November 21, 2024

Dangerous Legal Drug? Or Nature's Answer to Opioid Addiction?

Investigating the potent green powder that's illegal in six states — but not in Michigan.
By Todd VanSickle | Feb. 22, 2020

In January 2017, Ron Porritt remembers waking up with a sheriff’s deputy standing over him. He had overdosed on heroin, and a friend had called the police. It was at that moment he realized his life needed to change.

Porritt’s addiction to opiates began after a series of back surgeries. He was prescribed Percocet and various versions of Hydrocodone. Throughout most of the 1990s and 2000s he was constantly on opiate medications, and when doctors started cutting back on his prescriptions, he turned to heroin.

“I got into legal trouble. I lost my marriage. I lost everything,” Porritt said. “I wanted to get my life back.”

He went through a detox program and managed to stay off the opiates but found himself in pain from his arthritis and still struggled with his urges for opiates.

 “I was willing to try anything,” Porritt said. 

 In March 2019 he found something that gave him relief and helped him take back control of his life, he said: kratom. 

 He had read about kratom on the internet and decided one day to stop at AllWell Natural Health store in Gaylord, where he had seen it advertised. 

Now, he buys 250 grams of kratom each week. He takes it twice a day by mixing it with his tea in the morning and in the afternoon. 

“It is not the first thing I tried; it is the best thing I tried,” Porritt said. 

Porritt, who is in his 50s and lives in Otsego County, says kratom has given him more energy during the day, and he is able to sleep better at night

“I can’t say it is all the kratom, but it has helped get my life back. I can actually function like a person should function. I started using it because I was desperate to find something else than opiate medication,” he said.

SOURCE & EFFECT
Kratom comes from a tree, Mitragyna Speciosa, that grows in tropical regions of Southeast Asia. It is a cousin of the region’s coffee plants. Traditionally, its leaves and extracts have been used within the tree’s home countries for what is thought to be its medicinal properties — to increase energy and appetite, for intestinal deworming, and as a mood enhancer and pain reliever.  Most commonly today, its leaves are harvested and turned into a powder that can be ingested as is, or in a capsule.

According to the American Kratom Association, about five million Americans consume kratom.

In recent years, as the opioid crisis has ballooned, kratom has grown in popularity as an alternative to opiates. Former addicts say kratom helps stave off withdrawal symptoms, which, ultimately, keeps them drug-free.

However, kratom is not tested or approved by the FDA, and some question its consistency and effects on the user. Additionally, there have been reports of deaths linked to kratom. 

According to the Centers for Disease Control and Prevention, a 2019 study found kratom was the cause of 91 deaths during a 17-month period. However, about 80 percent of those who died had other substances in their system, including fentanyl, heroin, benzodiazepines, prescription opioids, and cocaine.

The Drug Enforcement Administration lists kratom as a drug of concern, but in 2016 dropped a plan to classify it as a controlled substance. 

From 2011 through 2017, 1,807 kratom exposures were reported to the United States Poison Control Centers. Almost 65 percent of the exposures occurred in 2016 and 2017. Most occurred among adults older than 20 years old.

“Kratom is associated with a variety of serious medical outcomes, especially when used with other substances,” according to a report by the Poison Center Research. “More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances.”

THE ADDICTION ISSUE
There are three main strains of kratom — white, red, and green — that have different effects on the user and vary in potency. The white strain is considered to be the strongest, with a mild stimulant effect. The strains are determined by how the leaves are processed and prepared. 

Porritt said he gets the opposite desired effect from the kratom that he uses. For example, if the kratom is known for its stimulant effect, it usually puts him to sleep. And the same is true for kratom that produces a sedative effect, which he said gives him more energy.

Prior to taking kratom, Porritt struggled to put in six hours of work a day.

“I was just dragging, and I hurt,” said Porritt, who works as a general labor and now uses CBD oil as well. “I tried kratom, and it was like it brought me back to when I was 20.”

 

Porritt said he has gone for four or five days without any kratom and hasn’t felt sick or experienced any side effects.

“I don’t know if it is addictive or not, but it works,” Porritt said. “You can’t have a cookie cutter approach for this addiction problem we have. There are many different paths. This works for me, but this might not work for the next person. If it is able to help one person, or five percent of the people who might end up in the ground, why would they take something like that away?”

