“Kratom is abused for its ability to produce opioid-like effects,” the DEA says. “Kratom is misused to self-treat chronic pain and opioid withdrawal symptoms, with users reporting its effects to be comparable to prescription opioids.” So if you use kratom to relax, relieve pain, or get off heroin, that’s abuse.[...]Any medicinal use of kratom has to be abuse, the DEA figures, because kratom has not been approved for any indication by the Food and Drug Administration. Nor has the government approved kratom as a recreational intoxicant or a utilitarian stimulant (possibly because no such regulatory categories exist for new drugs), so those uses are also beyond the pale.[...]Since the DEA assumes there is no rational, morally acceptable reason to use kratom, it does not need to muster much evidence that kratom is intolerably dangerous. That’s a good thing for the DEA, because the evidence indicates that kratom is less hazardous than drugs that are legally used for similar purposes.“Serious toxicity is rare and usually involves relatively high doses (more than 15 g) or coingestants,” says a 2014 article in the journal Pharmacotherapy by clinical pharmacologist Megan Rech and four of her colleagues at the Loyola University Medical Center in Maywood, Illinois. “Fatalities typically involve coingestants…. Withdrawal has been described as less intense but more protracted than with prescription opioids.”A 2015 literature review in the International Journal of Legal Medicine offers a similar assessment. “Kratom is considered minimally toxic,” write Florida forensic scientist Marcus Warner and two co-authors, although they add that “research evaluating its toxic effects on humans is limited, with the vast majority of studies involving animals.” Warner et al. say “withdrawal symptoms are generally nonexistent to mild, even for heavy users” and note that two Florida counties “have deemed kratom not ready for regulation due to the lack of information demonstrating the substance as being unsafe or hazardous.”[...]The DEA plays a similar trick when it cites a report on kratom-related calls to poison control centers that the U.S. Centers for Disease Control and Prevention published in July. From January 2010 through December 2015, the DEA notes, “U.S. poison centers received 660 calls related to kratom exposure.” It adds that “during this time, there was a tenfold increase in the number of calls received, from 26 in 2010 to 263 in 2015.” Reported symptoms included “agitation or irritability, tachycardia, nausea, drowsiness, and hypertension.”An average of 110 cases a year may sound like a lot, but it’s not. It represents about 0.004 percent of the 3 million or so calls received by poison control centers each year. By comparison, exposures involving analgesics accounted for nearly 300,000 calls in 2014, while cosmetics and personal care products, cleaning solutions, antidepressants, and antihistamines each accounted for more than 100,000. The DEA not only fails to put the number of kratom-related calls in perspective; it does not mention that two-thirds of the cases were deemed “minor” or “moderate,” while only 7 percent (eight per year) were described as “life-threatening.” The CDC noted a single death in six years, “reported in a person who was exposed to the medications paroxetine (an antidepressant) and lamotrigine (an anticonvulsant and mood stabilizer) in addition to kratom.”These numbers are pretty reassuring, especially since the DEA says “millions of dosage units” are imported into the U.S. each year. But the agency draws the opposite conclusion, saying “such alarming quantities create an imminent public health and safety threat.”