Posted: December 30, 2017
By John Pacenti, Palm Beach Post
Florida resident Ali Noble has a 2-year-old boy and is a recovered opioid addict and a frequent victim of panic attacks. She credits her sobriety and serenity to working the 12 steps and a little green leaf getting a lot of attention from the federal government in the past few years — kratom.
When she left substance abuse treatment in September 2014, the Boynton Beach resident received Suboxone. Used routinely for the treatment of opioid addiction, Noble’s experience with Suboxone almost drove her back to drug addiction, she said.
“Suboxone is 10 times harder than heroin to kick. Thank God I knew of kratom,” Noble said. “I was a zombie. I was a dead person walking. I couldn’t comprehend thoughts. It was not pretty and I wanted to be productive. Who wants to be like that?”
The Food and Drug Administration in a November public health advisory said kratom was a health risk and may contribute to the opioid crisis. Many kratom users believe the agency was clearing the way for the Drug Enforcement Agency to revisit banning the plant, which can be purchased at kava bars, vape shops and even gas station convenience stores.
In Palm Beach County, a Delray Beach woman has made it a crusade to regulate kratom, saying it led to her son’s suicide. The New York Times two years ago visited Palm Beach County for a story on kratom, painting it as a new addictive substance taking the kava bars by storm. CNN, though, countered in October with its own report, asking, “Can the kratom plant help fix the opioid crisis?”
Christopher McCurdy, president of the American Association of Pharmaceutical Scientists, is one of the foremost experts on kratom and is a professor at the University of Florida. He has said there is a wealth of information that shows the medical potential for the plant.
He told CNN that the debate about kratom is really a debate about profits for pharmaceutical companies, partly because they can’t patent a plant. “There’s no financial incentive for any drug company to really pursue developing this into a drug,” he said.
Kratom proponents say Big Pharma is behind it being unfairly demonized. Kratom users are on fire to get the word out about what they say is a good alternative to prescription pain medication for a host of ailments, such as fibromyalgia, and has helped addicts get off opioids. They are not opposed to regulation but say that making kratom illegal would fly in the face of common sense — and science.
They say they fear the FDA is carrying water for the pharmaceutical industry, which makes billions off the sale of opioid painkillers like OxyContin and anti-anxiety medications such as Xanax.
“There are many pharmaceutical companies who find kratom threatening,” Noble said. “There are few big ones who can lose lots of money if this becomes more popular.”
In South Florida, where there is a large drug recovery community, kratom also poses a paradox. For some recovered alcoholics and drug addicts, it’s a mind-altering substance and using it is akin to a relapse. For others, it is no worse than coffee, cigarettes or caffeinated energy drinks — all of which populate 12-step meetings.
For some kratom users, the drug has been a godsend.
When Noble was pregnant with her son, her anxiety got to the point that she asked her OB-GYN if was OK to drink kratom. He gave his consent.
“I can do kratom and in 10 minutes feel better,” she said. “With prescription medication, if you are in mid-panic attack, it’s like a half an hour to kick in.”
When The Palm Beach Post reported the FDA’s decision, the reaction from kratom users in the comment section was swift:
“This plant has saved so many lives and improved quality of life for so many,” posted a reader. Another commented: “I have depression, bipolar, CMT, degenerative disc disease and anxiety. Kratom helps me with all of it. … This stuff saved my life.”
Kristina Guerriero was one of those who posted comments. On her Facebook page, she has one profile photo with the tagline #Iamkratom.
“I have def benefited from kratom — more for anxiety use,” she said in a text interview. “I do not have a history of drug abuse or alcoholism. I merely use kratom to help with energy and really bad anxiety. I managed to come off my antidepressants. It has changed my life.”
One of the more adamant proponents of kratom in South Florida is attorney Elizabeth Gardener. The owner of two kava bars in North Carolina is ready with numerous examples of users — including law enforcement — who take it for chronic pain. She says it can be a vital tool in harm reduction when it comes to fighting the opioid epidemic.
“They feel it is the reason they are not using. There is no desire to go out to use,” she said. “I saw a woman change her entire life in just a couple years. She just blossomed. I see healing going on.”
She said kratom has also helped those in chronic pain who couldn’t work because they were on painkillers.
Gardener drank kratom for the first time on her birthday in 2011. She wanted to celebrate it in a place that didn’t serve alcohol and ended up at the kava bar.
“I saw the environment. They weren’t stumbling. They weren’t fighting. You could have a conversation there,” she said. “There was a mix of all types of people.”
The social scene at the kava bar allows people in recovery to enjoy camaraderie in an alcohol-free environment, Noble said.
“I met my fiance at a kava bar and I’ve met the majority of my best friends there,” she said. “It really is a family. I know if I’m in need of any shape or form, someone there would help me.”
Now there is one aspect of kratom that is fairly agreed upon. It tastes awful. The Mitragyna speciosa plant is in the coffee family, hails from Southeast Asia, and is often mixed with water or brewed into a tea. It can also be put in capsules and taken like a pill.
“Everybody is panicked,” Gardener said. “They are worried how they are going to continue with their life because if they stop drinking the tea, they are going to feel the pain or not be able to sleep as good at night.”
The DEA put the kratom debate into overdrive in 2016 when it tried to designate it as a Schedule 1 controlled substance on the same level as heroin or LSD. The agency backpedaled after congressional lawmakers urged the agency to give the public a chance to comment.
Then in November the FDA said calls to U.S. poison control centers regarding kratom increased 10-fold from 2010 to 2015, and attributed 36 deaths associated with products containing kratom. The federal government also reports that acetaminophen — the active painkiller in Tylenol — killed 1,500 people between 2001 and 2010.
The FDA concluded that kratom could make the opioid epidemic worse.
“We have a critical point in the opioid epidemic,” FDA Commissioner Scott Gottlieb said in a statement. “The increasing use of kratom as an alternative or adjunct to opioid use is extremely concerning.”
Marc Swogger, an associate professor in University of Rochester Medical Center, said there is a lot of anecdotal evidence that government moving to make kratom illegal “doesn’t make any sense.”
“People are reporting that they are using kratom to successfully get off of opioids,” he said. “It helps with the withdrawal symptoms and helps them dial back their opioid use and some of them say it helped them quick.”
Swogger said kratom, like caffeine or any drug, does have its own withdrawal and that studies through controlled trials need to look at the plant objectively.
“The science is in its infancy,” he said. “But cutting it off as an option is hurting people and potentially worsening the opioid crisis.”
In Palm Beach County, the person most associated with kratom is Linda Mautner, who blames the plant for leading to her son’s July 2014 suicide. She has lobbied the County Commission to ban it or at least force businesses that sell it to post warnings.
Mautner is a lightning rod for kratom proponents, but there is common ground. Mautner says kratom users have no idea what they are getting because it is unregulated. Noble agrees and would welcome regulation to make sure that kratom sold is pure.
“There is some bogus stuff coming from companies trying to jump on the bandwagon,” she said. “I’m all for some kind of system where it has to pass a test to be sold in the U.S. and not having anything in it. I hate that there are some companies that are trying to take advantage of good people just trying to find relief.”
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