political will – Opiate Nation

KRATOM: Another monkey on your back?

(Translation into most languages at tab to the right.)

It’s a new year around the world. Most developed and industrialized nations have similar hopes and concerns. Yet when one travels outside of the USA, we find some striking differences in how other leading countries in the world govern themselves. This is obvious in one particular area – when it comes to what substances are legal, allowed, or illegal.

Kratom is a good example. It is a Thai traditional medicine. The plant is in the coffee family and when used traditionally – i.e., chewed or dried for tea – it can produce mild stimulant or sedative-like effects. (1) But in the last decade, people driven by greed and profit (it is a billion-dollar industry), have once again figured out how to chemically super-charge the derivatives in Kratom in order to create a market with a highly addictive substance in the guise of a “natural” product sold at convenience stores and gas stations in all but six states in the USA. These concentrated derivatives contain 7-hydroxymitragynine (7-OH), a powerful psychoactive compound that occurs naturally in tiny amounts in kratom. 7-OH affects the same receptors in the brain as morphine and heroin – thus, the same effects that people seek in those drugs. And in these new potencies, kratom has the same strong potential for addiction.

A recent FDA report states that “7-OH is a naturally occurring substance in the kratom plant (Mitragyna speciosa), but only a minor constituent that comprises less than 2% of the total alkaloid content in natural kratom leaves. However, 7-OH demonstrates substantially greater mu-opioid receptor potency than kratom’s primary alkaloid constituent mitragynine, as well as other classical opioids such as morphine.” (2) There are too many articles documenting its opioid-like properties and side effects that I cannot cite them here, but the facts are easy to find, including its addictive qualities and associated deaths. I’ve given links to a few articles that are easy to read at the end of the blog.

Australia criminalized possession, supply, manufacture, production, growth or importation in 2005 and classified it as a Schedule 9 prohibited substance in all states and territories. It cannot be legally sold in health food stores or online in Australia. The only exceptions are for approved medical or scientific research, analytical, teaching, or training purposes, which require specific government authorization and licenses. (3)

What is interesting and frustrating is to see how one country can quicklky and efficiently act in agreement about a public health threat and create legislation that protects its citizens while it also leaves room for ongoing scientific investigation. Think about how many decades it has taken for the USA to come up with a similar approach for cannabis. It is currently illegal under federal law as a Schedule 1 controlled substance, but 40 of our 50 states have legalized it for medical use and 24 for recreational use. Schedule 1 classification places it alongside drugs like heroin and LSD. It can be scientifically studied legally, but there are complex federal regulations that require approval from the DEA (Drug Enforcement Agency) and the FDA. We just can’t seem to get our congress to simply function like other countries in a timely manner.

Kratom is a perfect example. In 2016 the DEA intended to put 7-OH into the Schedule 1 category, which would have banned it. But there was pushback from the public and congress who argued that it had potential for chronic pain relief or even opioid withdrawal. So why couldn’t we make it illegal or at least regulate it while also allowing for scientific research? Why?

In the meantime, young people and adults who listen to friends or influencers are being lured once again into experimenting with something that will sooner or later prove to be a monkey on their back. If there are young people in your life who are curious about any substance, take the time to do the homework and discuss the facts with them. And if you see “Natural” or “Organic” Kratom being sold at your local gas station or convenience store, let the owners know you will not be shopping there until they remove these addictive products from their shelves.

NOTE: Thank you to Dr. Bayo Curry-Winchell for her very informative article (5)

1. Not all kratom is equal: The important distinction between native leaf and extract products (2023)
https://onlinelibrary.wiley.com/doi/10.1111/add.16366
2. https://www.fda.gov/media/187899/download#:~:text=In%20vitro%20studies%20reveal%207,fentanyl%2C%20oxycodone%2C%20and%20hydrocodone.
3. Australian drug laws
https://www.lexology.com/library/detail.aspx?g=db6f3ba8-a2c5-4fb2-89b8-ab93d1b09b23
4. Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries (2015)
https://onlinelibrary.wiley.com/doi/10.1155/2015/968786
5. The Legal Drug That Could Fuel the Next Addiction Epidemic
A dangerous substance masked as “natural” is lurking on convenience store shelves. (2025)
https://katiecouric.com/health/wellness/is-kratom-dangerous-addiction-overdose/

HEALTHCARE – Privilege or Basic Need?

