Thursday, March 11, 2021

Cost Benefit Analysis of Kratom

 As a Vendor of something potentially addictive, I constantly have this inner dialogue / debate about whether I am adequately informing people about the dangers of Kratom. I'm perpetually paranoid about getting people addicted because they were ignorant or misinformed. Let's take a look at the potential costs and the potential benefits, so that we can all do our own analysis before making such an important decision. As long as we are making a well informed decision, I am confident that we will make the correct one. 

Understanding the plant is necessary in order to maximize the utility of this plant and avoid some of the pitfalls of addiction/abuse. This is partly why I'm so obsessed with uncovering the science that sometimes gets buried in the hype. There is undoubtedly a ton of misinformation in this industry, along with America in general. It appears to be a current trend for whatever reason. It's obviously incumbent on the individual to decide whether something is believable or not. In my mind, only the principles that can't be backed by evidence or theory should be shared. Anecdotal accounts can't really show more than a possible correlation between variables. But, sometimes that's good enough. it depends on the context. 

 There is an entire subreddit of angry people who say that Kratom ruined their lives and is 20K members deep. The subreddit r/kratom is 100k members. A recent survey showed that 20% of users in the US are addicted, vs 10% indigenously. A distinction should be made between addiction and physical dependency. Dependence is use to a point where it becomes necessary to use to avoid withdrawal or rebound. Addiction is use despite negative consequences, psychological and/or physical. 

How negative do they have to be to count? 

I personally think that if you're stressed about your use, that's enough. Even if you're only slightly stressed, I feel like that is addiction. If, on the other hand, you are not concerned with the fact that you cannot control your use, then I feel like it won't be an issue, unless of course there is some other negative consequence that outweighs the potential (physiological) benefit. So, only when costs outweigh the benefits, will there be negative consequences from it's use as a med: a net effect Just the fact that you are not in full control of your use is not enough to be considered addiction by my definition. This is not the prevailing definition of addiction in the recovery community, however. Dependence of any kind to any substance (not considered medicine) is considered addiction by the self help community (somehow not cigarettes or caffeine though), but not without dissonance. Replacement therapy like with suboxone is considered ok, but for some reason, in many circles, Kratom use is not. The main issue is that the FDA has not approved kratom for anything, not even as a dietary supplement. The entire medical community revolves around the FDA, unfortunately, who is excessively anti-kratom. They are so anti that they have been caught spreading propaganda falsehoods on numerous occasions, diminishing their credibility as a public health agency. So much of the politics has to do with the misunderstandings and the stigmas associated with an incredibly medicinal plant. Just the idea that there are scientists on the other side that want this banned makes me quiver. 

Because of the potency and possible addictive nature of the compound 7ohm, one must use cost benefit analysis when determining whether to use it. Unfortunately, all Opioid medications are going to have tradeoffs. The FDA approves medications that kill people for a reason. This is because the diseases that they treat most certainly will, or have worse consequences. The use of cost benefit analysis is the cornerstone of modern western medicine. Some people will say that the negative side is not negative enough for addiction to be considered a legitimate concern with this as a medication. The main reasons are the clear cut ceiling effect and the lack of beta arrestin. 

Although 7ohm is a G Protein signaled pathway to the MOR, there is addiction potential, tolerance, and respiratory depression at the level a fraction of opiates. Regardless, it needs to be respected as a powerful opioid. Responsible use, whether recreational or medicinal is what will ensure that the plant remains legal. There is a woman arguing that kratom withdrawal is what made here son commit suicide, although there is little evidence. Arguably, there could be deficit of neurotransmitters during rebound, causing instability. It would be hard to tell if that is ultimately what caused it. Being well informed on what it does and how to use it is essential, I feel. So, let's identify what they are, and calculate the probability they will occur. This way we can all make an informed decision on how to use this substance. 

Although it has been used for hundreds of years by indigenous people, it has not been studied extensively by science until just recently. So, while there is historical basis, there is not that much in the way of scholarly studies. These are historically based, or documented by science. 

Costs: 

Addiction (Compuslive Redosing) 

Dependence / Withdrawal Syndrome 

Hepatic Face (Dark Spots, Not reported by Americans) 

Hair Loss/Thinning (Not reported by Asian users) 

GI Irritation (Acidity) 

 Excessive Sweating 

 Constipation 


 Benefits: 

Addiction Treatment (New evidence shows efficacy with cigarette cessation, and alcoholism.)

 Antidepressant effects (Serotonin) 

Anxiolytic (Dopamine) 

 Reduced Stress Response (Reduced Cortisol in Rats) 

Antipsychotic (Showed Improvement in Dissociation, Alzheimer's potential?) 

Stimulating (Adenosine) 

Adrenergic (Addiction) 

Analgesia Muscle Relaxer 

Anti-inflammatory (Mitraphyline) 

Hypothalamus Regulator (Appetite Suppressor) 

Lower Blood Pressure (Raise or Lower) 

Lower Blood Sugar (A1C) 

Antiviral 

Antiparasitic 

Antidiarrhetic 

Diarrhetic (Cost or Benefit) 

High Cholesterol (Not much evidence exists for kratom per se, but anecdotally as opiates in general have a tendency to do this, there is a recent study of 100 kratom users who showed lower cholesterol) 


Please add to the list as you see fit when doing your own analysis. 


Keep in mind, that heart disease is the number one cause of death (650k) in this country, 1 in 10 people have diabetes, there were 70k opioid overdose deaths last year, 95k alcohol related deaths. 10% of worldwide disability claims are from depression. That's a lot of benefit to weigh against costs. I imagine the cost benefit curve is going to be a little different depending on the reason you're using Kratom. 

I would argue that medicinally speaking, overall, the benefits far outweigh the costs. However, it will be different for every individual as the potential cost of addiction will be different based on your personality, along with the potential benefit of why you use it. Only you can calculate what the probability and cost of your getting addicted to anything is. 

Used responsibly, this plant has very little downside, as far as the evidence suggests. It has a built-in, self-regulating function that makes it harder to abuse than a typical psychoactive compound. The danger of compulsive redosing is somewhat diminished because of wobbles. You can only take so much before it shuts down on you. Evidence shows that higher doses (irresponsible use if you will) actually prevent addiction, tolerance, and withdrawal to 7ohm. 

Up until recently, how Kratom works has been a bit of a mystery. However, now, the cost benefit is clear. Kratom is the cure to our global opioid crisis and then some. It could mean a healthier future for the world if used correctly and responsibly. Hopefully, we will go down as the generation who paved the way for this to become ubiquitous in American Culture. 

Be informed. Spread the Word. The future is Kratom. Did this just turn into a pharmaceutical commercial? Your chance to live longer? One could almost argue that you're better off, health wise, being a kratom user (if you're savvy enough to know about it).

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