However, kratom didn’t work for Steve, 33, whose name has been changed to protect his identity. 

“In the beginning it worked great,” he said. “I am very active. I run, and I work out. It gave me a lot of energy for that, and the muscle soreness wasn’t there.” 

But over the course of a year, he became addicted to kratom, he said. And when he tried to stop, he not only couldn’t but also was saddled with a host of withdrawals.

Steve first started taking kratom in December 2018. The avid runner was seeking out a pain reliever alternative to Ibuprofen for an injury he sustained while working out. He turned to the internet and found kratom, but the results were mixed.

“There were some things that were bad from the Mayo Clinic, but then there was this guy who was a writer from Forbes, and most of the things he wrote were positive,” Steve said. “I thought it must be relatively harmless if it’s still legal.”

He started taking it once a week in a tea, but couldn’t tolerate the taste, so he went to the toss-and-wash method, which involves gulping down a spoonful of kratom with a mouthful of water. 

“The first time I took it, I was surprised how effective it was with pain, and it got me a little high, like Vicodin,” Steve said, noting he does not have an opiate addiction. 

In the back of his mind he worried about becoming addicted, so he initially limited his use and purposefully took breaks that lasted days. He admits to having past addiction issues, especially with alcohol, but he had been sober for about three years prior to taking kratom. Nevertheless, because the high from the kratom made him feel like he was violating his sobriety, he hid his use from his wife. 

He remembers taking kratom for about a week straight, and then going on vacation and not having it. 

“I started noticing I couldn’t sleep very well. I was agitated, and I didn’t have any energy without it,” Steve said. 

When he returned from vacation, he began taking it every day for about two weeks straight.

“I tried to stop, but the withdrawals were hell at that point,” Steve said, who was using between nine and 12 grams a day.

"There was this aching pain that spread all over my legs — not just in my muscles but it was in every inch of my bones too. There was also this very uncomfortable and painful skincrawling and tingling sensation all over my body. I had extreme swings in body temperature, especially at night, and would get cold sweats. I could only sleep for about four hours a night, and that was interrupted every hour or so.

"I was also having extreme anxiety and depression, and I felt like I was never going to be normal again. I would get these waves of emotions that would just hit me, and I'd freak out and just want to start my life over. There was also an extreme lethargy that made easy tasks seem insurmountable — like taking the trash out or trying to remember a password just seemed impossible."  

Ultimately, the withdrawls were such a hindrance, Steve said he felt he had no choice but to go back to taking kratom for the sake of his job and family.

"I was so afraid I was going to have to miss work, or basically just drop all my responsibilities of being a husband and a father."  

Steve began working to taper down his usage to ease off the Kratom over the course of serveral weeks. By Christmas day, he had quit, cold turkey.

However, the day after quitting, he began having heart palpitations. The withdrawl symptoms not only returned but also — the heart palpitations and anxiety especially — got worse. 

"I had to be hospitalized," he said. "I thought I was going to die from quitting cold turkey like that."

Today, more than two months later, Steve remains free of kratom but not of withdrawl symptoms. He said the lethargy still lingers a bit.

LEGAL PERSPECTIVE
Kratom typically does not show up on a drug test, according to Michigan State Police Lieutenant Travis House. 

“It has to be something that has to be specifically tested for,” House said. “Since kratom isn’t illegal [in Michigan], it would have to be something a probation officer or employer would require.”

Kratom is somewhat new for Lieutenant House. About a year ago, he did some research into kratom when a journalist asked him about it. He said kratom is not considered contraband, and he can’t recall any incidents involving kratom where the Michigan State Police responded.

“The truth is, our narcotics officers aren’t dealing with plant-based substances like that very often anymore because of the legalization of marijuana,” House said. “What people should know is that it has not been approved as a FDA drug or food item. There is some inherent risk of the use of a product that hasn’t been approved. People should be cautious putting anything in their body that has not been vetted by officials.”

A request to speak to a doctor at Munson Medical Center about kratom was declined.

“Since Kratom is not something we deal with at the hospital, and it’s not part of our formulary, we would not have anything to offer,” said a Munson representative in an email.

