Kratom: I want a new drug

Kratom (pronounced KRAY-tum) is an evergreen tree that grows in Southeast Asia. Its broad, glossy leaves—some of them veined red—contain chemicals that when ingested, if you can stand their aggressively bitter flavor, will make you high. The effects, which vary depending on the kratom, the dose, and the user, can be similar to cocaine when taken in low doses and more like opiates at higher doses, which is a big reason why the leaf is now so controversial. Yet, incredibly, kratom remains legal and largely unregulated in the United States and large parts of Europe. It’s available online for cheap (and in large quantities) as well as at your local smoke shop, and at cafés where it’s often mixed with tea. There is [little reliable research]( on the dangers—or value—of kratom. But that hasn’t stopped the government from trying to ban it. And it hasn’t stopped activists, who celebrate its potential to relieve anxiety and pain, and to potentially ease opioid addiction, from promoting it. What it really needs is some science. 🐦 [Tweet this!]( 🌐 [View this email on the web]( Sponsored by [Quartz Obsession] Kratom October 09, 2019 Kratom (pronounced KRAY-tum) is an evergreen tree that grows in Southeast Asia. Its broad, glossy leaves—some of them veined red—contain chemicals that when ingested, if you can stand their aggressively bitter flavor, will make you high. The effects, which vary depending on the kratom, the dose, and the user, can be similar to cocaine when taken in low doses and more like opiates at higher doses, which is a big reason why the leaf is now so controversial. Yet, incredibly, kratom remains legal and largely unregulated in the United States and large parts of Europe. It’s available online for cheap (and in large quantities) as well as at your local smoke shop, and at cafés where it’s often mixed with tea. There is [little reliable research]( on the dangers—or value—of kratom. But that hasn’t stopped the government from trying to ban it. And it hasn’t stopped activists, who celebrate its potential to relieve anxiety and pain, and to potentially ease opioid addiction, from promoting it. What it really needs is some science. 🐦 [Tweet this!]( 🌐 [View this email on the web]( AP Photo/Mary Esch By the digits [3–5 million:]( Kratom users in the United States, estimated [95%:]( Share of global kratom supply that originates in Indonesia [400 metric tons (440 tons):]( Unprocessed kratom exported from West Kalimantan, Indonesia, to global markets every month [2 grams:]( Typical dose, which means Indonesia is exporting some 200 million doses worldwide, monthly [$130 million:]( Value of Indonesia’s monthly exports [$30:]( Typical price for 100 grams of kratom sold online in the US [1836:]( First known year that kratom was recommended to treat opioid addiction [91 of 27,000:]( Overdose deaths between 2016 and 2017 the Centers for Disease Control (CDC) attributes to kratom. In almost all of those 91 deaths, other drugs were present in the toxicology report. [62:]( House and Senate members who requested that the Drug Enforcement Agency (DEA) not make kratom a Schedule 1 drug in 2016 Origin story Kratom, meet the drug war --------------------------------------------------------------- Kratom has been swept up in the old-timey politics of the drug war. Regulatory and law enforcement agencies [now steeped in nearly a half century]( of fighting the sale and use of illicit drugs have called for prohibition, and are pressuring the countries where kratom originates to help contain it. There is no European Union-wide ban on kratom, and while it is legal in Germany, France, and Spain, it’s banned in Ireland, Sweden, Latvia, Lithuania, Poland, and the UK. In the US some[states have preemptively]( made the sale and possession of kratom illegal. The Federal Drug Administration[has warned against its use]( in part because of [contamination concerns]( as has the CDC. Both agencies point to overdose statistics to make their arguments. Those statistics, like most related to kratom, [are dubious at best](. In almost all of the cases where a kratom overdose led to death, there were other drugs involved. In one case, the patient had a bullet wound to the chest. The debate really[kicked off in 2016]( when the DEA first recommended the federal government list kratom as a [Schedule 1 drug]( a category for substances considered to have high potential for abuse and low value as medicine. The backlash was swift. Drawing on the infrastructure established in the fight to legalize marijuana, activists organized quickly, lobbied Congress, and kicked up enough dust that lawmakers tabled the issue. Failing a domestic solution, US regulatory agencies have gone after the drug at its source: Indonesia. Despite the potential windfalls from the lucrative crop, Indonesia appears close to[capitulating to US pressure]( to ban kratom’s cultivation and export. If Indonesia follows through with that, it would almost certainly crush the US kratom market. US attention on kratom production in Indonesia has also sparked an internal debate there about whether or not consuming the plant should be allowed. For now it remains widely used, though technically illegal in Indonesia [and Malaysia]( and [legal only for medical use in Thailand](. Indonesian farmers in Borneo regularly eat small amounts of the leaves to help with pain and, they say, as an energy boost during long working hours. Many roadside coffee stalls there offer kratom-infused drinks. Sponsored by AT&T Business A unified IoT platform can help take your business to the next level. --------------------------------------------------------------- Today’s companies are generating more data than ever, but they can’t unlock the true power of that data if their IoT systems don’t communicate.