Chronic Pain, alternative Treatment

IMPORTANT NOTE from Mayo Clinic pharmacist:

Kratom is a natural product but it does have significant risks and side effects. Because of these risks the FDA banned import of Kratom in August 2016 and issued a notice of intent to classify 2 chemicals in Kratom as Schedule 1 drugs (the same category as heroin).

Kratom can cause dependence and withdrawl symptoms including aggression, anxiety and other negative psychiatric effects, muscle aches, spasms, tremors, insomnia, fever and upset stomach. It can also cause dangerous slowed breathing and seizures. It can worsen psychiatric disease and may increase the risk of suicide. Kratom can impair liver function. Kratom interacts with other herbal medications including Jimson Weed. It interacts with sedating medications. It has the potential for many other drug interactions because of the way it is metabolized.

There are other medications and therapies for pain and withdrawal. Pain and withdrawal CAN be safely and effectively managed with prescription medications and other therapies by dedicated providers.Trying to manage serious medical conditions without your provider to guide you could make the condition worse.

Mayo Clinic Pain Rehabilitation Centers use group therapy, physical and occupational therapy and biofeedback and work with each individual to optimize therapy. http://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/overview

This is a link to opiate addiction treatment centers and has further information on Kratom addiction. http://americanaddictioncenters.org/withdrawal-timelines-treatments/kratom/

Thanks, Colleen.

@jenapower @cipaul @ayankeeinnm @lauren123 @allisonsnow @marield65 @virtuous69 and all participating in this discussion, please see this IMPORTANT NOTE from Mayo Clinic pharmacist:

Kratom is a natural product but it does have significant risks and side effects. Because of these risks the FDA banned import of Kratom in August 2016 and issued a notice of intent to classify 2 chemicals in Kratom as Schedule 1 drugs (the same category as heroin).

Kratom can cause dependence and withdrawl symptoms including aggression, anxiety and other negative psychiatric effects, muscle aches, spasms, tremors, insomnia, fever and upset stomach. It can also cause dangerous slowed breathing and seizures. It can worsen psychiatric disease and may increase the risk of suicide. Kratom can impair liver function. Kratom interacts with other herbal medications including Jimson Weed. It interacts with sedating medications. It has the potential for many other drug interactions because of the way it is metabolized.

There are other medications and therapies for pain and withdrawal. Pain and withdrawal CAN be safely and effectively managed with prescription medications and other therapies by dedicated providers.Trying to manage serious medical conditions without your provider to guide you could make the condition worse.

Mayo Clinic Pain Rehabilitation Centers use group therapy, physical and occupational therapy and biofeedback and work with each individual to optimize therapy. http://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/overview

This is a link to opiate addiction treatment centers and has further information on Kratom addiction. http://americanaddictioncenters.org/withdrawal-timelines-treatments/kratom/

I'm NOT an Expert, BUT the Side Effects that were mentioned, are far from the Truth, as I & ALOT of people, know to be NOT TRUE,  Kratom is like any OTC, You abuse it, DUMB, the write-up, says, that there are Better DRUGS, from Pharmacuticle? Company's, How many People have Died from GOOD DRUGS, ALOT more than from KRATOM!!!!!!! It's been fun & interesting, BUT I think this is where I get off!!! Good Luck with CONNECT, but I'm DONE, just another case of BIG $$$$$$$$$ Calling the Shots, BYE!!!

Thank you for the information Colleen, I tried Kratom once along time ago, but didn't really see that it did anything helpful for me. It was long before they put any restrictions on it. I read a lot about it that didn't sound good, so I never tried it again. I do appreciate all the information though. You confirmed what I kind of already knew from my reading. Thank you

@colleenyoung - thank you for your interest in this topic, but your information is simply incorrect. To the best of my knowledge, the FDA has no power to regulate imports of anything. They have made a number of seizures of Kratom over the years, but not because the substance is illegal (it is not), but that certain purveyors have made false medical claims. That is a no-no, and within the FDA’s jurisdiction. The drug is not illegal, and has not been banned by the DEA (nor has it been scheduled as a Schedule I). It was in 2016, but only very temporarily. The DEA has since changed their position. Kratom is currently only a “Drug of Concern”.
See: https://www.dea.gov/druginfo/factsheets.shtml
And: https://www.dea.gov/pr/multimedia-library/publications/drug_of_abuse.pdf#page=84

@cipaul I am really happy to hear of every person who has had success in relieving pain, After I read your post yesterday, I wish that I could just give it a try.. I just have so many issues besides the pain that I think I am going to ask my doc about it first. Thank you so much for sharing this information. i’ve been sick so long that I want to hear of any possibility of help and make my decision. Have a great day!

