- Published
Jeffrey Deaver, a 58-year-old retired timber cutter in the state of Washington, has taken kratom for four years to help with severe chronic hip and knee pain.
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Deaver → publish → pain
He discovered the herbal product when he couldn't find relief from doctors and while waiting for surgeries.
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he → discover → surgeries
Scared at first, he "started small", but then took more until his pain went away.
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pain → start → more
"It was like a miracle," Deaver said.
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Deaver → say → miracle
"I could sleep.
uncertain
I → sleep → ?
I could function.
uncertain
I → function → ?
"I just don't know what I'd do without it."
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I → know → it
Kratom - an herb with opioid-like effects - has grown in popularity in the US over the last decade, and is typically purchased over-the-counter and consumed in pill or liquid form.
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Kratom → grow → form
This week, investigators found packaged kratom in the possession of two deceased University of Mississippi students.
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investigators → find → students
Although their deaths were not attributed to kratom, officials are now issuing warnings about its consumption.
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officials → attribute → consumption
For years, anti-kratom advocates have pushed for bans, and in some countries, like the UK, it's illegal.
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it → push → UK
But Kratom is not regulated by the US Food and Drug Administration and is legal in some states, including Mississippi.
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Kratom → regulate → Mississippi
Here's what we know about it:
What is kratom?
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kratom → know → it
It's been used for centuries for its stimulant properties, grounded and consumed similar to tea.
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It → use → tea
As its popularity spread around the globe, it entered the US market as a supplement around 2016.
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it → spread → 2016
"That's really where the problems began," said Dr Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University.
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Speights → begin → University
In the US kratom is mostly sold in highly concentrated forms either via pill, powder or liquid, Speights said.
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Speights → sell → pill
It's also widely available - found everywhere from convenience stores and petrol stations to vape shops.
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It → find → shops
Also, because of the supplement classification, kratom products are not federally regulated.
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products → regulate → classification
"There's no way to know exactly what you're getting," Speight said.
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Speight → be → what
"You could go and create something in your basement, market it as a supplement, and nobody's really going to check and see what's in it.
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what → go → it
What is kratom used for?
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kratom → use → What
Kratom is often marketed as a safe, natural herbal supplement that helps with pain management, anxiety and depression.
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that → market → management
In lower doses, its stimulant properties create a "caffeine-kind of buzz", Speights explained.
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Speights → create → buzz
Because of its opioid-like effects, it has also been used with the goal of curbing addictions to actual opioids like fentanyl.
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it → use → fentanyl
Those properties stem from the way the plant's compounds - like 7-Hydroxymitragynine - activate various hormones, including dopamine.
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compounds → stem → dopamine
"It's almost like taking a narcotic," Speights said.
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Speights → take → narcotic
"At higher doses, it can create more euphoria and give you more of a general high."
Hallucinations are possible, too.
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Hallucinations → create → high
The higher doses also pose greater risk for adverse side effects.
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doses → pose → effects
That includes central nervous system (CNS) depression - which is "where the deaths come in," Speights said.
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Speights → include → depression
CNS can result in cardiovascular collapse and loss of breathing.
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CNS → result → breathing
Withdrawal symptoms and addiction are also risks, said Jana Wu, director of clinical integration at the addiction treatment centre Mountainside.
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Wu → say → centre
"It affects marriages, relationships," she said.
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she → affect → marriages
"I've seen people lose jobs, spend thousands of dollars a month on it.
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people → see → it
"
Because it's easy to develop a high tolerance to the herb, users may need to take an increasing amount to achieve the same effect over time.
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users → develop → time
"I've worked with people that were taking like up to 20 pills a day," Wu said.
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Wu → work → pills
Experts told the BBC that the biggest dangers come from the fact that kratom is not federally regulated.
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kratom → tell → fact
"Is there a safe dose?" Speights said.
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Speights → say → ?
"My answer is going to be no because - I'm going to go back to this - we don't know what's in it.
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what → go → it
Kratom is banned in 11 states: Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Massachusetts, North Dakota, Tennessee, Vermont and Wisconsin.
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Kratom → ban → states
…and 7 more, not listed.
The Aporia