[Learn more]( Reuters/Jose Gomez Pop quiz What popular plant is the cousin of kratom? CoffeePoppyChocolateMarijuana Correct. Kratom is in the same family as coffee. Caffeine is the world’s most widely consumed psychoactive substance. Incorrect. If your inbox doesn’t support this quiz, find the solution at bottom of email. Explain it like I’m 5! What we don’t know about kratom could fill a pharmacopia --------------------------------------------------------------- Kratom [acts like an opioid](. That’s about as much as we know for sure. As such, [it can help with pain relief.]( But the effects are milder than, say, morphine. And there is a lower risk of stopping breathing, which is the big concern with strong opioids. Scientists now know that kratom contains two key chemicals: Mitragynine and 7-hydroxymitragynine. Of the two, there is more of the former. The latter is 13 times more potent than morphine, but there’s less of it. “There are no published human pharmacologic, pharmacokinetic, or drug interaction studies on kratom, making it virtually impossible to fully understand kratom’s therapeutic potential and risks,” according to[the American Journal of Health-System Pharmacy](. Quotable “There’s a lot of super sexy research you could do with this.” —Edward Boyer, professor of emergency medicine at the University of Massachusetts Medical School, [speaking to Bloomberg]( Have a friend who would enjoy our Obsession with Kratom? [ [Forward link to a friend](mailto:?subject=Thought you'd enjoy.&body=Read this Quartz Obsession email – to the email – REUTERS/Yves Herman/Illustration/File Photo The way we 🍃 now How do people use kratom? --------------------------------------------------------------- While we don’t know very much about how kratom works on the human body, users offer plenty of feedback about why they take it, much of which suggests the substance warrants further study. 💊 Pain relief: Indonesian farmers swear by kratom’s ability to ease their aches and pains. And there’s plenty of anecdotal evidence among Americans that say the same. The[New York Times quoted]( a Navy vet who was on 20 different pain medications before discovering kratom. “It was a night-and-day difference,” he said. 😟Anxiety: A prominent immigration attorney who[wrote a defense of kratom]( when the DEA considered scheduling it in 2016, described himself as a daily kratom user. “Kratom is not a ‘cure’ or a ‘treatment’ for my anxiety,” he wrote. “It simply puts me in the right state of mind to work through my anxiety without impairing my mind, body, or judgment.” ☠️ Opioid addiction: Kratom’s ability to help addicts kick heroin or other strong opioids was the primary argument advocates used when fighting the DEA’s efforts to schedule the plant in 2016. Online message boards are filled with discussions about best strains and doses for stepping down from stronger drugs, but there is little reliable science. One[small study in Malaysia]( found kratom helped respondents quit stronger opioids, but most of them were not able to then quit kratom. 🎉 For fun: Because it’s been studied so little, there are a lot of competing ideas about what strains and doses do. There are three main strains—red, white, and green—all of which have slightly different effects. Anecdotally, red is the more chill one, white is more of a stimulant, and green is somewhere in between. But, again, there is little published research on this,[so proceed with caution](. Fun Fact! For some Indonesian farmers, [kratom is lucrative enough]( to turn them away from the [environmentally destructive palm oil industry.]( Watch this! Vice News follows Adrian Quiroga, who has been using heroin for six years, as he detoxes using kratom. Take me down this 🐰 hole! From a policy perspective, what makes kratom interesting is that it remains legal in the United States. And so far, activists have managed to keep it that way. They are able to do this by drawing on research and experiences arising from the [legalization of marijuana in various US states and Canada](. But the arguments still center mostly around whether the plant is beneficial to one’s health or not. The idea that people simply have a right to do drugs remains too radical to use as an argument in front of American courts, but drug decriminalization has been a [successful strategy for endemic addiction in many places](. Giphy Poll Should kratom remain legal? [Click here to vote]( YesNoLet’s do some science before we decide 💬let's talk! In yesterday’s poll about [bachelorette parties]( 42% of you said the first dance is your favorite wedding tradition, 33% voted for toasts, 15% of you are into the cookie table 🍪, and just 10% of you like the cake smush. 💌 Emma wrote in to say, “Just a friendly reminder that not every wedding is between a man and a woman. 😉 In fact, “[Batchelorx” parties]( are emerging for non-binary individuals or those who don’t want their celebration to be aggressively gender stereotypical.” And Giselle asked, “How on Earth could you forget the cinema gem starring Tom Hanks that is Bachelor Party???” 🤔 [What did you think of today’s email?](mailto:obsession%2Bfeedback@qz.com?cc=&subject=Thoughts%20about%20kratom&body=) 💡 [What should we obsess over next?](mailto:obsession%2Bideas@qz.com?cc=&subject=Obsess%20over%20this%20next.&body=) [🎲 Show me a random Obsession]( Today’s email was written by [Pete Gelling]( edited by [Annaliese Griffin]( and produced by [Luiz Romero](. 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