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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Yeah, so it's interesting that we have this discussion today because just the other day, yesterday, literally, I was giving a presentation at the North American Congress on Clinical Toxicology on Kratom together with a few other folks. And we are not yet sure how somebody can get to very high concentrations in their blood of mitragynine that would cause or would contribute to a fatality.
With this evolution of the kratom market where we see extracts, concentrates, isolates emerging, that might be a driving force behind these lethal outcomes, which we have not seen in Southeast Asia with just chewing on the leaf or making that tea. So it's clear there's a strong suspicion that these high potency extracts and isolates are driving the lethality.
Yeah. I actually think that what is happening now in the crypto market is exactly mirroring what is happening with cannabis, right? When we look at A decade ago, we had THC concentrations that ranged from like maybe 5 to 12 percent, maybe 15 percent in high quality cannabis products. And now we have concentrates or edibles that contain 40 percent THC.
So very different ballgame, very different amount that you can get into your body from sometimes ingesting much smaller amounts.
Yeah. So I like the way you phrased that because it wouldn't fit in the current regulatory scheme or how this would ever be realized.
But if you look, for example, at some of the ephedrine, pseudoephedrine products that were kind of pulled from the market in regards to just being over the counter, so you could just buy them from a pharmacy without any questions being asked, because we know that pseudoephedrine, ephedrine and the like products are being used in the manufacture of methamphetamine.
And instead, they're now behind the counter and you can get a certain amount without requiring a prescription, but you still need to present some form of identification that has been done in all US states by now. So I think that Kratom and or Tianeptin would qualify for something like that because then you need to interact with a pharmacist or a pharmacy technician to
that can ask you, do you have any underlying health conditions? Do you have a prior substance use disorder? To kind of provide a little bit of counseling and a little bit of information and actually utilizing the pharmacist. I realize I'm advertising for pharmacists here because I'm with the College of Pharmacy and not just...
being pill counters because to be honest, pharmacists are a lot more and they can provide a lot more and they remain the most accessible healthcare professionals out there. If you want to go to a doctor, you need to make an appointment.
If you need some help with figuring out is this medication safe to take or is this substance safe to take, you can go into a pharmacy and there will be a pharmacist. Is that how it works in Europe? So I grew up in Germany and I trained as a pharmacist there.
And yes, we don't necessarily have over-the-counter, although some medications are now available like Tylenol or so that you can buy in small amounts, small packages in a grocery store. But most of even what is considered over-the-counter here in the U.S. is behind the counter. So either a pharmacy technician or pharmacist needs to grab it at least once.
and put it on the counter for you in order for you to purchase it. In addition to that, we have certain supplements that are considered supplements here, St. John's word, Ginkgo, that you can actually get as a prescription from your doctor and it is paid by your insurance, by your health insurance.
So we do have a different system where we value more the expertise of pharmacists beyond their ability to count pills.
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