Considering Kratom as an Alternative to Opioids for Cancer-Related Pain

Kratom Researcher at work

Kratom is a far more obscure plant than cannabis, but it is similar to the better-known botanical in many ways. Particularly when viewed as a potential therapy for the symptoms of cancer and the side effects of treatment.

Kratom and Cannabis Similarities

  • both originated in Asia
  • has been used there for both medical and recreational purposes
  • both plants contain so many active ingredients that researchers struggle to identify all their bodily effects
  • according to users and some scientists, both are a safer way to treat pain than opioids
  • passionate users who herald its medicinal powers
  • govern­ment regulators who claim the plant is medically useless
  • unregulated dealers whose products don’t always come as advertised
  • both plants have yet to undergo the sort of rigorous trials that would allow for definitive assertions about the risks and benefits of using them during cancer treatment.

“Kratom advocates are vocally enthusiastic about what they perceive as its ability to ease pain, boost mood and, especially, reduce opioid dependence. That noted, there isn’t much research to support any of those claims, and there’s growing evidence that kratom use poses significant dangers,” says Megan Rech, Pharm.D, a clinical pharma­cist in the emergency medicine department at Loyola University Medical Center in Chicago.

Kratom is related to the coffee plant, and, after ingesting a couple of grams, produces a mild buzz and stimulant effect. In higher doses, however, kratom exerts a depressant effect: Muscles relax, and heartbeat and respiration slow.

This depressant effect, which tends to kick in when users consume 5 grams or so, is said by kratom enthusiasts to reduce anxiety and pain and improve sleep. Researchers have yet to verify these claims, but findings have shown that kratom bonds to opioid receptors in the body, so it could have similar effects.

The advocacy of passionate fans has led to an exponen­tial growth in kratom use. What was once a very obscure substance in the U.S. has, according to one researcher’s estimates, attracted up to 5 million active users.

The combination of opioidlike effects and surging popu­larity has concerned regulators in Washington. The FDA banned kratom imports, and the DEA announced in 2016 that it would temporarily add kratom to its list of schedule 1 drugs — those that are illegal because of high potential for abuse but no recognized medical uses.

Backlash from passionate users and a few members of Congress prevented the DEA from criminalizing kratom, however, so it is still legal to purchase without any sort of prescription, except in six states and a number of cities that have passed their own bans.

The FDA has linked kratom use to 44 deaths, although nearly all the victims had other drugs in their systems when they died. Regulators say this proves kratom is dangerous. Kratom advocates say it proves that the drug is a wildly safer alternative to opioids, which killed more than 47,000 Americans in 2017 alone.

“(Although) some may feel that kratom is less dangerous than opioids, it’s an unproven, unregulated and potentially dangerous way to treat opioid addiction. Until we know more, patients would likely be better off using treatments like methadone or buprenorphine/naloxone that we know to be safe and effective if used appropriately,” Rech says. “As for treating pain safely, I’d love to see more research on kratom, cannabidiol and any other substance that looks promising, because we clearly need safer alternatives to prescription opioids and new medication-assisted treatments for opioid dependence. But the research just isn’t there yet.”

Original Author: Andrew

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