TREATMENT TOOL
Adam DeVaney is a licensed clinical social worker at Life’s Work, a behavioral health and opioid addiction medicine clinic in Kalkaska. The facility has only been open for about nine months, but is seeing some success.

“We help a lot of different people who have a lot of different struggles,” DeVaney said. “We are finding that Kalkaska has a lot more heroin and intravenous use than Traverse City.”

Often, patients are already using kratom prior to coming to the clinic for Buprenorphine — a pharmaceutical drug used to wean addicts off opiates. 

“Many of the patients found [kratom] does help,” DeVaney said. “But it is a lot less stable than Suboxone or other types of drugs like that. A lot of patients use it to tamp down their withdrawals from opiates.”

He warns that the consistency in kratom can be very unreliable, and people should research which strain of kratom is best for them before taking it. Additionally, he suggests taking smaller doses at first.

“Everybody is trying to find balance in their life, and kratom is definitely one of the ways people are seeking that,” DeVaney said. “From one bag to another, kratom can be quite different. The challenge with a plant-based product that is grown from the same strain of kratom overseas, in the same field, produces a different result every year. It is not as consistent as a pharmaceutical, but many people feel that it is more affordable and more accessible than medical assisted treatment for opioid abuse and disorders.”

DeVaney doesn’t discourage anyone from using kratom but said a successful recovery often requires a team of professionals that are looking out for them and can address behavioral issues.

“One of the challenges of people medicating themselves is that there is nobody there to help with course correction, support ,and advice,” DeVaney said. “There are many different approaches to recovery. For some, a product like kratom will get them through the worst of it and maintain them.”

BEWARE INCONSISTENCY
Kratom can easily be found on the internet and ordered with ease. A quick search on Google produced several websites offering kratom for sale and free shipping. On average, one ounce of the green powder goes for about $10. An additional search lists more than 10 places in Traverse City that carry the product.

On several occasions, Steve noticed inconsistency in the kratom he bought. For the most part, he only bought it from a head shop in Traverse City. He described it as “very powerful” and was unsure if he was taking an extract.

“The place I got it in town is kind of shady,” Steve said. “He buys it wholesale and then puts it into unlabeled packaging. So, I don’t know what it exactly was. Maybe, that nine to 12 grams I was taking was equivalent to a lot more.”

Not having any guidance or information about how to take it worried Steve.

“So I called the [head shop] and asked them, and he told me that he couldn’t tell me that, and I would have to look it up on the internet,” Steve said. “I don’t know why he couldn’t tell me how to take it. I guess to protect himself if I did overdose.” 

He did get receive some basic information about the different strains and effects, but it was limited. He even tried buying kratom from a different source but was disappointed.

“I got it from somewhere else one other time, and it was bogus,” Steve said.

PERSONAL EXPERIENCE
At AllWell Natural Health, where Porritt was introduced to kratom, Veronica James, co-owner, sits behind a desk in front of a wall lined with shelves of kratom, CBD and other health supplement products.

When customers come through the door, James greets them in her friendly Texan accent. 

“Hi honey, how can I help you?” she says.

She has extensive knowledgeable about kratom and good bedside manner, something that impressed Porritt the first time he met her, whom he refers to as Ms. V.

“I think she cared more about my well-being and listened to me more than any doctor ever had,” Porritt said.

The health store has been open for about six years and has carried kratom for five years. On AllWell Natural Health’s website, a red banner across the top of the site proclaims that the store’s products are “All 3rd Party Tested!” 

Before James began selling kratom at her store, she tried different strains in the capsule form to see if the effects were accurate to the information that was available.

“We learn from the information that is out there, and we share it with others. It is very beneficial,” James said. “We also learned about how to get the best vendors. That is very important.”

She doesn’t advise people what kratom to take or how to take it; but gives customers information that she knows to be accurate about the strains, and then leaves the customer to make his or her own decision.

“What makes us unique from most people who sell kratom is that we offer guidance,” James said. “We can do the same for you.”

I had never tried kratom, but thought this would be a good place to start. I opted for something that gives me more energy and selected a strain called White Horn. It was in an orange medicine bottle sporting an AllWell Natural Health label.  There were no instructions or warnings on the label.

