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Kratom increasingly being criminalized in Mississippi

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Photo by ThorPorre - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=25187127

Mississippi cities and counties are banning kratom, making the use, possession or sale of the herb illegal.

Earlier this month, the Oxford, Miss., Board of Alderman approved a ban based on the recommendation of Jeff McCutcheon, the city’s police chief. In May, McCutcheon reported kratom was a contributing factor in a death in April, and that the substance was found in the blood of other overdose victims.

“We had 11 overdoses where kratom was involved,” McCutchen told the board. “It doesn’t mean it was the primary cause, but it was involved.”

In Mississippi, ten counties have criminalized the substance: Alcorn, Calhoun, Itawamba, Lowndes, Monroe, Noxubee, Prentiss, Tippah, Tishomingo and Union. In addition, about two dozen municipalities have followed suit. Warren County and Vicksburg have not banned it.

But is kratom dangerous? After all, correlation doesn’t equal causation.

Kratom has been used in traditional medicines since at least the nineteenth century. Photo by DMTrott – Own work. Originally published in The Honest Drug Book [ISBN: 978-0995593602]., CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=72040981

“The fact that kratom was present in these people’s blood does not mean that those [overdoses] … were caused by kratom,” states the website Kraoma, which markets kratom products online. “It would be equivalent to saying that the overdose victims had bacon or coffee in their system and that it caused their death.”

Clearly, there is disagreement on whether or not kratom should be remain legal.

In November 2017, Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, issued a public health advisory about the substance, saying, “There’s clear data on the increasing harms associated with kratom. Calls to U.S. poison control centers regarding kratom have increased 10-fold from 2010 to 2015, with hundreds of calls made each year. The FDA is aware of reports of 36 deaths associated with the use of kratom-containing products. There have been reports of kratom being laced with other opioids like hydrocodone. The use of kratom is also associated with serious side effects like seizures, liver damage and withdrawal symptoms. …  [T]here are currently no FDA-approved therapeutic uses of kratom.”

During the last session of the Mississippi legislature, lawmakers failed to pass a bill making the herb illegal throughout the state. Federally, the Drug Enforcement Agency recommended in 2017 putting two of the herb’s active ingredients on its Schedule 1 list of drugs that includes everything from heroin to peyote to marijuana. That placement is pending.

“The two principal opioid compounds in kratom DEA has sought to place in Schedule I are: 1) Mitragynine and 2) 7-Hydroxymitraynine,” DEA spokeswoman Debora Webber told WLBT in an email. “Both are abused for their opioid-like effects that are similar to those produced by other opioid drugs including morphine (Schedule II) and other Schedule I opioids, such as heroin.”

What is kratom?

The National Institute on Drug Abuse, a division of the National Institutes of Health says that Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects.

In cultures where the plant grows, practitioners of traditional medicine have used kratom for a variety of complaints. Users chew the leaves for musculoskeletal pain and to increase energy, appetite and sexual desire in ways similar to khat and coca. They use the leaves or leaf extracts to heal wounds and as a local anesthetic. They are also prescribed for coughs, diarrhea and even as intestinal deworming agents. The herb has also been used as a substitute for opioids, or to help opioid addicts treat their addiction; however, there seem to be scant clinical trials or research on whether any such uses are effective.

Recreational use of kratom began early in this decade in Southeast Asia, and by 2015, the herb was available in the U.S. in head shops. By now, it is available anywhere you might find vaping products including gas station convenience stores, and online, of course.

What does kratom do?

Twenty five size 0 capsules of 500 mg of Malaysian Kratom.

Most people take kratom as a pill or capsule. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.

When ingested, kratom has some opioid qualities and also some simulant effects. The two compounds in kratom leaves that the DEA is concerned about, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure and decreased pain, especially when users consume large amounts of the plant. Mitragynine also interacts with other receptor systems in the brain to produce stimulant effects. In small amounts, users report increased energy, sociability and alertness instead of sedation.

Kratom also has its share of uncomfortable and sometimes dangerous side effects, from nausea and itching to seizures and hallucinations.

It can also kill you if you take enough of it, although most recorded deaths in the U.S. that showed kratom use also involved other substances, including fentanyl and alcohol. And, like any mind-altering substance, some kratom users have reported becoming addicted.

As the NIDA concludes, further research is needed to fully understand how kratom affects the body and brain, and whether there are any legitimate uses for the herb. Until then, let the buyer beware.

“While we remain open to the potential medicinal uses of kratom, those uses must be backed by sound-science and weighed appropriately against the potential for abuse. They must be put through a proper evaluative process that involves the DEA and the FDA,” Commissioner Gottlieb wrote in his statement. “To those who believe in the proposed medicinal uses of kratom, I encourage you to conduct the research that will help us better understand kratom’s risk and benefit profile, so that well studied and potentially beneficial products can be considered. In the meantime, based on the weight of the evidence, the FDA will continue to take action on these products in order to protect public health.”

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Free helpline available for Medicare beneficiaries

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Leaders of Merit Health River Region recently announced the availability of a toll-free helpline designed to help Medicare beneficiaries select a health plan that fits their needs and budget.

The free helpline connects callers with licensed agents who can assist in comparing traditional Medicare, Medicare Advantage, Supplement and Prescription plans, and then facilitate enrollment in the plan selected. Through this program it will be easier for Medicare beneficiaries to find a plan that is best for them during Medicare annual enrollment from Oct. 15 through Dec. 7. Licensed insurance agents are available at no cost or obligation to help consumers find a Medicare plan that meets their health care needs.

Local consumers can access the helpline at 855-583-2003, Monday through Friday, 9 a.m. to 8 p.m. EDT, or online at www.medicarecompareusa.com.

