Health Effects & Risks of Kratom, Opioids & Other Natural Occurring Medicines | Dr. Chris McCurdy
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Dr. Chris McCurdy joins Andrew Huberman to discuss *Mitragyna speciosa*, commonly known in Southeast Asia as Kratom, a plant native to Malaysia and Thailand traditionally used by laborers for energy, pain relief, and social lubrication. While traditional use involves chewing fresh leaves or drinking decoctions made from them, the products available in the United States differ significantly due to processing; they are typically dried leaf materials that have been ground into powders, capsules, or extracts using solvents like ethanol or oil. This extraction process concentrates active alkaloids and alters their pharmacokinetics, allowing for much faster absorption compared to traditional methods. Dr. McCurdy emphasizes a critical distinction between these concentrated isolates and semi-synthetics versus the less processed leaf material, comparing them to the difference between light beer and high-proof spirits in terms of dosage intensity and potential risk profiles. The conversation highlights that *Mitragyna* contains approximately 20 to 40 different alkaloids, with mitragynine being the most abundant and metabolized into 7-hydroxymitragynine (often referred to as "tragoxyline" or similar derivatives in isolation products). While traditional leaf use offers a dual effect of stimulation at lower doses and euphoria/sedation at higher doses, isolated compounds like 7-hydroxymitragynine exhibit opioid-like properties that can cause respiratory depression comparable to prescription opioids. Dr. McCurdy warns against the assumption that all *Kratom* products are safe alternatives; specifically, he notes that while anecdotal evidence suggests reduced alcohol consumption and potential benefits for weaning off traditional opioids, there is currently no solid scientific data proving these claims or confirming safety regarding interactions with other substances like alcohol. A major point of contention addressed in the episode concerns age restrictions and developmental risks. Dr. McCurdy strongly advises against use by anyone under 25, citing that the human prefrontal cortex continues to develop until approximately age 24 or 25. He draws parallels to cannabis research showing slowed brain development and lower IQs when used during adolescence, expressing significant concern for naive young users who may not understand dosage risks or habit-forming potential. For adults over this threshold, he suggests a "stay low and stay slow" approach using leaf-based products rather than concentrates, noting that tolerance can develop to pain-relieving effects while side effects like constipation and respiratory depression persist, potentially leading to increased dosages and subsequent harm. The episode concludes with Dr. McCurdy's personal history in medicinal chemistry, tracing his path from a pharmacy student interested in caffeine to researching natural products for Alzheimer’s disease before focusing on opioids and *Mitragyna*. He explains the historical context of why pharmaceutical companies like Smith Kline & French shelved mitragynine decades ago because it was deemed no better than codeine but with similar risks, leading to its current status as an unregulated supplement. Dr. McCurdy advocates for science-based regulation that distinguishes between benign leaf products and dangerous isolates, urging consumers to be vigilant about serving sizes and product formulations while acknowledging the complex role these natural compounds play in both pain management and public health crises involving opioids.
Read the full video transcript
Welcome to the Hubberman Lab podcast,
where we discuss science and
science-based tools for everyday life.
I'm Andrew Huberman and I'm a professor
of neurobiology and opthalmology at
Stanford School of Medicine. My guest
today is Dr. Chris McCertie. Dr. Chris
McCertie is a professor of medicinal
chemistry at the University of Florida
where he directs research on natural
products and their pharmacologic
effects. most recently the plant-
derived compound which is readily sold
in the US and around the world and is
now used by tens of millions of people
daily and those numbers are increasing
fast. Dr. McCert's research focuses on
understanding how interacts with our
nervous system and affects our
physiology and behavior. He also studies
its potential for addiction. During
today's episode, we discuss the complex
effects of its relationship to the
opioid system. Dr. Dr. McCertie explains
how's active compounds work in the
brain, why it shares certain
similarities to opioid drugs, and
critically howratom products available
in the US and elsewhere are largely
derivatives and isolates of theratom
leaf, which is very different in terms
of the effects it produces when compared
to the traditional leaf products. And
unfortunately, that has confused and in
many cases harmed consumers. So today,
you'll learn aboutratom's effects at
different doses and when it's sourced in
different ways. You'll learn about how
it can be a stimulant, how it can
increase focus, how it can be a
painkiller, how it can increase
euphoria, but also its strong potential
for addiction. You'll also learn what is
known about in terms of its ability to
help people transition off traditional
opioid drugs. It has been shown to be
effective for that. However, we are also
going to explain the potential harms of
in particular in young people whose
brains are still developing and in
people that don't have a prior opioid
addiction. Our discussion aboutratom
also opens up a broader discussion about
other plant alkaloids that have
medicinal properties including those
found in things like cocoa and 100%
chocolate. And we discussed the
incredible history of soft drinks like
Coca-Cola, Pepsi, 7Up, and Dr. Pepper,
which believe it or not were originally
developed as pharmacologic tools before
becoming the ultra popular beverages
that we're familiar with today. So I
realize many people have heard
aboutratom, but also many of you perhaps
have not. What everyone should know,
however, is that products are pretty
much everywhere now. You can find them
in supermarkets, convenience stores,
online, and they're sold under the
pretense of having very specific effects
related to energy, pain management, or
mood. But by the end of today's episode,
you'll have a thorough understanding of
how this plant compound actually works.
