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Indiana Prevention Resource Center (IPRC)

Kratom to be classified as Schedule I Drug

The Drug Enforcement Administration (DEA) announced on August 30th its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act. Mitragynine and 7-hydroxymitragynine are found in kratom (Mitragyna speciosa), a tropical tree indigenous to Thailand, Malaysia, Myanmar, and other areas of Southeast Asia. Kratom is brewed as a tea, chewed, smoked, or ingested in capsules.

Kratom is known as Biak-biak in Malaysia, and Kartom, Kakuam, Kraton, Ithang, or Thom in Thailand. It is illegal to buy, sell, import, possess or plant kratom in Thailand. Malaysia prohibits selling kratom leaves or preparations. In Indonesia, kratom is cultivated and exported. Kratom is a member of the Rubiaceae family of flowering plants and is related to the coffee tree.

Small amounts of kratom provide a stimulant effect, according to users. Larger amounts of kratom provide pain relief and sedation much like opiates. The drug is used in Southeast Asia as a traditional remedy to relieve fatigue by laborers, and to alleviate pain and diarrhea. Kratom users may self-administer the drug in an attempt to treat themselves for addiction to opiates or as a substitute for opiates.

Possible side-effects of kratom include hallucinations, tremors, seizures, constipation, tachycardia, nausea, and dehydration. Users may develop tolerance to kratom and require increasing amounts, or become dependent and suffer withdrawal symptoms if they stop using it. One study found that half of those who used kratom for more than six months developed dependency problems (Singh, Müller, & Vicknasingam, 2014).While there isn’t a human overdose level established for kratom, animal studies suggest that 200mg/kg is a lethal amount for rats. Kratom’s negative side effects may be increased if it is used in combination with alcohol, narcotics, benzodiazepines, and other drugs.

Between 2010 and 2015, U.S. poison centers received 660 calls related to kratom exposure (Anwar, Law, & Schier, 2016). A case report in the Journal of Forensic Science refers to one fatality being certified by a medical examiner as a “possible kratom toxicity.” The subject in this case had a high level of mitragynine in his system as well as dextromethorphan (cough syrup), diphenhydramine (antihistamine), Temazepam (a benzodiazepine hypnotic for insomnia), and 7-amino-clonazapam (a benzodiazepine often used for preventing seizures) (Neerman, Frost, & Deking, 2012).

At present, national and regional drug use surveys do not collect statistics on Kratom use. The DEA reports that from February 2014 to July 2016, over 55,000 kilograms (over 121,000 pounds) of kratom material was encountered by law enforcement at various ports of entry. Additionally, another 57,000+ kilograms (over 125,000 pounds) of kratom material offered for import into the United States between 2014 and 2016 are awaiting an FDA admissibility decision. This material is enough, according to the DEA, enough to produce over 12 million doses of kratom.

The FDA has also warned the public not to use any products labeled as containing kratom due to concerns about toxicity and potential health impacts. On August 4th, the FDA seized a shipment of 100 cases of kratom products from a distributer in California as “an unapproved new drug.”

Kratom was sold on eBay until recently. It is, as of this date (September 7, 2016) still available for internet sales. A vendor in Florida posted this notice on their website: “Kratom will be illegal on September 30th in all 50 states if we don't act now! We need to come together to defeat this! Please sign this petition and share on social media. It takes less than 30 seconds. If we don't act now our rights to this plant will be gone.”

Kratom advertisement:

Source: http://kratomcapsules.com

Kratom, while not mentioned by name in the Indiana Code has been illegal in Indiana since 2012 as a “synthetic drug” or “synthetic look-alike substance.” Another plant, salvia divinorum, is mentioned by name in the code and Kratom may be listed in the same fashion as the state code adds kratom as a Schedule I drug.


Select Bibliography and References

Anwar, M., Law, R., & Schier, J. (2016). Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers — United States, 2010–2015. https://www.cdc.gov/mmwr/volumes/65/wr/mm6529a4.htm?s_cid=mm6529a4_w

Boodman, Eric. (2016). Poison control centers are getting a surge of calls about ‘natural painkiller kratom. https://www.statnews.com/2016/07/28/kratom-opioid-overdoses/

Hassan, Z., Muzaimi, M., Navaratnam, V., Yusoff, N.H.M., Suhaimi, F. W., Vadivelu, R., et al. (2013). From Kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction. Neuroscience & Biobehavioral Reviews, 37,(2), 138-151

Huss, Kari. (March 19, 2012). Asian leaf ‘kratom’ making presence felt in US emergency rooms. MSNBC. Retrieved from http://usnews.msnbc.msn.com/_news/2012/03/19/10760892-asian-leaf-kratom-making-presence-felt-in-us-emergency-rooms

National Institute on Drug Abuse. DrugFacts: kratom. Bethesda, MD: National Institute on Drug Abuse; 2016. https://www.drugabuse.gov/publications/drugfacts/kratom

Neerman, M.F., Frost, R.E., & Deking, J. (2012) A Drug Fatality Involving Kratom. Journal of Forensic Sciences. Article first published online: 19 OCT 2012, DOI: 10.1111/1556-4029.12009

Schultes, Richard Evans. (2001). Plants of the gods: their sacred, healing, and hallucinogenic powers. Rochester, VT.

Singh, D., Müller, C. P., & Vicknasingam, B. K. (2014). Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug and alcohol dependence, 139, 132-137.

Spring, T. (2009). Online drugs: Mostly legal, maybe lethal. PC World, 27(3), 12-14.

United States Drug Enforcement Agency. (2013). Drugs of Concern: Kratom. https://www.dea.gov/pr/multimedia-library/publications/drug_of_abuse.pdf#page=84

United States Drug Enforcement Agency. (August 30, 2016). DEA Announces Intent to Schedule Kratom: SE Asian drug is imminent hazard to public safety. https://www.dea.gov/divisions/hq/2016/hq083016.shtml

United States Food and Drug Administration. Kratom seized in California by US Marshals Service. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm515085.htm

By Carole Nowicke, Ph.D., M.L.S. 9/7/2016