(Translation into most languages at tab to right)

If access to health care is considered a human right, who is considered human enough to have that right?

I critique market-based medicine not because I haven’t seen its heights but because I’ve seen its depths.

~Paul Farmer, M.D., Ph.D. (1)

In sorting through bins of old notes and letters, I knew one bin in particular would bring up painful memories. It was our son, JL’s. It was difficult, as I had imagined. And one of the – no, THE – most painful reminder related to his death from an overdose. It was the fact that we played a role in his preventable death. And so does the American capitalistic healthcare debacle.

The previous New Year’s eve, he was with two of his friends who overdosed and one died. It shook him to his core and he came to us and asked for help. We went together to his addiction doctor and after separate sessions, we then talked together. His doctor said: “This young man cannot start using again because if he does, he will die.” This came from his years of experience working with young people who had been inadverntently caught up in the opioid epidemic of the 2000’s. He felt JL would need to be on Suboxone for a long period of time and maybe for the rest of his life.

JL was hesitant because he had been on Suboxone years ago when it was very expensive and being prescribed at 32 mg a day – a huge amount that left patients feeling like they were drugged. And the worse part was trying to get off it. Tapering off was extremely difficult and took forever – like extended withdrawals.

Aside from the physical hurdles was the cost. It was very expensive and, guess what? It was, of course, not covered by our private health insurance (which cost us almost $1000/mo as self-employed workers) because addiction was not considered a healthcare issue. As a matter of fact, if a person said they had an illegal drug addiction, they would likely be dropped from health insurance coverage and be reported to the police.

What is so painful for us now is that we made the decision that January to drop JL from our costly policy and to not cover his getting Suboxone due to the expenses (it would have been hundreds of dollars a month for the Rx). And in the mistaken belief that he just needed to try harder. We thought this would force him to stay clean – good old fashioned will power and hard work. He did go into a detox program for a month and then into a great sober living program where he did so well we thought we had turned the corner in his 10-year struggle with opioid addiction (which had started when he was 14 and experimenting with Oxy’s).

What we didn’t understand at that time was that opioid addiction is not overcome by willpower. The result was after 6 months, he finally had impacted wisdom teeth surgery and weeks of opioid pain meds – because we thought there was no other option and we thought he could handle it. Within 3 weeks he began using heroin again and after a few days, overdosed and died. August 2, 2014.

What our family did not have as an option was what was finally put into law in 2014: The Affordable Care Act (ACA). This law mandates that all new individual and small-group plans cover substance use disorder (SUD) treatment as one of the ten essential health benefits. It also prevents insurers from denying coverage or charging more because of a pre-existing condition, including addiction.

Sadly, there are politicians who want to revoke the ACA or limit much of its coverage. As the supposed leading nation in the developed world, we are the only one without universal health care for every person from cradle to grave. All of our peer nations have it. Some systems work better than others. Regardless, health care is not seen as an option or a privilege for those who can afford it. It is considered part of a healthy and egalitarian society.

But in order for our government to save money (since our elected officials don’t want to tax millionaires and billionaires equitably), there have been significant cuts to Medicaid and SNAP and changes to the Affordable Care Act (ACA), that are projected to increase costs and reduce coverage for millions. There are too many details to go into here, but the bottom line to me is this:

Why are we even debating how much coverage these programs and health insurance companies offer when we should be pressing for complete health care coverage for all Americans – especially for the least of us who can barely afford food?

If we consider ourselves a nation built on Judeo-Christian principles, how can we not believe that as a society it is our responsibility to care for the sick – as people of faith have always done?

If how we viewed health care changed – as a basic need instead of a privilege – then the necessary changes to our taxing structure and health insurance would change. Where there is a will, there is a way.

Dr. Paul Farmer. https://www.pih.org/paul

If my son were alive today during the Covid-19 pandemic…..

I would fear for his life more than ever.

“Drug Overdoses Soaring: Suspected overdoses nationally jumped 18% in March, 29% in April, 42% in May, data from ambulance teams, hospitals, and police shows.”

As a young man in America who wanted more than anything to be free of his deadly heroin addiction, how would he be weathering the Covid-19 pandemic?

“The drug-overdose-and-death epidemic already was hurting communities before COVID-19, but during the pandemic there have been reports from every region of the country on spikes in opioid-related calls to first responders, visits to emergency rooms, fentanyl and tainted-drug-related overdoses. There also have been challenges to accessing sterile needle and syringe and exchange services.”