Kratom is a type of tree that grows throughout the countries of Southeast Asia. Extracts from the leaves of the tree have been used in regional folk medicine for a wide variety of ailments for hundreds of years, but two particular uses have sparked Western interest in it: pain relief and treatment of drug addiction.
From what has been learned about it through scientific study, kratom appears to function like both an opiate and a stimulant. It acts on the same receptors that opiates do, specifically the mu-opioid receptor that morphine targets. Kratom does not appear to share the high rates of addiction risk that opiates do, and while opiates tend to be depressive, kratom also acts as a central nervous system stimulant, promoting alertness in a manner similar to caffeine.
There was previously almost nothing in the way of restriction on sale or use of kratom in the United States, to save it from being declared illegal in six states. However, it suddenly went from having almost no federal regulation to a Schedule I narcotic classification when the US Drug Enforcement Administration issued a statement in August 2016, citing increasing use as a recreational drug and opiate-like effects. Given lack of established medical use and lack of knowledge about safe dosing, along with claims of high potential for abuse, the DEA believes the drug meets all the criteria necessary to be classified at the Schedule I level.
Though kratom does not display the same potential to cause addiction that opioids do, there are still legitimate causes for concern. Though it is not well-studied in humans, development of physical tolerance has been demonstrated in animal studies, a precursor to the development of addiction. There is also the potential for death by overdose due to slowed respiration. The DEA claims that at least 15 deaths since 2014 can be attributed to kratom, although their statement does not specify if these were overdose deaths or if drugs other than kratom were involved.
Critics of the DEA’s decision are upset at the classification due to kratom’s perceived potential as a pain reliever and as a treatment for addiction to opiates and to methamphetamine, the two most significant drug problems facing the US today. A pain reliever with the potential effectiveness of an opioid, minus the high risk of addiction, is the holy grail of the pain management world. Although kratom still presents its own considerable set of risks due to lack of proper study, further study of it will be rendered much more difficult by its classification at the highest levels of controlled substances.
This initial classification is a temporary one, good for up to two years. Under the Controlled Substances Act, the DEA has that amount of time to continue investigating the drug and make a determination about permanently classifying it with other Schedule I drugs, such as Heroin, LSD, and Cannabis.
