What Is Kratom? Kratom (Herbal Speedball, Biak-biak, Ketum, Kahuam, Ithang, Thom) is a tropical evergreen tree in the coffee family, native to Southeast Asia and small areas of Africa. In addition, its bitter leaves contain psychoactive (mind-altering) opioid compounds and are consumed for their pain-relieving qualities, mood-uplifting effects and as an aphrodisiac. Also, in the U.S., kratom is relatively new to the illicit market and used in a manner different from its traditional applications. Luckily, substance abuse treatment programs can help with addiction to Kratom.1,2\u00a0Kratom leaves are used in the following ways: \tChewed alone or as a gum \tMixed into food \tDried or powdered and brewed as a tea \tAdded to other drinks as a liquid extract \tSmoked like marijuana \tIngested in gel capsules1 Kratom Controversy Much controversy has surrounded kratom both in Southeast Asia and more recently in the U.S. Thailand is seeking to reverse a 74-year-old ban on kratom enacted under a rather dubious pretense. Also, options include making kratom available only by prescription, decriminalizing small amounts and total legalization. In addition, many years ago, kratom was used in Thailand to effectively help opium users beat addiction, thereby cutting into lucrative opium taxes raked in by the government. Also, even after the 1943 ban, the kratom prohibition was loosely observed. In addition, in Thailand, people have been chewing the leaves for thousands of years with no cases of overdose, psychosis, murder or violent crime. Also, thai officials and drug experts believe its therapeutic use could be a potential solution for the horrific meth epidemic plaguing the country.3 In 2012, the U.S. Drug Enforcement Administration (DEA) placed kratom on its Drugs of Concern list (substances not currently regulated by the Controlled Substances Act, but believed to pose risks to persons who abuse them). In addition, the National Institute on Drug Abuse identified kratom as an emerging drug of abuse. While many states have already banned kratom, it is still legal in the U.S. and is often classified as a food product or supplement. In addition, many more states are in the process of attempting to enact legislation to ban it.2,4,5 Several anecdotal reports by kratom users suggest it has benefits for the management of pain and opioid withdrawal, as well as depression and anxiety. In addition, in August 2016, the DEA suggested plans to add the psychoactive compounds found in the herbal agent kratom to the list of Schedule I drugs banned under the Controlled Substances Act. Also, the DEA asked for public response and received comments touting kratom as a safe and legal psychoactive product that improves mood, relieves pain and may even be beneficial in treating opioid addiction. (FDA).2,4,5,6 Kratom Abuse Kratom is an emerging substance of abuse in the U.S. so scientific evidence about its inherent addictive properties is limited compared to other psychoactive plants like cannabis but csan be helped through addiction treatment programs. Also, there have been no controlled human studies regarding the use of kratom, and formal safety and efficacy studies are lacking. However, the number of reported adverse events associated with its use has increased in the U.S.6 Opioid-Like Effects Concern from U.S. government agencies is associated with the opioid-like effects of kratom noted in animal studies, therefore the suggested evidence that kratom and related substances (mitragynines) may interact with opioid receptors. In addition, a variety of studies have shown dose-dependent kratom causes mitragynine to bind to the same mu-opioid receptor as morphine. Also, another recent concern has been increasing reports of adulterated kratom, with reported side effects of tachycardia, seizures, liver damage and in some cases, fatalities.4,6 Stats and Facts \tKratom-related calls to U.S. poison control centers increased tenfold from 26 in 2010 to 263 in 2015.2 \tOf 660 poison center calls associated with the use of kratom, an estimated 74% of exposures were intentional, and 90% resulted from ingestion.2 \tAlso, the most commonly reported substances used with kratom were ethanol, other botanicals, benzodiazepines, narcotics and acetaminophen.2 \tIn addition, some regions of southern Thailand, as many as 70% of males use kratom on a daily basis.7 \tIn 2014, the FDA abolished the inclusion of kratom in its dietary supplement category.8 Relapse Prevention Although it is theorized kratom can have addictive properties, relapse may be less likely than with more powerful opioids. In addition, the same types of behavioral interventions should be able to help individuals who abuse kratom address the underlying reasons for addiction and find healthier coping mechanisms including inpatient rehab\u00a0and\u00a0outpatient programs. \tWhat is kratom? National Institute on Drug Abuse website.\u00a0https:\/\/www.drugabuse.gov\/publications\/drugfacts\/kratom\u00a0Updated February 2016. Accessed February 13, 2017. \tAnwar M, Law R, Schier J. Notes from the Field. Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers \u2013 United States, 2010\u20132015.\u00a0MMWR Morb Mortal Wkly Rep.\u00a02016;65:748\u2013749. DOI: https:\/\/dx.doi.org\/10.15585\/mmwr.mm6529a4. \tThailand looks to legalize kratom\u2026 Speciosa website.\u00a0https:\/\/speciosa.org\/thailand-looks-to-legalize-kratom-justice-minister-chaikasem-nitsiri-is-pushing-senior-officials-to-end-a-70-year-old-ban-on-kratom-enacted-under-a-dubious-pretense-kratom-once-helped-opium-users-kic\/\u00a0Published May 4, 2016. Accessed February 13, 2017. \tLarry Greenemeier. Should Kratom Use Be Legal?\u00a0Scientific American. September 30, 2013.\u00a0https:\/\/www.scientificamerican.com\/article\/should-kratom-be-legal\/\u00a0Accessed February 13, 2017. \tRobert Glatter. Kratom: New \u2018Emerging Public Health Threat\u2019, Says CDC.\u00a0Forbes. July 30, 2016.\u00a0https:\/\/www.forbes.com\/sites\/robertglatter\/2016\/07\/30\/kratom-new-emerging-public-health-threat-says-cdc\/#5192414b5ae0\u00a0Accessed February 13, 2017. \tKratom: What We Know. Medscape website.\u00a0https:\/\/www.medscape.com\/viewarticle\/874301\u00a0Published January 23, 2017. Accessed February 13, 2017. \tWhy the CDC is Wrong about Kratom. Botanical Education Alliance website.\u00a0https:\/\/www.botanical-education.org\/cdc-wrong-kratom\/\u00a0Accessed February 13, 2017. \tChang-Chien GC, Odonkor CA, Amorapanth P. Is Kratom the New \u2018Legal High\u2019 on the Block?: The Case of an Emerging Opioid Receptor Agonist with Substance Abuse Potential.\u00a0Pain Physician. 2017 Jan-Feb;20(1):E195-E198. Written by The Right Step Editorial Staff Contact our Texas center today for more information on our treatment programs.