Dr. Oliver Grunman
speaker
33 appearances
1 recordings
1 series
first heard Oct 2024
last heard Oct 2024
Dr. Oliver Grunman’s voice in public audio — every appearance, attributed to the second.
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Sure. Yes. Hello. My name is Oliver Gruntman. I'm a clinical professor and assistant dean at the College of Pharmacy, University of Florida.
Yeah, some call it kratom, others call it kratom. What do you say? I say kratom because in its native Southeast Asia, it's called kratom. So they put the emphasis on the last syllable. And I've studied it since 2016.
So Kratom is both the name of a tree that grows natively in Southeast Asia, in Malaysia, Thailand, Indonesia now, and also the actual product. Kratom, like the leaves of the tree that are being used to prepare a number of different products that are now on the market in the US.
Traditionally, it has been used for at least the last 150 years, tracing it back to 1830 when it was first reported by a Dutch botanist who was traveling to Thailand and Malaysia. And his name is Korthalis. And Korthalis actually observed the plant being used, both the fresh leaves being chewed
to give a stimulant effect, as well as the leaves being brewed into a tea, prepared into a tea, cooked for like two to three hours, the fresh leaves, and then that tea being consumed by indigenous folks, native folks in Southeast Asia.
Yeah, so the stimulant effect, some people describe it as when you get a little bit tipsy on alcohol in the beginning, you kind of get more sociable, so more of a kind of releasing, inhibition releasing effect. Others describe it as the slight boost that they get in the morning from their cup of joe, so from caffeine or coffee.
And then others sometimes compare it to a little bit stronger stimulant effect. So I think it depends on the individual who is consuming it. When we talk about euphoria, that is more related to its comparison with opioids. So the opioid-like euphoria you would get at much higher doses when you kind of pass the relaxing and sedative stages and go into the more analgesic and opioid-like effects.
kratom was for? Yeah, so there were a number of different uses for it. It has been used both as a slight stimulant by day laborers who use it primarily to water fatigue when they work in the hot sun and the tropical humid climates to continue working, but also for pain relief, for fever, for diarrhea by indigenous folks, specifically when it is prepared as a tea.
Now, with the opium trades that happened in the 18th century or 19th century, 1830s, 1840s, we saw a huge influx of opium from China as well as across the world, really. That's what the opium wars of the British colonizers was about in the 19th century.
And whenever opium supplies were scarce in these areas of Malaysia and Thailand, people turned to kratom to use it as a harm reduction or as simply a substitute for opium.
So at the time, we had the American Kratom Association, which still exists to this day. I think they have evolved over time from a relatively really user-driven and user advocacy group to a little bit of a lobbying arm as well. But at the time, I reached out to them and asked, hey, would you be willing to just send out an email to your members to distribute this survey.
I didn't ask them for input on how to design the survey, but just to distribute it. The first survey, I capped it at 10,000 responses, thinking that maybe I get 500 if I'm lucky in two weeks or so. And within two weeks, I got 10,000 responses and I had to end the survey. So I would never have expected such a huge response rate.
So that was the first survey that was published on Kratom use in the United States.
I didn't know about it until after my survey, I think right around the time that my survey was published. And the FDA recommended to the DEA to place...
and 7-hydroxymitragynin, which were known at the time to act on opioid receptors, to place them into Schedule 1, make them basically illegal, which would have prevented us as researchers, as academicians, to conduct research on it, which has been a challenge for cannabis research for a very, very long time because it's It is very difficult to get a DEA Schedule 1 license to begin with.
So from that perspective, from the research perspective, we were concerned.
Yeah, I have not been involved with other drugs before that were at risk of being placed into Schedule 1. But it doesn't happen very often that the DEA does not move forward with placing a drug into Schedule 1. So this was certainly very surprising for a lot of people at the time.
Yeah, so that's a good question because only in recent years have a few NIDA studies, National Institute on Drug Abuse studies, under Kirsten Smith, who was a postdoc at NIDA and now is a faculty member at Johns Hopkins University, kind of elucidated to some degree what the symptoms of a potential Kratom use disorder are.
And when we look at the criteria for what constitutes dependence, tolerance, withdrawal, and some other behaviors, we really see Kratom at the lower end of meeting these criteria.
What people primarily report is tolerance, meaning they increase their dose of Kratom over time. And if they stop taking it, they get withdrawal symptoms. Interesting. In general, these withdrawal symptoms are relatively mild for most people, maybe comparable to heavy caffeine use when you stop using it.
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