Comment by nikcub | Hacker News Reader

Comment by nikcub | Hacker News Reader

> Schedule I substances are those that have the following findings:

> 1. The drug or other substance has a high potential for abuse.

> 2. The drug or other substance has no currently accepted medical use in treatment in the United States.

> 3. There is a lack of accepted safety for use of the drug or other substance under medical supervision

Kratom doesn't meet any of those requirements, let alone all three. The scheduling process requires reform, and this impacts a large part of the world since drug scheduling (and patent protection on pharma) are part of American trade agreements.

Almost every action the DEA has taken has worsened the opioid epidemic and benefited the Mexican cartels. They didn't require doctor licensing or tracking for lower-level pain medication, they were then slow to crack down on the pill mills - once a large part of the population was addicted, they were then very slow to license more methadone programs and suboxone doctors for the fresh wave of addicts, and now they want to shut down one of the only free and working treatment options (Kratom)

The only result you can expect from the DEA's actions are more and more opioid deaths. It is up to 18,000 a year now - over 3x as many Americans who were killed in Iraq in total - so 3 Iraq wars per year.

The NYTimes has an excellent series of stories on the opioid epidemic - the video of the woman overdosing in a supermarket while her child attempts to wake her up are shattering:

http://www.nytimes.com/2016/09/28/us/addicted-parents-get-th...

http://www.nytimes.com/2015/11/08/opinion/sunday/how-doctors...

http://www.nytimes.com/2016/10/13/well/family/opioids-may-in...

>>over 3x as many Americans who were killed in Iraq in total - so 3 Iraq wars per year.

I know what you mean, but it really bothers me that you are only counting American deaths. The total number of Iraqi deaths arising from the Iraq war is highly disputed, but it seems to be somewhere between 150,000 and a bit over 1,000,000, depending on the survey and whether it only counts direct deaths of combatants vs. surveys that count civilian deaths and indirect effects. In any case, deaths arising from opioids are nowhere near any amount of "Iraq wars per year".

I remember listening to a rare press conference with President Bush in 2006. Someone asked him how many people had died as a result of the war in Iraq. To my genuine astonishment, he answered that approximately 60000 had died thus far. I couldn't decide whether to be more astonished at the figure, or that he had just given a straightforward answer to a direct question.

Only Americans are real people. Others are just foreign statistics. Nobody died at Stalingrad, for instance.

sad but true, i guess rest of the world should all adapt to this approach and just ignore US overdose epidemics, because it doesn't matter, right?

> and just ignore US overdose epidemics

Actually, that would be fine. The US doesn't need the world to pay attention to its opioid overdose problems. The world has enough problems to focus on, like millions of people still dying from malaria, or a billion people without access to clean running water or electricity. The US has plenty of tax revenue - ~$6.6 trillion annually, larger than Japan's entire economy - to deal with the problem completely on its own.

Even if you only count American deaths, the majority of them were probably caused by spending money on the war that could have been spent elsewhere.

Because this is a matter of U.S. government policy, the responsibility is to the people of the United States.

Seems pretty simple to me.

All humans have the responsibility to not kill each other.

Who said that? Some times humans think other humans have a responsibility to kill eachother; I'm guessing you sometimes agree.

Even if you believe humans should sometimes kill each other (which is not a universally held opinion, but also not insane) you should see all loss of human life as, at best, a necessary cost. To not consider enemy casualties as a cost goes against this. To not consider civilian casualties on the other side as a cost is even worse. If killing foreign people is not considered something costly, then war becomes too easy a choice for the countries with the most powerful armies.

Every heard of "human rights" ? They're not called "American rights" or "European rights", are they?

I think he's just comparing deaths of Americans by action A to deaths of Americans by action B.

There's no ulterior motive there; just a desire to compare apples to apples.

It would appear that refined sugar fits this profile more than kratom does.

Sucrose is used widely in medical treatment in the United States.

Use of sucrose under medical supervision is unfathomably safe. You can literally feel, in your hand, the quantity of sucrose which is unsuitable for your diet.

I'm not sure what would qualify as abuse, but I'm pretty sure they don't consider all recreational alcohol use to be abuse even though a pretty large chunk of the people who drink it are alcoholics.