“Consumers are bombarded with confusing messages from competing health plans and options — and this is especially true for those just turning 65 and becoming eligible for Medicare for the first time,” said Ben Richaud, chief executive officer of Merit Health River Region. “This helpline is a one-stop resource for insurance information, so individuals can be confident in the selections they make.”

MedicareCompareUSA is dedicated to helping consumers make this important insurance decision.

Not owned or managed by any Medicare insurance company, MedicareCompareUSA’s mission is to provide individuals the unbiased information they need while simplifying the enrollment process.

In addition to providing assistance throughout the plan application and enrollment process, agents of MedicareCompareUSA can provide an annual review of an enrollee’s Medicare coverage during Medicare’s enrollment period. This often includes assisting members affected by Medicare plan network changes that sometimes occur. Doing so assures that beneficiaries have the information they need to proactively select a plan that best meets their specific needs, preferences and budget.

Richaud points out that Merit Health is not in-network with all insurance options or health plans, and contractual relationships may change over time. If a patient enrolls with a health plan that does not include the hospital in the network, their care and relationships with their doctors could be affected.

“Members of our community have been entrusting us to be their health care partner for many years, and that’s a responsibility and honor we don’t take lightly,” Richaud said. “This helpline will help those on Medicare make an informed decision regarding their insurance options at this important time in their life. We urge all eligible consumers to take advantage of this free service.”

Traditional Medicare and the Medicare Advantage plans offered by Allwell, Cigna, Clover Health (new in 2021), Humana, Magnolia, Shared Health (new in 2021), United Healthcare and WellCare all allow consumers covered by these plans full access to in-network medical care and procedures at the Merit Health hospitals and employed physician clinics.

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MSDH Office of Tobacco Control receives two awards for smokefree efforts

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The Mississippi State Department of Health’s Office of Tobacco Control received two awards from the American Nonsmoker’s Rights Foundation: the Smokefree Air Challenge award and the Smokefree Air Challenge E-Cigarettes award.

The awards were presented at the ANR annual Smokefree Indoor Air Challenge and Voices for Smokefree Air awards ceremony.

The virtual awards ceremony was established by ANR to acknowledge and recognize states that excel in passing 100% smokefree provisions in workplaces, restaurants and bars. Mississippi has 171 smokefree cities with the passage of comprehensive smokefree air ordinances, 137 of which have ordinance that include restrictions on electronic cigarettes.

“The smokefree air policies implemented by these cities will protect all employees and customers in businesses and other public places from the harmful effects of secondhand smoke,” said Amy Winter, director of the Office of Tobacco Control at MSDH. “There is no safe level of exposure to secondhand smoke.”

In 2019, 14 Mississippi cities passed comprehensive smokefree air ordinances. At this time, 36% of Mississippi’s population is protected from the harmful effects of secondhand smoke and e-cigarettes.

“The adoption of these smokefree air ordinances by cities across Mississippi is an important step in improving our state’s overall health status,” Winter said. “We hope this activity at the local level demonstrates the widespread public desire for a comprehensive statewide policy.”

For information and resources about the dangers of e-cigarettes and tobacco products, visit www.healthyms.com/tobacco. For help with quitting visit www.quitlinems.com, or call the Mississippi Tobacco Quitline at 1-800-QUIT-NOW.

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MS Health Department emphasizes importance of flu vaccines

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(Photo by by LuAnn Hunt from Pixabay)

Seasonal influenza vaccinations are now available for children and qualifying adults at all Mississippi State Department of Health county health departments. Flu vaccination is recommended for everyone 6 months old and older as the best protection against the flu.

“We recommend that all Mississippians get their flu shots every year, but especially this year with COVID-19. We don’t want to risk overwhelming our hospitals,” said MSDH State Epidemiologist Dr. Paul Byers in a statement.

Byers said flu season can occur as early as November and as late as March in Mississippi, but usually peaks anywhere from December through February.

Individual flu cases are not reported to MSDH, but the agency monitors flu activity through the ILI System, made up of health care providers in Mississippi who report the percentage of patients with flu-like symptoms to a statewide database. Providers participating in the system also submit respiratory samples for flu testing to the MSDH lab. State health officials use this information to determine the presence and spread of flu throughout the state.

“We recommend getting vaccinated now before we reach peak flu activity. Influenza vaccine is especially important for young children, pregnant women, those over 65 and those with underlying health problems,” Byers said. “Flu vaccination is the best way to protect both children and adults from serious complications such as hospitalization, and in many cases, death.”

Those 18 and under who are eligible for the Vaccines for Children program can receive a flu vaccination for $10. Insurance, Medicaid and Children’s Health Insurance Program is accepted for children’s flu shots. A list of all VFC providers can be found at www.HealthyMS.com/vfc.

Adults who are underinsured or uninsured and who meet certain high-risk criteria qualify for an adult flu vaccination at MSDH county health department clinics. Flu shots for insured adults are now widely available through private physicians, pharmacies and retail centers.

Flu symptoms include fever, cough, sore throat, muscle and body aches and fatigue. Most people recover from the flu without complications, but nationwide there are up to 200,000 hospitalizations from flu each year.

While vaccination is the best protection, basic infection control measures can also reduce the spread of flu and should be taken whether individuals are vaccinated or not. These measures include covering your mouth when coughing and sneezing, staying at home when you or your children are sick and washing your hands frequently. Wearing a face covering in public places offers additional protection against the flu.

Please call your local county health department to make an appointment for your vaccination.

For Vicksburg and Warren County residents, the Warren County Health Department is located at 807 Monroe St. in Vicksburg, and it is open Monday through Friday from 8 a.m. to 5 p.m. Call 601-636-4356 for more information.

To locate other county health department clinics or for more information on flu, visit the MSDH website.

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