Yes, its potential effects, but also its
serious risks. Before we begin, I'd like
to emphasize that this podcast is
separate from my teaching and research
roles at Stanford. It is however part of
my desire and effort to bring zero cost
to consumer information about science
and science related tools to the general
public. In keeping with that theme,
today's episode does include sponsors.
And now for my discussion with Dr. Chris
McCertie. Dr. Chris Mccertie, welcome.
>> Thank you. It's really a pleasure to be
here. I'm excited to have you here
because you work on some incredibly
interesting compounds, several of which
are very controversial and all of which
are impacting health and society in a
major way right now, especially in the
United States. The most notable of those
isratom. I'm guessing some people have
heard ofratom. I'm guessing some people
perhaps have not. I'm pretty certain
everyone has seen a catratom product
because they are everywhere.
>> Yeah.
>> But it's often in the fine print. So
could you just tell us whatratom is
where it's found in nature and in the
United States and some of its properties
that people take it in order to achieve
certain effects maybe some of its
lesserk known properties. So that's a
lot of questions. So maybe just a
general description of them where it's
found and what it does.
>> Let's just start from the beginning and
make it easy. It's it's a tree that's
called metro speciosa by its botanical
name. um is called Cretam in Southeast
Asia, which is where it's native to.
It's actually native to uh where
Peninsula Malaysia and Thailand connect.
So, at the border of of those two
countries is thought to be ground zero
for where this tree species came from.
And in that region, it's very rural.
It's lots of farmers and lots of outdoor
laborers. And those outdoor laborers
chew the leaves um in Thailand or they
make a tea or more technically what we
call a decoction because they boil the
leaves for hours. Um but they'll harvest
fresh leaves and boil those leaves and
then drink that just like we would drink
a coffee drink in the morning to give
them energy to give them sort of
sustainability throughout the day to
tolerate that heat, humidity and very
harsh tropical environment. and it gives
them the stamina to make it make it
through the day. Um, and that's really
what the traditional use has has always
been uh more or less for energy and to
get through that day. U but it also has
been used to treat pain. It's been used
to treat um of all things u uh erectile
dysfunction. It's been said to be
nature's sort of Viagra. Um it's used
for uh mood elevation primarily. Um and
so these these individuals will will
utilize it uh like I said throughout the
day. It's a Muslim population in that
area. So there's no uh alcohol really
and no consumption of alcohol. Um and
this is sort of a socially lubricating
product. Um and so in the evenings on
Friday, Saturday evenings, the men would
generally gather and then increase their
consumption of of the tea um just
socially uh and and it could get them
into a more seditive like effect. And so
there's this always this sort of um
paradoxical description of of uh cretam
or or as we say in the United States.
um where you get this stimulant effect
at lower doses or or smaller amounts and
you get this more euphoric or seditive
like opioid like effect if you will at
higher doses and so they they tend to
use that traditionally. So they'll
they'll take the the benefits of it um
just like we would use coffee I think uh
to to sort of get us moving in the
mornings. that's what they sort of use
in those regions and they move into um
you know on the weekend evenings they'll
use it as more of a social uh beverage
and so that's where that's been. We got
interested in it from the standpoint
that
there were also reports that this could
be utilized when they ran out of heroin
or raw opium um so that they wouldn't go
into withdrawals. And so essentially
they're already using it. they would
increase the consumption when they ran
out of heroin or opium and that would
stave off withdrawals for them. And that
became really interesting to me uh as an
opioid researcher, a pain researcher,
could this be something that uh has
potential uh and and obviously would
have potential in helping with the
opioid crisis uh that we're in? And
that's that's kind of what drove us into
starting to look at this.