For 10 days straight I mixed a teaspoon into my morning coffee. The bitter green powder masked the coffee’s flavor and rendered my cup of Joe into something that tasted more like a green tea than you would drink at a Chinese Buffet. Beginners tip: Stir it constantly, or you will end up with a glob of green sludge at the bottom of the cup. 

The effects were immediately noticeable. I felt a boost of energy. It was a different feeling than I normally would have had after drinking coffee. I wasn’t jittery or nauseous. So, every morning I continued the routine, eventually upping my dosage to two teaspoons per cup.  

Early one evening, a few hours before bedtime, I drank some kratom with a cup of dandelion tea. I had trouble falling sleeping, but this was to be expected with the white strain of kratom — known for its stimulant effects. The only other noticeable side effect was a loss of appetite. I didn’t feel hungry and had to remind myself to eat.

A little more than a week after meeting James, she sent an email checking up on me.

“Howdy Todd, I hope you don't mind if I follow up on your personal experience with the Kratom you took to try,” she wrote. “Would always like to hear from those new to kratom in particular.  The information may help me with the next person new to kratom.”

I replied and told her about my experience and also Steve’s addiction and withdrawals. She responded quickly.

“It has stimulation appeal,” James wrote. “Since it is stimulating the same cell receptors opioids stimulate, a person can wean off said opioid a lot easier. [There is] less body discomfort when taking the Kratom tea. Unlike coffee, it doesn't offer the eye popping or shaking hands symptoms. However, it can be noticed when the stimulation is absent. Stimulation can have many feeling an up sensation and improved energy level.  And what goes up, can make you feel down when absent.”

As I write, I haven’t had any kratom in about three days and haven’t had any withdrawals or cravings. And I am happy to report that my coffee tastes like coffee and not like green tea. 

Dispelling misinformation is imperative for James, who said people can’t overdose on kratom and that it has no addictive properties. 

“Kratom does not have any addictive properties,” James said in the email. “However, customers sometimes are aware or reminded that Kratom comes from a coffee family plant.  Many times you will read that Kratom does not offer withdrawals as it is utilizing alkaloids for effect and stimulation.”

She warns people to stay away from certain brands that have been known to use “fillers” in their products. She also recommends not mixing it with energy drinks, and that pregnant women should use extreme caution or not use it at all. Mixing it with other medications is also a concern, because there isn’t enough research, she said.

COMING & GOING CLEAN
When Steve told his wife, who knew very little about the substance, that he was using kratom, he said she was shocked and very disappointed.  

At the time, Steve’s sister was living with him and his wife. His sister, who takes kratom openly, is a recovering opiate addict after being prescribed opiates to deal with her chronic pain from a car accident.

“She takes a lot of it,” Steve said. “She has to know she is addicted.”

Steve’s relationship with kratom is complicated. Although his experience with it wasn’t positive, he admits he would rather see his sister taking kratom than opiates.

“I have seen so much evidence that it gets people off opiates,” he said. “The overdoses I have seen on the internet are when people are taking it with a million things. … I kind of justified it because it is like marijuana. You can almost take an insane amount, and you’re not going to overdose. You might have a bad time. … I would definitely prefer [my sister] to take kratom than opiates.”

He said kratom also helped him and his sister abstain from drinking, but he still has concerns about it.

“There are some benefits,” Steve said. “But one concern I have about kratom is the way that it is sold to people. It should be regulated, because it is so addictive. But I realize with the opiate crisis, it could cause more harm to make it illegal. But who knows what people are mixing it with or cutting it with. All along the chain, from where they’re making it in Asia to selling it in the store. Are they spraying it with nicotine to make it super addictive, or spraying it with a fertilizer? Who knows?”

Steve said today he doesn’t have any fears of going back to kratom, because of how bad the withdrawals were. 

“I am 99 percent sure I won’t take it again,” he said. 

James is adamant about kratom’s benefits and said she enjoys hearing all the success stories that come through her doors.

“[Hearing the success people have with kratom] is very addicting — maybe that isn’t the best word,” she joked. “I think it’s the hugs that are so addicting.”

Porritt hasn’t given James a hug yet but credits her for helping him change his life for the better.

“It has been night and day,” he said. “It is something I would hate to live without, but it is to the point where if I miss it for a day I might feel a little sluggish, but it isn’t anything like the awful withdrawals I had with opiates. … You got to find something that gives you hope again.

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