Thank you for the additional information regarding Kratom and the FDA's jurisdiction, @efexnot. I appreciate the correction.

For further clarification on the FDA's position, I found this statement originally posted Nov 17, 2017 and updated 04/05/2018.

- Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm

@colleenyoung -- Thank you again for the post regarding kratom. I would just add that significant controversy persists regarding Dr. Gottlieb's statement, and the FDA advisory opinions pertaining to 'deadly' disks associated with kratom.

This isn't a comprehensive list, as there are numerous critiques on this issue, but here are four reputable reviews on this topic. The consensus from those on the other side is that it is unlikely that kratom has been responsible for any deaths at all. The general argument is that the cases cited involve multiple agents, and in some cases, suicide, and that none can be attributed to kratom directly. If one looks hard enough, a small handfull of cases with kratom as the single agent can be found, although many critiques for those exist as well.

First, here is a compilation of fatality cases from the FDA (02/2018) that readers may read to derive their own conclusions:
https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/CDERFOIAElectronicReadingRoom/UCM595575.pdf
Risk assessment from Pinney Associates (a Pharmaceutical Research Firm). [See page 52)
http://216.30.191.148/HL-AKA-Eight_Factor_and_Recommendations_by_PinneyAssoc.pdf
Letter from David Kroll, PhD, Academic Pharmacologist in Forbes Magazine:
https://www.forbes.com/sites/davidkroll/2018/02/09/fda-weaponizes-opioid-label-against-kratom-consumers/#38c4a4804536
Rebuttal from nine prominent academic scientists:
https://docs.wixstatic.com/ugd/9ba5da_345dd7a4f5d54c1088d86fc6299381cc.pdf
To be fair, here is an excellent piece that details deception on both sides of the issue:
https://thedrugclassroom.com/video/deception-on-both-sides-the-fda-vs-pro-kratom-advocates/
In short, I would assert that Dr. Gottleib's statement, and the FDA's position notwithstanding, the controversial issue of kratom safety is far from settled.

...for the record: I am not a Kratom advocate. I am an interested stakeholder actively observing this complicated issue as it develops.

Hi @efexnot,

Thanks for contributing to an interesting discussion. I wanted to mention a few updates, especially since the controversy surrounding the use of kratom may not abate very soon.

There are a plethora of well established studies that "has not determined if biochemical benefits of kratom may prove to outweigh its toxicity and risks. On the contrary, it seems that its potential side effects outweigh the benefits, and severe and real health hazards can, insidiously, lead to death." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402527/

Addiction to Kratom has been well described, and as it becomes more popular, emergency rooms are seeing an increasing number of patients who've transitioned from oral use to injecting various forms of Kratom. http://www.scientificoajournals.org/jtp.003.php
Moreover, as recreational use of this drug increases, physicians are being made aware of previously unreported complication. http://journals.sagepub.com/doi/full/10.1177/2324709618765022

in February, the FDA, the CDC, and state and local officials began investigating a multi-state outbreak of salmonellosis from a rare strain of Salmonella, which has been linked to kratom and kratom-containing products. https://nccih.nih.gov/news/kratom

In its latest update, "The FDA has determined that kratom, or Mitragyna speciosa, a plant-based supplement that grows naturally in Thailand, Malaysia, Indonesia and Papua New Guinea, is actually an “opioid analogue,” making it wholly unsuitable for treating opioid addiction or withdrawal...It may actually contribute to the opioid epidemic and puts patients at risk of serious side effects,” https://www.marketwatch.com/story/fda-continues-crackdown-on-controversial-supplement-kratom-2018-05-22

Although significant research is ongoing, we know very little about possible medicinal properties of kratom; but, I think, what we do know is that kratom is emerging as a drug of abuse, and it would be best to proceed with caution until proven otherwise?