Kratom debate reaches new level

TUPPER LAKE — The release of a coroner’s report on the death of Tupper Lake police Sgt. Matthew Dana has been met with controversy surrounding kratom, the plant cited as the cause of death.

Kratom, known scientifically as Mitragyna speciosa, is a southeast Asian plant traditionally used for pain relief or to stimulate energy, which is now utilized for bodybuilding, recreational highs and easing withdrawal from heroin or prescription medication. The plant has opioid-like effects of euphoria and pain relief, and is currently unregulated. Although some countries — and six states — have banned kratom, it remains legal in New York.

Since August 2016, the plant has sat in an uncertain place. The federal Drug Enforcement Administration announced last fall it would classify it as a Schedule 1 illegal drug, alongside heroin, LSD and cocaine, but then sidelined that plan.

Hundreds of kratom supporters from around the U.S. posted comments Tuesday on the Enterprise story about Dana’s reported cause of death. They rejected Franklin County Coroner Shawn Stuart’s ruling that Dana had died of a kratom overdose. Many said it is impossible to overdose on kratom and that vomiting would occur before an overdose.

The Enterprise’s report on Dana’s reported cause of death went viral Tuesday on a Reddit page on kratom. A link to the news, headlined “We need to investigate the reported kratom overdose of police sergeant,” was the top post on the kratom subreddit Tuesday and this morning, and there were three other posts regarding Dana’s cause of death.

The DEA reported last year that it is aware of 15 kratom-related deaths in the U.S. between 2014 and 2016. All of those deaths involved other factors, and most involved other drugs. However, Dana’s toxicology screening did not find any type of narcotic or opioid in its month-long investigation, according to Stuart. Therefore, this may be the first time an overdose death has been attributed to kratom alone.

Stuart said Dana’s blood contained an extremely high concentration of kratom, five times that found in other kratom-related deaths.

The coroner’s report contradicts the belief of many kratom supporters that the plant does not pose a health risk.

The Enterprise also received emails, calls and Facebook messages from fathers, veterans and businesspeople who are daily users of kratom and say they live peaceful, less painful lives because of it.

“Many people, including myself, have had extreme success by utilizing this plant to overcome mental and physical health hurdles,” David of Wichita, Kansas, wrote in an email.

Army veteran Steve Pechacek of Gent, New York, recently finished 44 surgeries reconstructing his legs after he was injured in Korea in the 1980s.

“I wanted to get off all the medications because taking morphine and everything else. … It was killing me,” Pechacek said. “So I used kratom to actually get off of the narcotics.”

He said this experience of stopping the medications cold turkey worked better than the last time when he was house-bound and vomiting on a daily basis for a month while going through morphine withdrawal.

Kratom is not an opiate. Its active ingredient, mitragynine, binds to delta opioid receptors, whereas heroin or prescription medications bind to mu opioid receptors.

Kratom can still develop a mild dependence in long-term users. Large doses are also not healthy, according to the U.S. Centers for Disease Controll’s study of calls to poison centers with reports of exposure to kratom from 2010 through 2015. Though 24.5 percent had minimal symptoms and 41.7 percent received mild treatment, 7.4 percent showed what was classified as life-threatening signs, including vomiting and rapidly increased heart rate.

“The jury is still out on it,” Stuart said. “One of the problems with kratom is it hasn’t been studied and it’s unregulated.”

A lack of regulation can mean that untested or store-bought kratom can be a blend of several drugs. A team of Swedish forensic physicians reported in 2010 that the brand Krypton killed nine people in one year because it had been mixed with the mu opioid O-desmethyltramadol.

The U.S. Food and Drug Administration has warned the public not to use any products labeled as containing kratom, due to concerns about toxicity and potential health impacts.

“As our Nation struggles with epidemic levels of opioid abuse, we should be doing everything possible to ensure that those suffering with addiction have access to FDA-approved medicines and appropriate treatment options; not unregulated substances bought and sold over the Internet,” DEA spokeswoman Katherine Pfaff said.

In October 2016, the DEA withdrew its notice of intent to allow for a scientific and medical evaluation of kratom by the FDA to be expedited, following a period of public comment, according to Pfaff. When the open comment period ended in December, 23,000 comments were added to the permanent record. The FDA is currently mid-evaluation with no time frame established to complete the analysis.

Faced with accusations from internet commenters that he is incompetent or took bribes from pharmaceutical corporations, Stuart defends his report linking Dana’s death to kratom.

The substance was found at the scene and was the only thing to be revealed by a toxicology report which also searched for narcotics and prescription medication. With unusually high levels of kratom discovered in toxicology and blood in the lungs ruled as the cause of death, Stuart said he filed his report as accurately as possible.

“I don’t know why there’s questions about the report,” Stuart said. “No one is paying me, and no one is paying you [the Enterprise].”

For now, Kratom is on import alert, meaning it will be detained if found passing through international mail facilities.

When Stuart’s full written report is finished, he said it will be available for the public to read.