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When we see a catratom product in the
United States, and I realize there are a
variety of those, but um let's just take
for example, I'm aware of uh a product
that's very popular nowadays. It's a
small blue bottle. Um it includes cava
andratom as its primary ingredients. I
have zero financial relationship to this
company. I actually had the opportunity
to be an early investor, uh, turned it
down. Um,
when somebody takes a bottle of that,
when they drink a bottle of that,
how concentrated and how muchratom are
they getting compared to say the typical
adult user in Malaysia who drinks I
don't know what a mug of this
concoction. Um,
Are they comparable? Um are they even
the same compound? Can we think about
them the same way? because this is very
much in my mind uh like comparing um
smoked cannabis
uh let's just say there is no typical
variety but um compared to a highly
concentrated uh uh THC tincture for
instance I mean there same chemical
structure but at some point the
phocinetics changes and you're basically
looking at different brain circuits
different bodily organs engaged is like
kind of different experience alto
together
>> correct and I and I think it's an
important distinction to make at the
outset of this is that, you know, what I
described as the traditional use is is
freshly picked leaves that day. They're
either chewing them directly when they
pull it off the tree or they're brewing
this decoction right away. um in the in
the United States and in the Western
world, it's a very different product
from day one because it's a dried leaf
material um that's been exposed to the
air, the sun, whatever environmental
factors are there, plus shipping it all
the way across the world from Indonesia,
which is the primary country where most
of this is grown. Um the last I heard a
year ago was there's about 250,000
um cratom farmers in in Indonesia that
are producing and exporting um raw
materials around the globe but primarily
to the United States. So that leaf
material comes in and then leaf material
has been ground and put into capsules,
put into um various products, even just
powdered product uh where people will
use tablespoons of powder and you know
couple grams of powder in their in their
warm water or however they like to do.
Um, so it's an interesting product
because that's as close to the
traditional
use that you can get in in the western
world, right? Because you're you're
still using leaf, you're ingesting it um
or or you're making a tea from it. Water
is the worst uh least efficient
extractor of chemicals out of a plant
material. And even if we don't make a
tea out of it, if we just take the leaf
material internally, our body has to
work incredibly hard to pull those
active ingredients out of the plant
material. So it's a it's an active
process for us as humans or as animals
if we want to talk about the animal
research too and where we've learned
most all of this from that that our body
has to work hard to get that into our
system. Now you take that leaf material
and then you do something like you
mentioned, put it into a tonic or you
put it into a concentrate form uh or an
extract. And now the compounds have been
already pulled out of the leaf material
by the the the solvent or the liquid
that's being utilized, whether it's
ethanol or it's uh oil or some other
some other type of uh vehicle. I think
in the product you mentioned is
pineapple juice, which again is not as
efficient as something like oil or or a
solvent would be, but you start to pull
these compounds into that liquid instead
of our body having to pull it out of the
leaf. It's already out of the leaf. Now
we can ingest that and those compounds
are absorbed much faster into our body,
into our system. And it totally changes
the dynamics of what our body is exposed
to um from that sort of more
traditionalbased
product. And this is also where we feel
that things have become problematic. And
so if we go back to paracelies and you
know hundreds of years ago talking about
the poison is in the dose um where we
where we've seen somewhat um
nonproatic use I would say the majority
of nonproatic use is with that leaf
material more of that closer to
traditional use but as you start to make
these concentrates and extracts and and
and now isolates which are even a whole
another discussion because they're no
longer even creating products. Um, you
you start to move ever so far across
that spectrum. And I like to equate it
to the the alcohol world where we talk
about seltzers or light beers being um
more comparable in an alcohol beverage
to that traditional use of whereas we
get to things like almost pure alcohol
ever clear 190 proof 95% alcohol. Now
you're talking about these isolate
products and we have products in the in
the alcohol industry through that whole
span. But we've classified all of them.
