Whitney M. Woodworth

Statesman Journal

More than a dozen bills have already been proposed in the upcoming Oregon Legislature dealing with marijuana, but there is also one bill about a lesser-known herb unheard of by many, fiercely adored by some and almost banned by the DEA.

For millennia, people in Southeast Asia used the leaves from the tree Mitragyna speciosa — more commonly known as kratom — to combat fatigue and as a traditional medicine.

The herb's modern proponents claim it can help with opioid withdrawal, pain, fatigue, anxiety and depression. Its detractors decry it as an "imminent hazard to public safety," citing 15 kratom-related deaths in the United States during a two-year period.

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Senate Bill 518 would declare an emergency and direct the Oregon Board of Pharmacy to conduct a study to determine whether the plant and its drug derivatives should be scheduled as a controlled substance.

The move has many users and proponents of the herb nervous.

"It's a little bit of a surprise," said Susan Ash of Portland, director and founder of the American Kratom Association. "We did not think we were going to see a push in Oregon."

Ash said she knows firsthand the life-changing benefits of kratom. She worked for years as an environmentalist and advocate for places like the Audubon Society of Portland and as a naturalist at Bryce Canyon National Park. She left her job after a case of Lyme disease went undiagnosed for eight years, saddling her with lifelong fatigue and pain.

Doctors prescribed painkillers, and soon she was addicted to opioids. She went to rehab, but nothing seemed to alleviate the debilitating symptoms of withdrawal. When someone from her Lyme disease support group suggested using an obscure herb called kratom, she dismissed it as nonsense.

She soon faced two options: be on the narcotic Suboxone for the rest of her life or have nothing. Ash decided to give kratom a try.

"It was like night and day," she said. "My withdrawal symptoms were totally manageable."

Because her case of Lyme disease was diagnosed so late, it is now a chronic condition, which she has treated with kratom for the past three years. She drinks a tea made from kratom leaves two to three times a day. She describes the effect as "espresso without the jitters" and likens the pain relief to taking a strong ibuprofen.

Ash formed the American Kratom Association in 2014 with the intent to support and protect consumers of kratom and to educate potential consumers and regulators.

She said imports of the substance indicate that about three million to five million people in the United States are regular kratom users. It can be brewed in a tea, chewed, smoked or ingested in capsules.

The substance has been on the DEA's list of drugs and chemicals of concerns for several years. In August, the agency announced its intent to label kratom as a Schedule I controlled substance and deemed it "an imminent hazard to public safety."

With the designation, kratom would join the ranks of heroin, LSD and marijuana. Agency officials based the decision on the drug's lack of accepted medical use and high potential for abuse.

They also cited an uptick in calls to poison control centers and deaths related to kratom. Between 2000 and 2005, the American Association of Poison Control Centers received two calls related to kratom. From 2010 to 2015, calls skyrocketed to 660.

The Centers for Disease Control and Prevention said kratom abuse can lead to agitation, nausea, hypertension, seizures and vomiting. DEA officials said they were aware of 15 kratom-related deaths from 2014 to 2016.

After the DEA's announcement, an outpouring of senators, representatives, doctors, scientists and kratom users contacted the agency, imploring it to reconsider. Sen. Ron Wyden, D-Ore, penned a letter with Sen. Cory Booker, D-New Jersey, and Sen. Kirsten Gillibrand, D-New York, urging the acting DEA administrator to allow more time for experts and the members of the public to weigh in on the benefits of kratom.

"Given that we are in the midst of a drug crisis and there is promising evidence of kratom's potential medical benefits, including the possibility of new, safer medications for the treatment of pain, we believe that placing kratom in Schedule I without adequate time... may have unintended consequences," the letter read.

The American Kratom Association organized protesters and a petition garnered more than 140,000 signatures. By Oct. 13, the DEA withdrew its intent for scheduling and opened up a public comment period. PBS News Hour reported the agencyreceived about 23,210 comments online — an "abnormally high amount."

Dr. Michael Moss , a medical toxicology fellow and emergency room physician with Oregon Health & Science University and Oregon Poison Center, said he is not aware of any local deaths caused by kratom. The poison center, which receives about 60,000 calls a year, has not seen a surge in kratom-related incidents.

"We have not seen a huge rash of these cases in Oregon," he said.

Moss said he remains wary of the substance.

"It's still a drug. It's still a chemical," he said, adding that kratom, which is available in smoke shops and online, is largely unregulated.

He said it's safest to avoid kratom, but if people do seek out the substance, they should exercise extreme caution.

"You never know what exactly you're going to get," Moss said.

Kratom can be a stimulant or pain reliever depending on the dosage and type of leaf. Ash said she supports making sure kratom is safe for consumers, the dosage is correct, the herb is uncontaminated and that product with kratom are not advertised to children.

The DEA claims of kratom having a "high potential for abuse" are way off base, Ash said. It doesn't taste good — she compared the flavor to a strong green tea mixed with dirt — and if someone tries to take enough to get high, they usually just make themselves nauseous. A lot of people lump the substance into the same category as bath salts and synthetic cannabinoids like "spice," but it is completely different, Ash said.

Jessica Peterson , manager of Dizzy's Smoke Shop in Salem, estimated less than one percent of her customers buy kratom to use recreationally.

Most people use it to help them break their opiate addictions or for pain management.

"I believe it's a huge benefit," she said. "We've watched people come off opiates and become functional people."

About a year and a half ago, the substance started growing in popularity. Customers shared their stories of recovery with Peterson, and she came to believe in its ability to help people.

"I look at it differently now," she added.

The store took it off of their shelves after the DEA's announcement but restocked after the reversal.

"I had customers on the verge of tears," Peterson said.

Oregon Board of Pharmacy executive director Marcus Watt said kratom was on a list of drugs to make controls on last year, but the board dropped it due to lack of negative feedback. The board works with law enforcement, emergency room personnel and doctors to determine a substance's impact in the community. They look for drug busts, emergency room visits and overdoses to help determine whether to embark on a study. The board didn't hear from anyone with strong negative feelings about kratom, Watt said.

If ordered by legislators to study the herb, the board would hold public hearings and meetings to investigate whether the effects of kratom warrant making it a controlled substance. A normal study and review takes about three to six months. Declaring a public health emergency would lead to a quicker, two-month study.

Six states, including Vermont, Indiana and Alabama, have banned the substance.

Ash said she hopes Oregon officials take their time, wait for the DEA to make its ruling and talk to people who've benefited from kratom use, law enforcement and doctors before deciding its future in the state.

"This has a huge potential to help in the nation's opioid epidemic," she said.

Email wmwoodwort@statesmanjournal.com, call 503-399-6884 or follow on Twitter @wmwoodworth

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