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Comment by irthomasthomas | Hacker News Reader

Sorry to burst your bubble but U.S. drug policy is not as progressive as you might think. Cannabis is still illegal under federal law. And right now America is petitioning the WHO for a GLOBAL ban on KRATOM, a herb which has been used in Asia for hundreds of years with no recorded deaths. It has been in use in Europe and America for a couple of decades and still there are no deaths recorded from pure Kratom use. Kratom can be used to treat or replace alcohol, cocaine and opiate addiction. It is a herb harvested from the leaves of a tree related to the coffee plant and has incredible pain relieving properties, as well as being a mild stimulant and mood regulator. For more info see this recent study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612999/

And please tell the FDA and WHO not to ban this awesome herb. The deadline for comments is August 9th. https://www.americankratom.org/

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Please don’t glorify Kratom as some sort of miracle herb without downsides.

Kratom is an opioid, full stop. People are under the mistaken impression that it’s less addictive because it’s less potent on a per-gram basis, but addicts simply end up consuming more grams to get similar highs.

It’s not a “mood regulator” in any magical sense other than it’s an opioid and opioids temporarily put people in good moods.

There are many communities dedicated to quitting Kratom and handling Kratom withdrawal, which is the same as withdrawing from other opioids (For instance: https://www.reddit.com/r/quittingkratom/ ).

Whether or not you think Kratom should be legal, we shouldn’t be glorifying it as a harmless substance that somehow defies the realities of every other opioid.

Disclaimer: Don't start using opioids. You could become addicted and end up using street drugs and overdose and die.

But the physiological reality is most opioids are harmless if dosed correctly. They do tend to make people happier although often less productive or driven.

We should focus on harm reduction. If registered addicts can get a regular dose of a pure opioid in a safe setting they can often be productive members of society albeit maybe less so than if they had never became addicts.

People function for decades on methadone or buperenorphine therapies with few if any ill effects besides constipation.

I would like to see a society where people with refractory depression were given the option to try opioids. Often depressiom is caused by obsessive ruminations on topics of anxiety or social isolation. By supressing the subjective feeling of psychic pain opioids directly attack these problems at their root. SSRIs may be more indirect. I bet in many cases it would help.

Opioid tolerance is a real thing but we should be looking for ways to attenuate the tolerance formation process.

It is bizarre to me how current progressive circles push cannabis but demonise opioids.

In my opinion as a non-addict but somebody who has had limited experience with various opioids years ago I think they are the closest thing to a psychological wonder drug.

I wonder if they are so demonised because they actually work?

It is true overdose can be lethal but this is a dosing issue with unpure stree products not an inevitability.

Driving too fast can be lethal too.

Psychedelics would be a much better choice for that sort of therapy. Opiates would be about as effective for psychological treatment as alcohol.

opioids are a large class of drugs with widely varying effects and potential for abuse. for instance, the active ingredient in Imodium is an opioid, but you don't see a lot of recreational Imodium users.

kratom is certainly not a miracle herb, but its characteristics do make it a lot less addictive and lethal than its more popular relatives. it's not unreasonable to think it might be used in replacement therapy, similar to buprenorphine.

Using Imodium as an example really hurts your case here. Loperamide (Imodium's active ingredient) isn't used recreationally because it's not psychoactive - or more accurately, it doesn't cross the blood-brain barrier. Meanwhile, you'd be hard pressed to find an opioid which does (as kratom obviously does) that lacks recreational users.

that's exactly my point. maybe it wasn't worded well. "X is an opioid" does not imply "X is an extremely dangerous drug with high potential for addiction". not all opioids have psychoactive effects. some (eg, buprenorphine) do have psychoactive effects that are generally considered unpleasant by users. it's a large class of drugs...

Occasionally people with opioid addictions actually do use loperamide at high doses to stave off withdrawals. But it does not have the same effects as ones that cross the BBB, correct.

- kratom is certainly not a miracle herb, but its characteristics do make it a lot less addictive and lethal than its more popular relatives.

