However, compared to the harm caused by illicit opioids (or even prescription opioids) doesn’t this seem like a low priority?

So someone is spending $100 or $200 per month on their kratom. They aren’t committing crimes to pay for it, they aren’t overdosing and dying in the street and they aren’t getting diseases by sharing needles.

It doesn’t seem like a major health cocern.

Kind of like tobacco without the second hand smoke or lung cancer. Sure it would be better if people didn’t do it, but that’s true of a lot of things.

However it is true that drugs like heroin (when pure) are quite safe overall - aside from the respiratory depresssion overdose scenario.

I haven't checked their sources, though.

In general taking excessive amounts triggers vomiting, similar to when you eat too many psilocybin mushrooms (well, some say it’s ideal to vomit shroom-wise, but I’m not a fan). So mitragyna speciosa is incredibly safe.

Unfortunately Wikipedia’s treatment of the topic could be improved, but there is very little existing literature out there. I read one review study I was pretty happy with but I’m not on a laptop so i can’t go dig up the link unfortunately

They spend billions on developing and promoting these, and they can't figure out the side effects for a specific drug? Maybe they should spend just a little bit more.

Interestingly, it has a mix of opioid antagonists and agonists. I’m not sure if that specifically is why tolerance doesn’t build aggressively, or if it’s some other MoA like nmda receptor antagonism

We see huge harm from legal opioids which are widely mis-prescribed. They cause addiction and fail to treat the pain for which they are prescribed.

So I’d be careful with “only $x a month” as an argument.

Anyway if it is addictive it’s hard to imagine it being more addictive than oxycodone and that is totally legal and aggressively pushed by companies that know exactly how addictive it is, so mostly this goes back to the standard government motto of only making drugs legal if large companies can make a huge profit off it. Anything that can be easily grown by average consumers (like weed) doesn’t meet that requirement and so tends to be illegal.

I was dependent on both for about 12 months just to function (without them I had a hard time getting out of bed or anything done). But the combo helped to finally get regular exercise, which helped with sleep, which helped me to heal.

The caffeine was _much_ harder to kick than the kratom. A full week of headaches and fatigue due to caffeine withdrawal.

When people talk of kratom being bad because it produces dependency, why don’t they talk of caffeine in the same way? What real negative effects does the kratom have if used long term? My experience says there is none. And all this handwringing is simply due to lack of familiarity.

So yeah, two freaking massive 20oz pours of highly caffeinated coffee will get you to around 1 gram.

But FWIW the daily recommended dose is 400mg. 1g is a ton of caffeine and way beyond what you would get to by sipping on coffee throughout the day (it's 10+ cups of drip).

I cannot find where the number originates, but there is at least one study @ https://www.sciencedirect.com/science/article/pii/S027869151... which explicitly claims "vidence supported consumption of ≤400 mg/day in adults is not associated with overt, adverse effects."

[1] Counter-intuitive I know, but it seems to help - it makes the intrusive thoughts easier to ignore

It's similar to vaping or nicotine gum in that respect.

The MAOI theory is interesting, there are a lot of alkaloids in tobacco. Apparently nicotine uptake across alveoli membranes is very pH dependent - the ionic form won't cross the barrier. Cigarette smoke is cured at a high temp and has a low pH, pipe tobacco is cured at room temp and has a high pH. [0]

It seems that cigarettes are processed to specifically give a minimal dose per volume inhaled that quickly delivers nicotine as a way to maximize reinforcement behavior. I would be interesting to test the pH of commercial vaporization solutions.

[0]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953858/

Just because something is dependence inducing doesn't mean it should be ever illegal.

If Kratom addicts start robbing convenience stores and offering blowies for Kratom cash i'll believe it.

I don't mean this in an offensive way, but that's just because you're ignorant of the effects.

I suffer from chronic pain and use opioids every waking moment, but they do not impair my ability to drive safely.

Of course "being on opioids" isn't a binary thing; my medicinal dose is very different from a recreational one.

Is there any reason you personally feel that way or is it more of "opioids are strong and dangerous so I figure people driving on them is dangerous"?

A few years ago the UK revised their regulations regarding driving while using prescribed opioids, taking an approach that essentially allows the driver to decide if they are too impaired to drive.

https://www.ncbi.nlm.nih.gov/pubmed/14650448

This has very little to do with the properties of a drug itself, and more to do with the demographics (poverty, unemployment, overall disenfranchisement, environmental factors like urban density and access to services) of people who use other drugs; specically, that usage of these substances often correlates with such disenfranchisement.

In other words, the people currently using Kratom may not be the same people using other drugs, and their circumstances may be different.

(Not a comment on Kratom, which I don't know much about, besides its popularity in some websites)

Xanax is a benzo and is addictive, but Prozac is an SSRI. SSRIs are not addictive, and aren't even interesting recreationally because they don't make you feel anything good.