>> Schedule I substances are those that have the following >>findings:

>> 1. The drug or other substance has a high potential for >>abuse.

>> 2. The drug or other substance has no currently accepted >>medical use in treatment in the United States.

>> 3. There is a lack of accepted safety for use of the >>drug or other substance under medical supervision

>Kratom doesn't meet any of those requirements, let alone >all three. The scheduling process requires reform, and >this impacts a large part of the world since drug >scheduling (and patent protection on pharma) are part of >American trade agreements.

Mitragynine, the major alkaloid identified from Kratom, has been reported as a partial opioid agonist producing similar or more potent effects than morphine. An interesting minor alkaloid of Kratom, 7-hydroxymitragynine, has been reported to be significantly more potent than morphine. (Actually, in studies, mitragynine was shown to be 13x more potent than morphine, and 7-hydroxymitragynine to be 4x more potent than mitragynine, as per Vicknasingam et al 2010 in the International Journal of Drug Policy, and Matsumoto et al., 2005, Life Sciences). Both Kratom alkaloids are reported to activate supraspinal mu- and delta- opioid receptors, explaining their use by chronic narcotics users to ameliorate opioid withdrawal symptoms.

The problem here isn't getting rid of a "legal high." Kratom should not be: it carries all the risks of opiates, and may have an independent mechanism of seizure activity. Physiologic dependence has also been reported, as well as thyroid dysfunction, liver damage, and if mixed with another opioid agonist (tramadol is easy to score on the street, as a very common med for diabetic neuropathic pain) it'll put you right in the ground, as has been seen in a number of deaths in Sweden.

You're right it doesn't meet all three criteria, although it certainly meets 1 and 2. 3 is a valid basis for conducting for medical research, to determine proper pharmacokinetics and see what safe usage scenarios are.

However, it's a serious drug, and needs to be regulated as such. It should not be Schedule I, the DEA's favorite way of creating job security for itself, but it seems like the opposition position that has developed is yelling "keep it freely available," which is unconscionable.

It is extremely misleading to compare the binding affinity of a partial mu opioid agonist with profoundly different molecular structure to the binding affinity of a full mu opioid agonist. Mitragynine is not 13x more potent than morphine in any effect observed in vivo. Preliminary research shows that the novel binding mechanism of mitragynine results in drastically different effects (supposedly by selective avoidance of beta arrestin activation). For instance, it does not cause respiratory depression to a significant extent in mammals.

Thyroid dysfunction and liver damage have never been demonstrated in a study, and anecdotal reports do not seem to suggest that they occur.

The deaths in Sweden were attributed to an isolated metabolite of tramadol that is sold as a research chemical and was mixed into powdered kratom leaf. There is no evidence that kratom contributed to those deaths.

I encourage you to read the "Talk" section of the Wikipedia page before repeating claims in the article without context.

The effects of kratom are extremely mild, you vomit quickly if you take too much, the withdrawal symptoms are comparable to caffeine, and there has never been a death attributed to kratom alone.

The delivery method matters. It's not accurate to consider the dangers of kratom just by looking at the dangers of the active chemicals. One important difference is that when consuming the kratom leaf, you will get nauseous and throw up before you can overdose, assuming kratom is the only depressant you're taking.

You talk about chemicals being "stronger" than others, but what that means is that it requires lower doses to achieve the same effect, not that its inherently more dangerous. My understanding is that mitrogynine opioids cause less respiratory depression than comparable levels of morphine. I think that there is a pharmaceutical product derived from some mitrogynine opioid that's prescribed because of its relatively low risk of making users stop breathing.

I don't know what you mean by "serious drug", but why are you so keen to regulate something that doesn't have much evidence of causing damage? The purpose of regulation should not be to stop people from getting high. I'd prefer much less regulation of all drugs, but I can understand regulating for the sake of the collective good: to avoid public health crises, to limit the number of addicts who become burdens of the state. There isn't evidence that kratom is hurting the collective good though, so why limit people's freedom?

Sorry, but as someone who has used Kratom many times I will tell you that I get more high off a morning espresso than off of Kratom. It's far less of a serious drug than alcohol or marijuana, I can say that much.

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