CLAIM: KRATOM IS ADDICTIVE
The most commonly used argument against certain plant medicines being used to treat chronic pain in recovery is that they are “addictive,” or have a “high potential for abuse.”
This argument is based on a misunderstanding of addiction itself.
The first misunderstanding lies in the confusion many laypersons have about the difference between addiction and dependence.
ADDICTION VS. PHYSICAL DEPENDENCE
In short a physical dependence to opioids means that the body relies on a external source of opioids to prevent withdrawal. Physical dependence is predictable, easily managed with medication, and is ultimately resolved with a slow taper off of the opioid.
Normally, the body is able to produce enough endogenous opioids (example: endorphins) to prevent withdrawal. But as tolerance increases, eventually the body’s ability to maintain this equilibrium is exceeded and the body becomes dependent on that external source.
Many substances – such as caffeine, nicotine, sugar, anti-depressants, to name a few – can cause physical dependence, it is not a property unique to opioids. Physical dependence to opioids is normal and expected and a distraction from the real problem, addiction.
Physical dependence is sometimes simply called dependence, but this can lead to confusion because addiction is sometimes called dependence as well.
Unlike physical dependence addiction is abnormal and classified as a disease.
Addiction is a primary condition manifesting as uncontrollable cravings, inability to control drug use, compulsive drug use, and use despite doing harm to oneself or others.
Uncontrollable cravings prompt the destructive behaviors of addiction. There is no addiction without cravings.
Strong cravings are common to all addictions. These cravings are rooted in altered brain biology. Recovery is the process of reversing, to the extent possible, these brain changes. This is accomplished through therapy and replacing the addictive behaviors with healthy alternative behaviors.
Addiction is sometimes called; opioid dependence, substance dependence, and most recently opioid use disorder, but still too often simply dependence, which leads to confusion.
Anything can be addicting. A deck of cards is only “addicting” to a gambler. A Budweiser is only addictive to an alcoholic. And we don’t blame Budweiser when someone becomes alcoholic. We instinctively know that when people abuse alcohol they are doing it to suppress some type of emotional or perhaps even physical pain or trauma. We tell them to get help for the thing that led them to drink in the first place- in other words, we ask them to get to the root cause.
And yet for some reason our society doesn’t use this same reasoning when it comes to substances.
One of the problems with taking opioid medication for chronic pain is the possibility of overdose. However, most overdoses occur as a result of combining opioids with alcohol, sedatives or benzodiazapines.
Now, people suffering from chronic pain cannot be expected to give up and not function. Chronic pain patients want to live their lives to the fullest just like everyone else. So, what do they do?
KRATOM HAS BEEN USED IN TRADITIONAL SOCIETIES FOR HUNDREDS OF YEARS
In fact, kratom has an amazing safety profile:
Direct kratom overdoses from the life threatening respiratory depression that usually occurs with opioid overdoses have not been reported.
– Oliver Grundmann, Clinical Associate Professor of Medicinal Chemistry University of Florida