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North Carolina Lawmakers Consider Restricting Drug Used To Manage Opioid Withdrawal

GamblinMan22 via Wikimedia Commons

A legislative proposal to ban kratom, a mood-altering drug, has been dialed down so that its use would only be illegal in North Carolina for people younger than 18.

According to the National Conference of State Legislatures, a number of states have either banned or restricted the use of the substance.

Kratom users, store owners, and advocates gathered at a hearing of the Senate Health Care Committee at the General Assembly in Raleigh Tuesday, where they discussed House Bill 747. As amended Tuesday, the bill would prohibit the use of kratom for minors and call for a public health study on its effects.

“We could end up in a scenario where we ban kratom, we could end up in a scenario where you have be 21 or older to buy kratom, we can end up where you are 18 and older and you can buy kratom, or there’ll be no restrictions on it whatsoever,” said Senator Tommy Tucker (R-Waxhaw), who presented the bill to the same committee in May. “We simply want to find out the facts and… not move too fast.”

“We want to look at this very hard,” he said.

A ‘Subtle’ Drug

Kratom is substance derived from the leaves of the Mitragyna speciosa plant, found mostly in Southeast Asia. There are mixed reports about the effects of kratom, but some user accounts include descriptions of euphoria, pain relief, sleepiness, and calm.

Mitragyna Speciosa, the plant from which kratom is derived, is native to Southeast Asia.
Credit ThorPorre via Wikkimedia Commons
Mitragyna Speciosa, the plant from which kratom is derived, is native to Southeast Asia.

An international team of researchers that reviewed more than a hundred studies on kratom found it affects some of the same neuroreceptors in the brain as heroin and has similar effects. At the same time, kratom doesn’t seem to make people as “high,” or alter their consciousness in the same way as opioids.

And some former addicts say the substance has helped them beat their opiate addictions and ease withdrawal symptoms.

Laura Davis, a clinical social worker, who has a private practice in Chapel Hill, has seen this first-hand. She incorporates kratom in her treatment plan for clients.

“Kratom is a huge part of therapy for a young man who was shooting heroin in New York,” she said. “He came down here and has been sober since December.”

But lawmakers are asking for evidence beyond anecdotes.

“I do not understand how someone can go from taking opiates and being addicted and then go get street heroin and then all of a sudden be able to get off both of them by taking kratom,” Tucker said.

Concern about kratom has grown since the state’s medical examiner’s office found that 23 opiate overdose victims also tested positive for kratom, a significant rise, according to bill co-sponsor Sen. Tom McInnis (R-Rockingham).

However, Elizabeth Gardner, owner of Krave, a kava bar in Carrboro, says this concern is a result of misleading information.

“I was there when all this started being looked at, when a mother, I think wrongfully, blamed kratom for her son’s decision to kill himself,” Gardner said.

“The autopsy showed he had kratom in his system, but he also had three psychotropic medications that shouldn’t have been prescribed together in the amounts they were.”

Gardner describes the drug as having the effect of changing mood, rather than being mind-altering.

“It’s subtle. If you abuse it or be irresponsible with it, you’ll throw up. You can’t tolerate high levels,” she said.

Fact Checking

“We have to have the facts before we make the right move,” said Tucker as the senators changed their bill from a measure that would ban kratom altogether to one that would study it and only apply the ban to minors.

Advocates sitting in the back of the committee room cheered during Tucker’s comments. Outside, in the hallway, they said they supported the Senate’s decision to hold off on the total ban.

“I don’t think we could be happier right now,” said Susan Ash, Founder of the American Kratom Association.

“The fact that our voices made that much of an impact shows just how much the grassroots can work together with the professional organization and industry to get our message that this is something that we use responsibly, that our health and well being depends on,” Ash said. “And again just that our voices were heard.”

After the May Senate hearing on kratom, the American Kratom Association commissioned a toxicologist to put a report together which, Ash said, cited “clear conclusions” about the safety of kratom and its lack of ties to any deaths.

But the science known about the risks and effects of kratom is slim. Researchers in one large study caution categorizing kratom as a safe drug, citing it has the potential to cause withdrawal symptoms and life-threatening effects, especially when taken with other drugs. They state more studies are needed to understand kratom consumption.

Sens. Tucker and McInnis received numerous emails, from as far away as Australia and Tanzania, on the benefits of kratom for chronic pain and addiction. They decided to modify the bill to prevent sale, distribution and consumption of kratom only among minors — for now.

Minors who are caught in possession of the substance would be charged with an infraction, rather than a felony. This would keep their records clean, according to McInnis.

The bill, Tucker said, also extends the study to look at the effects of nitrous oxide “whippets,” which aren’t related to kratom but can still give users a buzz.

“We wanted to do the right thing and not have a knee-jerk reaction,” McInnis said about letting go of the ban for now.