Yea, that's what you read online. But after going 2.5 months without sleep (I would doze off for half an hour once a twice per night), 4 months of acute depression, and umm like a year of PAWS, I beg to differ. If you're going off of personal experience, congrats, you didn't abuse it.

Someone already linked the quitting kratom subreddit where you can hear all kinds of horror stories.

Finally, comparing Kratom to traditional opiods isn't all that useful. Kratom has a shitload of other active alkaloids and very little research on their effects. Saying it's less addictive than other opiodis is like saying you'd rather get hit by a car going 60 vs 100.

Personally, I would have been much much better off if Kratom had been illegal, and I am amazed it still is.

I've only tried kratom a couple times, many years ago. I can see how someone like me could have a severe problem with it, but I didn't find it to be nearly as addictive (to me) as heroin. I knew someone, like you, who had withdrawal symptoms for a very long time after quitting. I've also known a couple of the mythical "chippers", who've used heroin/oxy/etc occasionally over the course of many years without becoming addicted.

humans can become addicted to pretty much anything that's enjoyable. some things are probably much more addictive than others, but you can't really create a strict ordering of addictive substances/activities when every individual responds differently. is kratom less addictive than heroin? I would guess yes. is it more addictive than alcohol? I don't know, probably yes for some, no for others.

Did you try weed?

> addicts simply end up consuming more grams to get similar highs.

That doesn’t really work with kratom. There’s a ceiling to the effects, unlike regular opiates (which kratom is not) and consuming more doesn’t produce stronger enjoyable effects. It tops out at about codeine level, or perhaps 1 hydrocodone.

I dunno about illegal drugs, they're illegal for a reason.

"I dunno about illegal drugs, they're illegal for a reason. "

They're illegal for many reasons, which are mostly: stupid, unjust, racist, harmful, and hypocritical.

Alcohol is one of the most harmful "recreational" drugs, but it's still perfectly legal, and no one is seriously proposing we make it illegal again, despite all the violence, addiction, sickness, and death it causes.

Virtually all of the illegal drugs are less harmful than alcohol, and when they are harmful it's largely because they're illegal, as it means people can't reliably get what they thought they were buying, which leads to overdoses.

Not to mention all of the organized crime, imprisonment, and ruining of lives that prohibition causes (especially of the poor and minorities).

Also, some of the most illegal drugs that are classified as highly addictive with no medical use are literally orders of magnitude less harmful and addictive than for example meth, which is acknowledged to at least have some medical use.

Is this satire?

Of course it was. I edited the comment because my thoughts on this are not welcome in "civilized society". God forbid people have some personal responsibility instead of relying on a system that tramples on the minority. But hey, it's a small minority, so fuck them, right.

> Of course it was.

Poe's law [1] -- it didn't seem like satire when I read it.

[1] https://en.wikipedia.org/wiki/Poe%27s_law

I and many others definitely agree with you. I think we're just so used to the opposing view being expressed in full earnestness that the satire was missed by some.

Compared to opioids peddled by pharmaceutical companies (who are, no doubt, responsible for the US pushing to get kratom banned), kratom _IS_ a miracle drug.

Edit: also, I'll bite on the r/quittingkratom link. The first upvoted thread I see is the following: https://www.reddit.com/r/quittingkratom/comments/ozuh1r/krat.... 90 grams per day for 10 years is an absolutely staggering amount of kratom to consume. (For reference, I would feel sick if I ate more than 4 grams at a time, and never felt the need to exceed 5 gpd.) And this person didn't even skip work during withdrawals. They claim the worst part is restless legs and not being able to sleep. Hardly seems comparable to a person quitting a heavy oxycontin habit.

I'm not familiar with that "awesome herb", so I wondered what other sources might have to say.

While the numbers are small (unsurprisingly, if it's not nearly as widely known and used as some other substances), it may not be quite as innocuous as you seem to imply:

> "A 2019 paper analyzing data from the National Poison Data System found that between 2011-2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances."

> "In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom."

