An Idiot Tries to Understand Kratom Science a 2nd Time

I am not a kratom scientist. I am just a humble writer. I am miles away from the nearest college or lab, or wherever great minds are studying sciencey stuff.

Here I write about and attempt to understand legitimate studies from the field of medical science.

Ladies and gentlemen. I present to you, An Idiot Trying to Understand Kratom Science:

Article by Smart People: “Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth)”

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670991/

Journal: Addiction

Date: June 2008

This is an early kratom study, authored by five scientists including Chris McCurdy, the well-known medicinal chemist and kratom expert.

A 43 year old man was shooting ground up hydromorphone capsules, which he began using for chronic pain before developing an addiction.

He went cold turkey from hydromorphone, and used kratom to lessen withdrawal effects.

During his kratom use, he tried modafinil to improve his alertness. This did not turn out to be a good idea, as 20 minutes after popping the modafinil he suffered a tonic-clonic seizure. After treatment for seizure, the patient ceased all use of kratom and saw an addiction specialist.

So one lesson so far is, be careful what you mix kratom with, especially in high doses. Seizures have been reported anecdotally when mixing kratom with tramadol, benzodiazepines, and lisdexamfetamine, three medicines I’m not sure if I am pronouncing correctly. However, these are anecdotes. Another kratom user commented that he mixed modafinil with kratom many times without incident. Please don’t listen to idiots for medical advice.

Despite the seizure in this particular case, the report states:

“The protracted use of kratom as a single therapy did not appear to produce any significant adverse effects in this patient; not until co-administration with modafinil was a potential adverse effect of kratom identified… The risk correlates of kratom use as well as outcomes from its long-term administration are unknown. Initiation of kratom use may reflect increasing interest in alternative therapies for chronic medical problems..”

To that, the report adds that self-management with kratom may be an alternative not only to the side-effects of prescribed medicines, but also to the headaches of having to deal with the healthcare system:

“patients’ satisfaction with existing systems that treat chronic pain or problematic opioid use—which frequently underprescribe analgesics, require treatment contracts, demand ongoing drug testing or stigmatize those who seek care—may be so poor that some patients shun physician contact [1,11]”

The headaches, not the mention the costs, of going through the healthcare system is adversely effecting health. This is a perfect example of how the failures of a societal system factor into medical science. People are turning to alternative therapies for a myriad of reasons, including the inability to afford high-dollar pills, co-pays, and the time it takes to visit a doctor’s office.

Another article by smart people: “Abuse liability of mitragynine assessed with a self-administration procedure in rats”

Link: https://www.ncbi.nlm.nih.gov/pubmed/30039246

Journal:Psychopharmacology

Date: October 2018

Last week we discussed the fact that there was a job in science getting zebrafish high. From this week’s study we can contemplate the fact that there is a science job getting rats high. In fact I want to feature stoned animals as much as possible in this blog.

Opiate addicted rats reminds me of the comic by Stuart McMillen about the rat park study – showing that rats living in a rat community are less likely to become drug-addicted than rats living in isolation. Perhaps throwing people in jail for possessing drugs only exacerbates the problem of modern isolation? Perhaps. (I like saying ‘perhaps’. It makes me feel smart.)

Being an idiot, I’m not sure I know what the term “abuse liability” means, so I relied on the smart people over at addiction.com: “Abuse liability is the potential that a drug has for addiction. The term is used interchangeably with ‘potential for addiction’ and ‘addiction-sustaining properties’.”

This study administered rats with heroin, methamphetamine, saline, and mitragynine to study the effects the drugs had on opiate receptors. First of all, it’s an obvious injustice in this country that lab rats don’t have to fight for their right to party, but human beings do. Saline is apparently used as a placebo in this case. Although if a government body wanted to ban salt we could paint an ominous picture of people binging on popcorn and potato chips and processed food, and point to how salt leads to high blood pressure and dehydration. But we’ve all agreed that food tasting good is worth the risk of death by salt. Maybe rats like cheese so much because it’s rather salty.

Anyway, back to science:

Mitragynine had > 2- or ~ 16-fold greater affinity for the mu opioid receptor than, respectively, for kappa or delta opioid receptors. Its affinity for the mu receptor was ~ 200-fold less than that for morphine.

Right now all I can think of is college fraternity parties I went to. If I was kratom I would want to party with the mu’s but the kappas and deltas are meatheads and don’t let dudes in unless it’s Rush Week.

In rats trained to self-administer methamphetamine, saline substitutions significantly decreased the number of responses, whereas different doses of methamphetamine (0.002-0.068 mg/kg/injection) or heroin (0.001-0.03 mg/kg/injection) maintained self-administration with maximal responding at 0.022 or 0.01 mg/kg/injection, respectively. In contrast, no dose of mitragynine maintained response rates greater than those obtained with saline. Presession mitragynine treatment (0.1 to 3.0 mg/kg) decreased response rates maintained by heroin but had little effect on responding maintained by across the same range of doses.

I think it means that rats like meth and heroin better than salt, but they like salt and kratom about the same. If I had the choice between a bag of potato chips and kratom tea, I’d take the chips. But if I had a choice between chips and a bottle of whiskey, you’re darn right I’d take the whiskey. And apparently this study shows kratom replaces heroin more effectively than methamphetamine. Although some, including the Thai Minister for Justice, have claimed kratom has aided in getting off of meth, and intoxicating substances in general.

As usual with kratom, the chorus from science is “More Research is Needed”. And that can only happen if kratom is kept legal. As the study concluded:

“These results suggest a limited abuse liability of mitragynine and potential for mitragynine treatment to specifically reduce opioid abuse. With the current prevalence of opioid abuse and misuse, it appears currently that mitragynine is deserving of more extensive exploration for its development or that of an analog as a medical treatment for opioid abuse.”