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Kratom, CBD and cannabis: How we got here and what's next

It started with medical marijuana.

Now, as consumers have embraced medical marijuana as a legal way to treat chronic pain, the taboo is lifting on other substances that proponents say have medical uses, such as CBD and kratom. As more consumers and doctors accept those substances, they increase demand, raise awareness and influence legislation.

It has helped lighten attitudes about the recreational use of marijuana as well, as more consumers call for an end to its prohibition. Here's what to look for this year.

Medical marijuana

When Gov. Andrew M. Cuomo took office in 2011, he opposed a medical marijuana program proposed for people with certain health ailments. Later, he embraced it.

In 2014, Cuomo signed legislation allowing medicinal marijuana use, and gave contracts to five marijuana growers, allowing them to operate four cannabis dispensaries each.

Now some of the foremost research in the world takes place at the Dent Cannabis Clinic, and there are doctors in almost every county of Western New York who are registered to prescribe marijuana for an approved list of medical conditions that include cancer, multiple sclerosis and post-traumatic stress disorder. More than 100,000 patients are legally prescribed marijuana in New York State, according to Marijuana Policy Project, which advocates for cannabis legalization.

Recreational cannabis

The discussion and debate about medical marijuana has spotlighted and perhaps strengthened support for recreational marijuana. Two-thirds of Americans support legalizing marijuana for recreational use, and only 8% favor keeping it illegal for both medicinal and recreational use, according to a survey by Pew Research Center. Opposition to legal marijuana has declined steadily since 201o, when more than half the country said they felt marijuana should stay illegal, according to Pew.

As recently as 2017, the governor shunned recreational marijuana legalization efforts, saying it was a “gateway drug." But after a state panel came out in favor of legalization, he changed his tune.

In 2018, the governor pushed for a study on the legal, economic and cultural effects of recreational cannabis, which was eventually completed by the Department of Health. The study found legalized marijuana would benefit the economy, public safety and public health, and recommended its legalization.

In July, the governor signed a bill decriminalizing marijuana possession. Last year, he tried to legalize marijuana for recreational use in New York. It failed in the Senate, but the governor recently announced in his State of the State address that he would try again this year to bring it into play as a highly regulated and taxed industry. The industry is projected to bring in an estimated $300 million in tax revenues.

CBD

Products made with the cannabis extract cannabidiol can be found in everything from shampoo and clothing to dog treats and mattresses. It is sold in stores as mainstream as CVS Pharmacy.

The extract doesn’t make a user feel high but reportedly eases inflammation, headaches, nausea and seizures, among other things. There isn't much scientific research to back up those claims, and some experts are skeptical, but CBD has been widely embraced by consumers as a natural remedy. Users say it eases conditions from anxiety to cancer, and they share glowing anecdotes.

In June, a CBD store opened in Dent Tower, selling CBD products formulated in conjunction with Dr. Laszlo Mechtler, medical director at Dent Neurologic Institute and its Cannabis Clinic. Mechtler said he created the CBD line to provide higher quality, more consistent CBD products to patients at a more affordable price than what is available elsewhere. Mechtler has been using CBD to treat patients for more than five years.

In December, Cuomo signed a law that brought new regulatory oversight, along with production and sales rules into New York State's hemp industry that affect CBD.

The law aims to promote legitimate farmers and retailers of hemp-based products. It will impose new testing and labeling requirements to protect consumers and keep ingredients safe.

The law also includes new labeling rules with codes that contain product information, along with new testing standards.

Kratom

Kratom is perhaps the most controversial and least understood of the taboo plants.

Until November, Buffalo didn't have a dedicated kratom store – the leaf was only available in head shops and online.

Purported to ease pain, lift mood and increase energy, it has been used in Southeast Asia for centuries. Consumers here use it for the same benefits, but it is gaining attention for another reason: Users say it can be used to wean opiate users away from addiction without the aid of heavy synthetics such as methadone or suboxone.

A starting dose of kratom is about one gram, which would cost 25 cents to 50 cents at the Kratom Shop on Elmwood Avenue. It can take effect as soon as 2o minutes and can last up to five hours.

But kratom has faced tough opposition from formidable foes, including the Food and Drug Administration. They say kratom is dangerous and addictive, and want it banned. They cite side effects ranging from increased heart rate and vomiting to seizure and overdose.

"There is no evidence to indicate that kratom is safe or effective for any medical use," said FDA Commissioner Dr. Scott Gottlieb in a statement.

The FDA has cracked down on companies making health claims about kratom, and instituted a mandatory recall of it in 2018 over salmonella concerns. The American Kratom Association says the research about kratom is flawed and skewed, and say unadulterated kratom is safe when used responsibly. It is pushing for regulation that would control kratom's quality.

The journal Clinical Toxicology acknowledged 11 deaths between 2011 and 2017 where kratom was a contributing factor. All but two involved other drugs such as cocaine, fentanyl and alcohol. In contrast, there have been 34 known deaths attributed to high-caffeine energy drinks, according to the FDA. In 2017, there were about 49,000 opioid deaths, according to the Centers for Disease Control and Prevention.

Kratom has been banned in six states and legislation is pending to restrict or outlaw it in others. In 2016, the Drug Enforcement Administration announced plans to list kratom as a Schedule 1 controlled substance, but gave way to public opposition. The DEA now lists kratom as a "Drug of Concern," but a 2017 bill to ban the substance in New York failed.

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