And are distinctly unpleasant at higher doses.

They can be addictive though: https://en.wikipedia.org/wiki/Antidepressant_discontinuation... (at least in that they can cause withdrawal when stopped).

At small doses Kratom is somewhat of a stimulant. 6-10G is where opiate effects start kicking in, so I'd say doing 6-10G is perfectly normal for Kratom usage.

Is it worse than coffee?

Furthermore, some drugs such as khat, betel nut, or coca are mildly stimulating and used heavily in certain cultures throughout the world.

[1] https://en.wikipedia.org/wiki/Mitragyna_speciosa#Regulation

> So because some people are idiots others should have to suffer?

It degrades discussion and encourages worse from others. And since it was obviously not what the commenter was saying, it breaks the guideline which asks you to respond to charitable interpretations, not weak ones: https://news.ycombinator.com/newsguidelines.html.

Also, you've gotten into flamewars about drugs on HN before, and we had to ask you to stop. I get that you have reason to feel strongly about this topic, but that doesn't make it ok to bring sharp elbows into the conversations. If you can't be respectful, including to people who seem completely wrong, then please don't post.

In a similar vein, the generic drug tianeptine, prescribed for over 30 years in other countries for depression & anxiety, is now a schedule 2 controlled substance in Michigan (https://www.usnews.com/news/best-states/michigan/articles/20...), one of the major base states for the Johnson & Johnson corp, which studied the substance (https://adisinsight.springer.com/drugs/800039841) entering clinical trails for release here, but was dropped with no reasoning. Before some talking-head chimes in that tianeptine is a μ-opioid receptor, read the atypical part and addiction data in countries where it has been prescribed widely. It is the only drug which effectively treats my depression and anxiety, it is generic so large drug companies cannot make an exorbitant profit off of it, and they are keeping it from the US through media scare-tactics, like Kratom, to ensure their profitability and the reception of their patented drugs like https://en.wikipedia.org/wiki/Esketamine. We should stop them.

If only tianeptine could be made available in the correct (12.5mg) doses, prescribed by a doctor, maybe I could use it. But as it stands, buying powder by the gram would lead to my demise.

Consuming plant matter directly with minimal processing is quite a different thing from isolating the active ingredients as much as possible, creating dosages much higher than found in nature and simultaneously removing buffering material such as fiber and other nutrients.

I’m not quite sure it’s fair to lump all those drugs under addictive... Xanax is a benzodiazepine, but Prozac is an SSRI. Both can cause withdrawal symptoms if you stop too quickly, but neither are really classified as addictive.

Some of these drugs also profoundly impact people’s lives for the positive as well as actually save lives from severe depression. The constant idea that these drugs are somehow dangerous does much more harm than good to those who need it.

For some reason people have no issue with drugs like Nexium for heartburn (which can also cause dependence) but if it’s a drug that effects your brain... it’s labeled as evil.

And to clarify, addictive substances are not defined simply as something that causes withdrawal. Lots of things cause withdrawal... Tylenol can cause rebound headaches, heartburn medicine can cause intensified heartburn, etc. True addictives on the other hand also cause reward and reinforcement behavior. The strong reward stimulus effects molecular transcription factors that result in reinforcement behavior, which drives the addiction (not fear of withdrawal)

https://en.m.wikipedia.org/wiki/Addiction#Mechanisms

https://en.m.wikipedia.org/wiki/Benzodiazepine_dependence

If you read the whole page, it goes into more detail:

“Addiction, or what is sometimes referred to as psychological dependence, includes people misusing or craving the drug not to relieve withdrawal symptoms, but to experience its euphoric or intoxicating effects.”

Also if you read the link on addiction you’ll note that benzos are not listed as drugs that elicits true addictive behavior.

Can you become dependent on benzos... yes that’s possible. But people typically don’t seek out ever increasing doses to get high, which is an important distinction. And people who abuse them are often self medicating due to untreated anxiety disorders rather than to party or get high.

Stigmatizing medicine like SSRI and Benzodiazepines as addictive like opiates is misleading and harmful.

Benzodiazepines, if used under a doctors supervision and for limited duration, almost never cause dependence. Opiates on the other hand, even short term doses, can lead some individuals to become quickly addicted and start drug seeking behavior.

Doesn’t mean benzos are totally safe all the time, but it’s just not fair to compare it to opiates or Kratom.

For persons scanning the conversation and absorbing the ambient folk opinions here on various substances — it is crucial to know that benzos are in fact very treacherous. You can die from them, they are highly abused, and they have a big tolerance effect as well as interactions (esp w alcohol) that can get folks in big distress or danger.

This is perhaps a more critical review, but still specifies the difference between physical and psychological dependence.

https://pro.psychcentral.com/benzodiazepines-are-bad-or-are-...