Pain relief Research finds kratom may have medical benefit as opioid alternative JAOA author suggests research into the herb’s unique pharmacologic properties would likely end if DEA adds it to Schedule 1 drugs list. Nov. 29, 2016Tuesday AOA Staff Contact AOA Staff Facebook Twitter LinkedIn Email Topics JAOAopioids A delayed U.S. Drug Enforcement Administration (DEA) ban on kratom would stifle scientific understanding of the herb’s active chemical components and documented pharmacologic properties if implemented, according to a recent special report published in The Journal of the American Osteopathic Association. The JAOA report emphasizes the extensive amount of anecdotal evidence and current scientific research indicating that kratom—sold in the U.S. as an herbal supplement—may be safer and less addictive than current treatments for pain and opioid withdrawal. The report also cites the need for further research of the pharmacologically active compounds in kratom, including mitragynine, 7-hydroxymitragynine, paynantheine, speciogynine and 20 other substances. “There’s no question kratom compounds have complex and potential useful pharmacologic activities and they produce chemically different actions from opioids,” says author Walter C. Prozialeck, PhD, chairman of the Department of Pharmacology at the Midwestern University Chicago College of Osteopathic Medicine in Downers Grove, Illinois. Indigenous to Southeast Asia, kratom was used for centuries to relieve fatigue, pain, cough and diarrhea and to aid in opioid withdrawal. The supplement drew DEA scrutiny after poison control centers noted 660 reports of adverse reactions to kratom products between January 2010 and December 2015. “While the DEA and physicians have valid safety concerns, it is not at all clear that kratom is the culprit behind the adverse effects,” says Anita Gupta, DO, PharmD, who serves as a special advisor to the FDA. Dr. Gupta, an osteopathic anesthesiologist, pain specialist and licensed pharmacist, has treated a number of patients who’ve used kratom. “Many of my patients are seeking non-pharmaceutical remedies to treat pain without the side effects, risk, and addiction potential of opioids,” she adds. The DEA is scheduled to decide whether to place kratom on its list of Schedule 1 drugs, a classification for compounds thought to have no known medical benefit. Marijuana, LSD and heroin are Schedule 1 drugs, which prevents the vast majority of U.S.-based researchers from studying those substances. The drug currently is banned in Alabama, Florida, Indiana, Arkansas, Wisconsin and Tennessee. More in Patient Care Enhanced payment to support longitudinal care: The new E/M complexity add-on code G2211 The office/outpatient E/M visit complexity add-on code was established to improve payment for the time, intensity and practice expense resources involved when physicians furnish O/O E/M office visit services that enable them to build longitudinal relationships with patients. The dark side of semaglutide: Gastric emptying delays pose a risk when undergoing surgery Semaglutide, hailed as a weight loss miracle, is facing new scrutiny over the potential risks to patients who are taking it and undergoing medical procedures. Previous articleEarn CME and master MACRA with upcoming webinar Next articleElection 2016: DOs in several states elected to office
Enhanced payment to support longitudinal care: The new E/M complexity add-on code G2211 The office/outpatient E/M visit complexity add-on code was established to improve payment for the time, intensity and practice expense resources involved when physicians furnish O/O E/M office visit services that enable them to build longitudinal relationships with patients.
The dark side of semaglutide: Gastric emptying delays pose a risk when undergoing surgery Semaglutide, hailed as a weight loss miracle, is facing new scrutiny over the potential risks to patients who are taking it and undergoing medical procedures.
Kratom has been reported to be a substance of abuse and research supporting its benefit for opioid dependence is sparse and less effective than buprenorphine. Research on Schedule I (DEA) substances can be done with a DEA research certificate. Applications for such are at http://www.usdoj.gov under DEA research Dec. 1, 2016, at 9:24 am Reply
Our healthcare system has created a massive population of opiate addicts, is attempting to criminalize and impede research on one of their options a good idea? This kratom issue is bigger than people drinking herbal tea for muscle pain. It is a demonstration of American corporatism at its finest. Dec. 1, 2016, at 12:00 pm Reply
If big pharma can’t profit FDA will ban it. Research needs to be done. Dec. 1, 2016, at 2:24 pm Reply
Practicing both pain and addiction is art, however, Kratom has been seen in my office primarily as a drug of abuse. I am very concerned that there are so many different acticmve compounds that studies need to be studied on each or in combination before it is assessed as safe for the public. But with the current epidemic in the US with Opioids, it is very concerning to let it free in the mainstream at this time. Dec. 1, 2016, at 5:51 pm Reply
The DEA’s move to schedule kratom is clearly political and not based in the realm of rational or scientific policy. This is analogous to cannabis being schedule 1 while there being synthetic cannabinioids that are FDA approved and patented medications. Patents for kratom derived compounds are already filed. As with any drug or plant there is a cost/ benefit ratio to assess, which will be much more difficult if a DEA permit is required to conduct research. http://thefreethoughtproject.com/pharma-kratom-dea-patent/ Dec. 6, 2016, at 2:26 pm Reply