.wikipedia.org/wiki/Opioid

Still waiting for the iboga renaissance ;)

I constantly see ads for NALOXONE. Does it use Kratom?

It has the opposite effect.

No. Naloxone (Narcan) is an opioid receptor blocker that prevents other opioids from having an effect while not producing any pleasurable or pain-relieving effects itself.

Interestingly, it's made from oxymorphone, one of the more powerful members of the opioid family.

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