A top federal health official and a former White House drug czar were among the featured speakers at a recent kratom-focused congressional briefing, laying out research priorities for the plant and broadly promoting alternative approaches to drug criminalization.
Last week’s event, organized by the American Kratom Association (AKA), was meant to give a science-based overview of kratom issues for congressional staff and stakeholders as bipartisan lawmakers work to advance a bill to federally regulate the substance, which is currently unscheduled and anecdotally used for pain relief, curbing withdrawal symptoms and other purposes.
National Institute on Drug Abuse (NIDA) Director Nora Volkow started by saying that while she always wants policy to be grounded in science, she’s come to understand that data is “not necessarily sufficient or enough.”
In the case of kratom, she said, “unfortunately, we don’t know much,” which is why NIDA is committed to expanding research into its potential risks and benefits. For example, she said health agencies have “invested significant resources” to synthesize the main compound of kratom so that researchers can conduct clinical trials investigating how it can be used for pain management and also “for the treatment of drug addiction.”
“We actually are very much open” to identifying those possible benefits, she said at the event. Volkow added, however, that the current lack of empirical data means there’s “no way of quantifying how to properly see the value.”
The National Institutes of Health (NIH) hosted a meeting last year to explore the therapeutic potential of the “controversial tree,” with an expert similarly providing an overview of the science of kratom and what role it could play in mitigating the overdose crisis.
Former Rep. Matt Salmon (R-AZ), who now serves as chairman of AKA, said at Wednesday’s briefing that he first learned about kratom during his last term in Congress, and he recalled how he eventually led a bipartisan letter to the Food and Drug Administration (FDA) to “get them to rethink their position” on scheduling kratom.
“I’m really thankful that, once they actually relied on science rather than emotion, that they’ve never tried to schedule it again,” he said. “But the fact is that there’s a lot of information out there—and I will say this point blank, most of it is misinformation.”
He talked about his own personal experience using kratom as an opioid alternative after he had knee replacement surgery, saying he used the plant-based medicine for about a month post-operation and he “didn’t have a lick of trouble not using it anymore” after that point.
Jim Carroll, who served as director of the Office of National Drug Control Policy (ONDCP) under President Donald Trump from 2018 to 2021, also participated in the briefing. Like Salmon, he said he became aware of FDA’s intent to schedule kratom and questioned what he described as a “one-sided” rationale, ultimately prompting him and other federal health officials to intervene.
— American Kratom Association (@TheKratomAssn) December 14, 2023
He said that FDA was trying to get the Drug Enforcement Administration (DEA) to “criminalize kratom” based on its argument that the plant was linked to overdose deaths, without providing an alternative perspective.
“So we did not have [the order] signed. We made sure that it was withdrawn,” Carroll said. “What we did really, as far as I am concerned, is took away the criminalization of research and the criminalization of treatment.”
The former drug czar made clear he isn’t personally advocating for the kratom cause; rather, he wants to contribute to the conversation about the harms of policies criminalizing drugs and substance misuse more broadly.
“If we’ve learned and we’ve all grown and realized that addiction is not a criminal event—that we’ve stopped criminalizing addiction—why are we going to criminalize research? Why are we going to criminalize treatment when it shows great potential?” he asked. “And I think that’s how we need to approach this issue, not only as Congress but also as families and as individuals and stop the stigma. I’m convinced that’s part of what’s going on here: It’s a continuation of this stigma.”
Mac Haddow, senior fellow on public policy at AKA, told Marijuana Moment that one of the challenges of informing lawmakers and congressional staff about kratom-related issues is lingering “chatter” from FDA officials who “persistently say that kratom is dangerous.”
“We thought it was important for those staffers and members to have an opportunity to hear from scientists and policymakers who have firsthand knowledge and understanding of kratom and how it can help,” he said. “It was a great step forward.”
Haddow said that the hope is this briefing will be instructive to lawmakers as advocates push to advance a bipartisan bill—the Kratom Consumer Protection Act, which was filed by Sens. Cory Booker (D-NJ) and Mike Lee (R-UT), as well as Reps. Mark Pocan (D-WI) and Jack Bergman (R-MI), in October.
If the bill becomes law, it would require FDA to take further steps to evaluate the health and safety of kratom and would also prohibit the agency from regulating kratom products in a way that’s more restrictive than regulations for food or dietary supplements.
Soren Shade, founder of the Colorado-based kratom company Top Tree Herbs who attended the congressional briefing, told Marijuana Moment that “this is an important bill to pass in order to help disseminate good information and help protect the supply of kratom for consumers, many of whom count on it, and getting rid of it would be a disaster and cause a lot of suffering.”
“In regards to the bare minimum goal of ensuring that a safe, clean and reliable supply of this wonderful leaf is available for the long-term, I think this bill is a good first step for that. I think there’s a lot of work to be done,” Shade, who was among many kratom stakeholders visiting D.C. to set meetings with congressional offices to advocate for reform, said.
There’s an open question as to why FDA has evidently targeted kratom, but stakeholders say it could also explain why it placed an import alert for products coming from countries like Indonesia. In a meeting with President Joe Biden last month, the president of Indonesia reportedly urged the administration to lift the alert. A top Indonesian administrative official separately made the request to FDA earlier this year, pledging to see to it that exported products meet safety requirements.
Meanwhile, after failing to secure the scheduling of kratom, FDA solicited public input in 2021 as it prepared to submit the U.S. perspective on a potential international kratom ban that never materialized. The United Nations World Health Organization (WHO) decided in 2021 not to recommend that kratom be globally prohibited.
While the decision was based on a scientific review of the risk of dependence, abuse potential and therapeutic applications of kratom, advocates touted the fact that about 80,000 people submitted comments to the panel, sharing their perspectives and experiences with the plant-derived substance.
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In July, meanwhile, the American Medical Association, in adopting a new slate of drug policy positions, said that people “who are using kratom only for personal use should not face criminal consequences.” The group added, however, that the substance should be evaluated by authorities “for its appropriateness for sale and potential oversight via the Controlled Substances Act, before it can be marketed, purchased, or prescribed.”
In 2020, the federal Agency for Healthcare Research and Quality (AHRQ) asked the public to help identify research that specifically looks at the risks and benefits of cannabinoids and kratom.
The Centers for Disease Control and Prevention (CDC) in 2020 separately received more than one thousand comments concerning kratom as part of another public solicitation.
Critics have said FDA misstated the facts on kratom to overstate its health risks, for example by failing to distinguish between health hazards associated with kratom itself and those caused by adulterants found in unregulated kratom products.
Photo courtesy of Wikimedia/ThorPorre.