The Drug Enforcement Administration has said it will ban the kratom plant for two years because it can produce effects similar to opiates. Although it's been used for centuries in Southeast Asia, its use is relatively new in the United States, spurred in large part by users sharing reports of their experiences with the drug on online forums.
One of the most well-known of those forums is the website Erowid.org, an "online encyclopedia of psychoactive substances," whose founders were profiled in the New Yorker last year. At Erowid, users of everything from caffeine to heroin can submit first-person reports of their experiences with drugs. These "trip reports" are reviewed by moderators, categorized thematically ("bad trips," "glowing experiences," etc.) and published on the website.
The reports are used by both researchers and drug users seeking out information on emerging substances or new use trends in established substances.
The website includes 286 user-submitted reports detailing experiences with kratom, either alone or in combination with other drugs. These reports were the subject of a study published last year in the journal Psychoactive Drugs. As authors Marc Swogger and his colleagues note, there has been "little scientific research into the short- and long-term effects of kratom in humans, and much of the information available is anecdotal."
Short of rigorous studies into the drug's effects, Erowid's archives represent the next-best thing.
Swogger and his colleagues read all of the kratom experience reports available on the site at the time — 198 of them, which they whittled down to 161 by tossing out multiple reports submitted by the same user. Then they categorized the reports according to the individuals' overall experiences, positive and negative — euphoria, pain relief, nausea, itching, etc.
Chart it all out, and here's what Erowid's universe of kratom use looks like:
"The most prominent theme (30.4%) was a sense of well-being that extended in degree to euphoria, especially at higher doses," Swogger and his co-authors write. "Numerous individuals described this effect as similar to that of opiates."
One user wrote that "kratom seems to create a pleasant, mellow and happy effect, like laying in a field of poppies."
Another felt "body relaxation and mental calm with no loss of clarity."
The most common negative experience was nausea, reported by 16 percent of users. A number of others reported chills and sweats.
Of particular interest to public health researchers were the reports relating to dependency — both on kratom itself, as well as reports detailing how people used kratom to wean off other substances. Ten percent of users reported problems with withdrawal after nonuse, while close to 11 percent reported using kratom as a substitute for other drugs, mostly opioids.
"In sum," the study concludes, "our findings suggest that the subjective effects of kratom are generally mild and pleasant, with some important negative physical side-effects, including what appears to be a mild (i.e., relative to opiates) dependence syndrome."
How do these self-reported effects compare with those of other drugs, legal and otherwise? It's tough to say. Swogger et. al. didn't run the same analysis for other substances on Erowid. But it's possible to get some sense of the range of site users' experiences for different drugs by looking at the ratio of negative to positive experience reports for each drug.
For each substance listed on Erowid, there are a number of experience categories that are unequivocally negative -- "difficult experiences," "bad trips," "health problems," "train wrecks and trip disasters" and "addiction & habituation." Similarly, other categories indicate positive reports: "glowing experiences," "mystical experiences," "health benefits" and "medical use." Still other categories, like "first time" and "retrospective/summary" don't denote any positive or negative experience.
For a handful of common drugs, legal and illegal, I tallied the number of reports falling under the positive and negative categories. Then, to correct for the fact that some drugs, like marijuana, generate many more experience reports than others, I expressed the numbers as a ratio: For each positive experience reported for the drug, how many negative experiences are there?
Here's what that looks like.
The first thing that stands out is that for all of these substances, negative experiences outweigh positive. This is somewhat surprising, as drug users are often characterized as irresponsible thrill-seekers careening through life from fix to fix, and looking to entice others to do the same.
But these numbers suggest that the users who visit Erowid are offering unvarnished assessments of their drug use, the good AND the bad.
Among the handful of drugs I looked at, kratom users had the lowest likelihood of reporting negative experiences, followed by users of marijuana and oxycodone. Heroin users reported five bad experiences for every good one. For cocaine users, the ratio was seven to one.
But by far the highest ratio of bad-to-good experiences can be found among the site's alcohol users, who submit nearly 13 negative reports for every positive one.
Key point here: This isn't a scientific assessment of drug effects, or relative harm, by any means. Erowid users aren't representative of the general population. People who go to the site are by definition looking for information on novel psychoactive experiences. They may be predisposed to feel negatively toward "traditional" highs, like alcohol.
But what these numbers do tell us is that within a fairly large and diverse community of drug users online, reports of negative experiences with kratom — including addiction and dependency — are relatively rare compared to other, more familiar drugs.
The more rigorous deep-dive into kratom's effects by Marc Swogger and his colleagues suggest that the drug's effects are "generally mild and pleasant," with a risk of some side effects, including a risk of dependency.
The DEA itself has admitted that kratom likely isn't deserving of the DEA's schedule 1 designation, reserved for only the most dangerous drugs.
To really understand the drug and its effects, risks and possible benefits, more quality research needs to be done on it. But with the DEA's plan to place it in schedule 1, some say that research will be difficult to do.
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