December 3, 2015
Chronic pain, as most who experience it will tell you, is all-consuming: I know, because I have been in its grip for over 20 years, as a sufferer of endometriosis and Crohn’s Disease. Chronic pain can be so debilitating, it controls your social life, your emotional state, your resiliency, and can even creep into your ability to do your job, whether you do physical labor or a desk job. The sharp, persistent, stabbing sensation is at the forefront of every thought that crosses my mind. What can add to the stress, however, is the judgment cast by the people in your life when they find out that you’re taking painkillers in your desperate quest for relief.
I have always been acutely aware of the stigma surrounding prescription pain medication, the way people who use them are dismissed as “pill poppers.” For me and many others with debilitating pain, taking pills was the only option if I wanted to get through my day “normally”—though my version of normal was somewhat warped at the time. After years of taking the same low dose of Vicodin or Lortab, my body was no longer responding, so my doctor prescribed the lowest dose of Oxycodone for what’s called the “breakthrough pain.”
Co-workers, bosses, and acquaintances noticed a shift in my behavior during this time, and made comments about my detached and spacey behavior, some mistaking this for an “I don’t care” attitude. At the time, I felt that I was fully functional, but after being off of all prescription medication, I can attest that I felt rather numb during the five years I spent taking Oxycodone. There were times when the non-narcotic prescriptions caused worse side effects than the narcotic ones, like prednisone, which wreaked havoc on my body and my mind.
Kelly Devine, a Kentucky resident, is very familiar with side effects of prescription drugs. There was a time she took over ten prescriptions— Oxycontin, Trazadone, Percocet, Prednisone—in an attempt to manage the severe pain caused by chronic fibromyalgia, degenerative disc disorder, spinal stenosis, and carpal tunnel syndrome. But they did little to alleviate the pain that she says made her suicidal—she tried to kill herself five times, she was so desperate for relief. Then a fellow member of a Facebook group for chronic-pain sufferers told Devine about kratom, a leaf that she could consume through tea or a capsule, that could relieve her pain. She was skeptical at first, but she purchased the leaf through an online vendor.
Kratom (Mitragyna Speciosa) is a tropical deciduous and evergreen tree in the Rubiaceae, or coffee family, and has been used for centuries in Southeast Asia, though it didn’t emerge in the U.S. until the 1990s. In the past five years, kratom has significantly increased in popularity—many people claim the plant has literally saved their lives. In its pure form, the leaf has more of a stimulant effect in smaller doses, and a sedative effect in larger quantities. Because there is little documented scientific data, it is difficult to claim how addictive kratom can be, and results can vary.
Kratom allowed Devine to break away from the nasty side effects from the cocktail of medications she was taking, and it did more than help with her physical pain; she finds that kratom helps with her PTSD, depression, and other mood disorders. “I no longer pace the floors; I no longer have rage attacks,” says Devine. “No more crying for no reason, and I am no longer suicidal or cutting myself.”
In fact, Devine is now a kratom activist: She runs an educational Facebook group, United States Kratom United, devoted to informing the general public about the benefits of kratom, and she is an active member of the United Kratom Association.
In 1996, Purdue Pharma released Oxycontin, an opioid analgesic that made the manufacturer 45 million in its first year. The American Society of Addiction Medicine estimates that over 6,600 women died of opioid overdoses in 2010 alone. Kratom helped me deal with the withdrawal symptoms of prescription pain medications and I found it did the same for many people I met both in person and online. I have found kratom, on the other hand, to be no more addictive than coffee—which is to say, the withdrawal is nowhere near as agonizing as that of an empty prescription bottle.
When I moved to South Florida five years ago, I was unaware of “pill mills”—pain-management clinics whose doctors prescribed narcotic pain medication like vitamins. Any “regular” doctor I went to refused to continue my pain-management regimen. They all referred me to pain management clinics. Each clinic I called required an upfront fee of at least $200, a current MRI scan (without a referral, so I would have to pay out-of-pocket), cash payment—and none of them accepted insurance. When I finally did find a doctor who would prescribe me pain medication, he refused the oxycodone, stating that laws had recently changed in Florida regarding certain Schedule 1 narcotics. A year into treatment with his physician’s assistant, I was told that the practice would no longer prescribe any Schedule 1 drugs to anyone, suddenly leaving me with no refills and no recourse. The PA wrote me a referral for an Orthopedic Pain Specialist, who told me that he didn’t understand my conditions and did not know how to treat them.
My situation was not unique: In 2011, Florida housed 856 pill mills, an epidemic that led to thousands of overdose deaths, and landed many people in drug addiction treatment programs. An investigation launched in 2010, “Operation Pill Nation,” and the DEA found patients were being processed quickly without actual medical exams, as well as being made to pay outrageous amounts in cash for their prescriptions. Over the last five years, authorities have shut down most of these clinics, and charged offending doctors for the deaths. Because of this, many Florida residents had to resort to illegal and/or dangerous means to get their medication. I didn’t want to go down that slippery slope, but I was desperate, and I was running out of options.