(https://www.drugabuse.gov/publications/drugfacts/kratom)

Actually, even the study you linked has some disturbing statements:

> Deaths attributed to the use of Kratom have been reported in Europe and the United States but not in Southeast Asia.

> The increasing trend in Kratom consumption in the West has corresponded with an increase in reports of Kratom-related exposures to Poison Control Centers in the United States, care received at a health care facility due to Kratom consumption, and association with overdose fatalities.

> Kratom was identified as the cause of death by a medical examiner in 91 of the 152 Kratom-positive deaths, but was the only identified substance in just seven of these cases.

This is the most reefer madness comment I have ever seen on Hacker News. Seven possible deaths with just Kratom and this justifies banning it?

How many deaths and ruined lives will those enforcing a Kratom ban be responsible for? Perhaps we should consult the history of bans of other drugs to get some idea.

Anyone claiming that their reason for adding yet another substance to The Forever War on Drugs is harm reduction should be laughed out of the room at this point. I reckon that, because the Covid vaccine has been responsible for at least ten blood clots we should also set up a global ban to ensure nobody ever gets to take it.

The person you were replying to said nothing about banning it. They simply said that a little poking around showed the previous poster's description of it as completely harmless was possibly contested. Your knee jerk reaction that asking questions about a drug is the same as demanding a ban on it reveals a pretty strong bias on your end.

It seems to support the harmless claim. Basically water, coffee, red meat, sunlight and so on are more dangerous than kratom if you look at similar numbers.

If you're going to label scientific papers you don't like as a "wall of FUD" [edit: I see you've decided to remove this remark], I'm not sure there's much we can discuss further.

I didn't say it should be banned. Or that it shouldn't. I don't know enough to form an opinion on the question.

I just wondered how balanced and objective the post from irthomasthomas was, did a quick search for other points of view, and felt it was worth offering some additional comments for consideration.

You didn’t link a scientific paper. You linked a government drug propaganda website.

Kratom is fundamentally an opioid. It happens to be cheap and relatively safe (consumed by ingesting large quantities of plant matter, rather than injection or insufflation of some extremely potent compound). I think opioids are over-vilified in general, and I'm on the side of legalization, but kratom isn't magic.

>Kratom can be used to treat or replace alcohol, cocaine and opiate addiction.

This is a strange claim. Kratom alkaloids appear to be opioid receptor partial agonists [1]. De-escalation from opioids to kratom makes sense. Cocaine and alcohol addiction usually do not require "maintenance" post-rehab [2,3], unlike opioid dependence which is highly persistent [4], and this seems to muddy the story of a promising treatment [5] (it may compete favorably with buspirone and methadone) by mixing in stories of polydrug users who switched from cocaine to kratom.

I think kratom deserves further investigation not because it is so miraculous but because the options for effective management of opioid use disorder are extremely limited, so I would think defenses of kratom should focus on this application in particular. It is certainly much less deadly than true opioids.

1: https://jpet.aspetjournals.org/content/376/3/410.abstract

2: https://jamanetwork.com/journals/jamapsychiatry/article-abst...

3: https://www.sciencedirect.com/science/article/pii/S037687160...

4: https://www.sciencedirect.com/science/article/pii/S014067369...

5: https://link.springer.com/article/10.1007/s40122-020-00151-x

Yep, addiction is a complex subject that we still know very little about. I recommend reading the study I linked to. And check out the kratom forums to read many personal accounts from people using kratom to quit alcohol, cocaine, heroine and more. Thanks.

>It is a herb harvested from the leaves of a tree

As opposed to heroin and cocaine right?

To clarify for other users, heroin doesn’t come from nature: that’s morphine. We then take morphine and put it through a chemical reaction.

And cocaine? Why is cocaine worse than alcohol?

Come to Oregon where we just decriminalized the party.

Thanks for pointing this out. I don’t know enough about kratom to have an opinion on how it should be regulated. I will add a comment though. Just because I am fundamentally opposed to America regulating drug use outside of its territory.

https://www.drugabuse.gov/publications/drugfacts/kratom

I will assume anything written under such a link to be false unless proven otherwise.

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