Wisconsin Society of Addiction Medicine (WISAM) President Ritu Bhatnagar, MD, MPH, testified against 2023 Assembly Bill 393 at a State Capitol public hearing September 13. The legislation would remove substances contained in the herb kratom from the state’s controlled substances act – the two opioid-like substances were put into state statutes in the 2013-14 state legislative session as part of the Heroin, Opioid Prevention and Education (HOPE) agenda to combat an increase in overdose deaths. As described in last week’s Medigram story, the bill would remove kratom as a Schedule I drug and instead consider it in the same category as food, drinks, chewing gum and food supplements.
Dr. Bhatnagar’s testimony was critical in countering a barrage of incomplete and opaque comments from the American Kratom Association (AKA), the primary proponents of the legislation who appeared in force before the Assembly Committee on State Affairs. Bringing her perspective as a physician helping patients with their addictions, Dr. Bhatnagar shared how kratom can affect users much like an opioid, including how higher doses can act as a sedative and prove deadly. She also shared kratom-related publications in WMJ.
“Despite its potential harm, kratom use is increasing and its marketing is becoming more aggressive,” Dr. Bhatnagar states in her testimony. “Kratom advocates assert that kratom is an effective treatment for wide-ranging conditions such as muscle pain, panic attacks and extreme diarrhea. However, current research supporting kratom’s medical benefits is insufficient to justify its substantial risk to consumers.
“Further,” Dr. Bhatnagar’s testimony says, “due to the unregulated nature of the expanding kratom industry, retailers are not required to disclose health risks to consumers, jeopardizing product transparency and threatening public health.”
Dr. Bhatnagar also challenged the AKA’s touting of kratom as a potential pain treatment or a way to deal with opioid use disorder (OUD), stressing that patients can currently utilize effective treatment options for OUD and that the state’s resources can be better spent increasing access to those effective treatments.
“We urge you and your colleagues, as lawmakers, to operate with extreme caution when considering legislation to expand the accessibility of kratom,” Bhatnagar said. “The dangers of this opioid drug of abuse are clear.”
Various law enforcement groups have also registered against the bill, joining WISAM and the Wisconsin Medical Society (WisMed) in opposing the legislation, which is now eligible for future committee vote – perhaps as soon as next Wednesday.
You can watch the hearing for free on Wisconsin Eye here. The hearing on AB 393 begins at this point, and the WisMed/WISAM testimony begins here. But don’t skip the AKA’s testimony – it shows why the Wisconsin physician voice needs to be heard on health care issues.
What You Can Do
WisMed members can urge their State Assembly and State Senate representatives to oppose Assembly Bill 393. You can find the contact information for your representatives on the State Legislature home page by putting your voting address in the “Who Are My Legislators” box. Note that Representatives David Murphy (R-Greenville), Robert Brooks (R-Saukville) and John Macco (R-Ledgeview) as well as Senators Rachael Cabral-Guevara (R-Appleton) and Mary Felzkowski (R-Irma) are currently sponsors for the bill, so the appropriate message for those members would be to remove their names from the bill. For other potential talking points, see last week’s Medigram.
Contact WisMed Chief Policy & Advocacy Officer Mark Grapentine, JD for more information.
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