To my relief, I discovered that kratom was not only legal but a very effective pain reliever. But earlier this year, Rep. Kristin Jacobs (D-Broward) introduced legislation to ban kratom completely. Thousands of members in the kratom community fought back, flooding Jacobs’s office with phone calls, letters, and emails, asking for their stories to be considered before taking the bill further.
Susan Ash, a lobbyist and executive director of the American Kratom Association (AKA), met with Sen. Greg Evers (R-Pensacola) for two hours, where she presented testimonies of how kratom positively changed the lives of 2,000 members of the kratom community. Sen. Evers took what she said into consideration, and altered the bill to request more research be done on kratom. While it seemed like progress was being made in Florida, other states continue efforts to ban kratom. Currently, kratom is legal in 46 of the 50 states.
But bans on kratom like the most recent in Talladega County, Alabama, continue because of claims that unadulterated kratom is as dangerous as synthetic drugs such as bath salts. I roll my eyes when I see headlines like “Kratom—An herbal drug that is trending, deadly and legal in NJ” and “Law, health officials warn about ‘kratom’ craze” because I have been prescribed medications that have put me in much greater danger. I’ve lost jobs, hair, teeth, memories, motor skills—I’ve even wound up in the ER twice because of pills that were given to me by a trusted physician.
In Luanne Wiles’s experience, medications such as oxymorphine and oxycodone were worse than dealing with the pain alone. What made it even more unbearable was the humiliation she faced when, like many of the women interviewed, her doctor accused her of abusing those medications.
“My pain-management doctor outright told me that I was taking the dosage of a cancer patient, and that if I needed a pill to get out of bed, I was an addict,” said Wiles. “He was very cruel, and every appointment left me in tears.”
Christina Karchmar found kratom after a year of untreated excruciating pain from her degenerative disc disease, sciatica, severe nerve damage and other painful conditions. She says that doctors didn’t treat her as a “drug-seeking” patient until she no longer had health insurance. Even when she qualified for Medicaid after a suicide attempt, doctors were cautious with their treatment.
Women report pain more frequently, experience it more intensely and for longer periods of time, but are treated less aggressively, according to a study titled “Chronic Pain in Women: Neglect, Dismissal and Discrimination,” research produced by the campaign to End Chronic Pain in Women, lead by the Chronic Pain Research Alliance. Health-care professionals in this study were more likely to dismiss a woman’s pain as “emotional, psychogenic, hysterical, or over-sensitive.” This assumption is connected to the 50 percent of endometriosis sufferers who have to visit at least five health-care professionals before receiving a diagnosis or referral. Because of this, many women feel uneasy being honest with medical professionals, and wind up buying opiates on the street. What’s worse: Many women are resorting to more dangerous alternatives. In the last decade, heroin use in women has doubled, in many cases because it is cheaper than prescription painkillers.
Faced with over a quarter of a million dollars of medical debt, Melissa Corichi lost her insurance and was finding it difficult to obtain medical treatment for her Crohn’s disease. She discovered kratom, which has alleviated much of Corichi’s severe pain.
“I still struggle to attain proper treatment due to my income level as a student, and the Medicaid gap in Florida,” says Corichi. “I fear that if kratom is outlawed, I may end up unable to continue the lifestyle I have now.”
Addiction-treatment facilities across the country post blogs and make press statements claiming that kratom is highly addictive and comparable to hallucinogenic drugs, though they lack the proof to back up these claims. It stands to reason recovery and drug addiction facilities would oppose kratom, because it has helped hundreds, if not thousands, get off of heroin and opiates. Christopher McCurdy, research and pharmacology professor of the School of Pharmacy University of Mississippi conducted a study that showed kratom was more effective than methadone for treating opiate withdrawal. He also studied kratom samples used by people who wound up in the emergency room, and found that the patients were there for another compound, or that the kratom had been laced with substances like oxycodone.
McCurdy says that further research needs to be conducted to understand the pharmacology, toxicology and abuse potential. “Decisions on kratom should be based on science and currently, there is a strong need for more science to be performed,” says McCurdy. “If the material is placed into Schedule 1, funding for further research will also be more difficult to obtain. It is paramount that we make our drug laws based on solid scientific evidence.”
Facebook groups like United States Kratom United give women like me and those I interviewed the support that allows us to recount our past humiliation and suffering, without fear of judgment. These online groups provide a forum where those who are curious can find information on how to use unadulterated kratom responsibly. At the base of these support systems lies a shared trepidation that kratom will be banned, and all of our success stories will be history, our physical autonomy an illusion once again.