With a climb-down on banning an herbal remedy for opiate addiction and a new law hogtying it from enforcing the leakage of prescription pain pills onto the street, it seems that the Drug Enforcement Administration (DEA) has lost its sense of direction even as it faces one of the greatest drugs crises since it was first established.
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Whatever you may think of the DEA you will not have been able to fault it for its clear trajectory. For instance, no matter the lobbying or scientific evidence around marijuana, the DEA has stood firm on its position. Maddeningly for medical scientists and drugs legalisation activists alike, the administration has banned many herbal remedies and new street drugs as steadily and steadfastly as a steamroller on a new piece of road; and woe betide anyone who stood in its way as, to continue the metaphor, they would become part of the Tarmac. New policies and a new law are signifying major changes, and not all of this appears to be good.

America’s drug problem

While for many years the loudest debate in the US was around whether marijuana was safe, a medicine or none of the above; America has been quietly developing a bad opiate addiction. It is estimated that four million Americans misuse opioid pain pills every month, and close to 300 million prescriptions are issued annually. Those with doctors unwilling to support their addiction or unable to afford the high prices often turn to heroin and fentanyl, and consequently 33,092 Americans died of opiate overdoses in 2015.

The figures have rocketed in the last 12 or so years, with the rate of opioid prescriptions increasing 104% between 2005 and 2010. It became clear to some in government that something had to be done, though others had other ideas.

October 2016 – the DEA backs down on an herbal remedy

The DEA was about to do something it does routinely in late 2016 – ban an herbal remedy from use by the public or experimentation by scientists. The Mitragyna speciosa bush commonly known as kratom is an herb that grows in Southeast Asia. It is an important plant in indigenous people’s pharmacopoeia with a variety of effects from being an energy drink not unlike coffee, to enabling those using it to withdraw from opiates.

Kratom has been used in the US for many years for much the same reasons as those in Southeast Asia. It is a painkiller and while not being an opioid in their own right, its active molecules have been shown in recent science to bind with opioid receptors in the brain and can significantly tackle the symptoms of opiate withdrawal. Kratom could well be one of many answers to America’s pain pill problem, and thousands of people buy kratom in the US to use it in this way.

The DEA didn’t like the fact that kratom has been used for ‘fun’, and cited a tiny number of deaths associated with its use when last year, all of which were highly debatabe since other substances were also found all cases. However, in any case, it announced plans to temporarily ban the herb as a Schedule 1 drug – up there with heroin, LSD and marijuana as a drug of no medical benefit in the opinion of the administration.

The response to the plans by the American public was one of horror and bemusement. 120,000 people signed a petition to the DEA demanding that it back down. On previous form this shouldn’t have had any effect, but for the first time in its history the administration backed down. Speaking to the Guardian newspaper, agency spokesman Russ Bayer said, “This is an unprecedented action. It’s never happened before… We’ve never withdrawn a notice to temporarily schedule any substance but we want to move through this process in a transparent manner.”

Given the body of research in existence already, kratom is unlikely to be given Schedule I status, though for the moment the outcome isn’t clear while government researchers assess the risks and benefits. In backing down however, this is one sign of a trend: the administration is losing its clear, steamroller-like trajectory.

Congress muddles the War on Drugs

Two Acts passed by the Federal government have firstly stopped the DEA from tackling the opiate problem at root, and then funded state agencies drug treatment programmes. The Marino bill was passed in April 2016, before President Obama signed the 21st Century Cures Act into law in December 2016 that would give states $1 billion to tackle the drugs crisis.

CBS News exposed the way that the DEA had been effectively hogtied by the April 2016 ‘Marino bill’ just the other week, while the Harvard Law and Policy Review mentioned the $1 billion that Obama had managed to get in funding for states’ drug treatment programmes as part of it being signed into law.

While exploring the years of clever political lobbying on the part of the pharmaceutical companies to maintain their profits on the likes of Oxycodone and its effects on the opioid crisis in America, the Harvard Law and Policy Review stated: “Passed by Congress and signed by President Obama in December 2016, the act issued one billion dollars to states for primary and secondary prevention measures over the next two years.”

Referring to the Marino bill, CBS 60 Minutes investigation took a different approach. The 60 Minutes website states, “Whistleblower Joe Rannazzisi says drug distributors pumped opioids into U.S. communities — knowing that people were dying — and says industry lobbyists and Congress derailed the DEA’s efforts to stop it.”

The story, published on October 15th, told a tale where the DEA was fighting to stop the leakage of prescription pain pills onto the street yet ended up being hogtied by the 21st Century Cures Act. Ex-senior investigator at the DEA Joe Rannazzisi told 60 Minutes, “If I was gonna write a book about how to harm the United States with pharmaceuticals, the only thing I could think of that would immediately harm is to take the authority away from the investigative agency that is trying to enforce the Controlled Substances Act and the regulations implemented under the act. And that’s what this bill did.”

Somewhat bafflingly, the architect of the Marino bill, Rep. Tom Marino was nominated by the Trump administration to be the President’s Drugs Czar – the pharmaceutical distributor’s favourite Congressman would potentially be in charge of US drugs policy. This may have signalled a charge toward the US government actively encouraging the opiate epidemic rather than protecting its citizens. Mercifully in the face of strong opposition in the Senate, Marino withdrew his nomination on October 16th this year.

A wobble or genuine reform at the DEA?

There are clear signals that the Marino bill could well be overturned by Congress, and the DEA will once again be able to fight the opiate addiction epidemic. The DEA will be able to do its job again in protecting the health of the nation against unquestionably dangerous drugs.

The issue regarding kratom may well be a different signal however. Possibly due to a sizeable amount of its budget being needed to fight opiates, the DEA is starting to respond to reason on other drugs, as shown in its response to the 120,000 signature petition. Could this be a sign of greater flexibility when presented with strong evidence to the contrary of its views in future? While the Marino bill is problematic, the signs are that the DEA is leaning toward sense rather than dogma in its direction of travel.