We don't call them alcohol in general.
We we'll define them
>> beer, wine, beer, wine, craft beer.
>> Yeah.
>> And ind and to spirits and then into
very fortified um beverages. And so we
don't have that delineation in the in
theratom space. And so allratom products
get dumped into a single bucket. And so
whether or not it's a benign product or
something that's highly highly
concentrated,
um, and I shouldn't say benign, but you
know, something that is much more close
to that traditional use that you're not
going to have a risk of getting a great
exposure when you take some of it versus
a shot that might be 15 milliliters and
it tells you on the bottle it's nine
servings, but nobody reads that part and
just downs the entire bottle. Is that
what we're talking about when we talk
about this little blue little blue
bottle?
>> No, the little blue bottle is more
actually is more similar in terms of
what is dosed in there to a traditional
exposure of a beverage.
>> One bottle.
>> One bottle. And forgive me for
interrupting because about a year and a
half ago, I ran into a friend and um his
assistant, she came running out and
knowing what I do, she said, "Hey, do
you know about this like little blue
bottle product?" And I I said, "Yeah,
I've seen it. Not tried it." And um why
what do you think? And she said, "Well,
I I liked it because I drank one, but
now I'm drinking six a day and I can't
seem to whittle it back." Like when I
went to three, I did not feel well.
Headaches, feel anxiety, not well. It
was how basically how she described it.
And
>> um I said, "Well, sounds like either
addictive or or a habit forming." And I
don't know where she's at with that, but
this seems very common. People start
with one, not unlike nicotine patch
pouches, start with three milligrams and
they're up to six milligrams and then
pretty soon it's a tin
>> a day or a canister a day. So um one
bottle of that ofratom cava is
comparable to the to the plant use.
>> I think if I remember right a bottle is
two servings. So we've tested we've
tested almost every single product in
the marketplace and we've analyzed it
for the content of alkaloids to see
what's what's there in what they
consider a serving. Um but if we only
look at a serving they're pretty much
all equivalent. Again, it's what's in
that bottle, right? Is it one serving,
two servings, nine servings, 15 servings
>> in a single bottle? So, most people
aren't going to look at it from the
standpoint of, hey, I've got I've got
this bottle here, which is actually
smaller than the the blue bottle,
>> but it's it's 10 times more servings,
right? And so if you're used to
consuming that blue bottle all at once,
which is two servings, I think, then if
you pick up one of those bottles that's
15 servings, and you consume the whole
thing at once, you're you're getting a
much greater exposure immediately and
it's in a much easier vehicle for our
body to um welcome those compounds in,
if you will. So it it becomes a very
very slippery slope in my opinion um um
with these different products that are
out there in the marketplace. And so if
if someone is not paying attention to
what the actual serving is supposed to
be, then this is where problems become.
And the other thing I would add to that
is that a lot of times, and I've seen
this, I've I've stopped in um of all
places, I stopped at a Murphy USA gas
station, Walmart's gas station, and they
had uh energy shots right next to the
5-hour energy shots. And so if if you
were in a hurry and you weren't even
paying attention, you might accidentally
grab something that you thought was a
five-hour energy shot, right? And
suddenly you and I I took I you normally
take two of those and I do it right back
back and throw them right back. And um
so if you if you get these and generally
what we worry about is kids getting
these right and getting these and then
taking a a shot a whole bottle uh which
may be multiple servings and they don't
feel anything right away and somebody
told them you're going to get high from
this. You can't believe it, but you'll
get high from this thing you can buy in
the gas station and then they don't feel
anything and then suddenly they have
another one, right? And then all of it
gets absorbed and hits them
harder almost all at once. You can think
of it like if you sat down and you drank
a light beer and you drank that 12 ounce
beer um in in a short period of time,
just you you could really drink it fast.
you're not going to get very much
alcohol exposure because there's only
3.5% in that 12 ounces. But if you sit
down and you do three shots of tequila
in a row in that same time frame, your
body is getting exposed to significantly
more alcohol in that time frame. And
that's what that's what our concerns are
around some of these products. And so
when you look at the specific serving,
yeah, they they dial it in to say, "Yep,
this is what uh is comparable to a
traditional
full glass of tea." Um but but they're
they're very very concentrated. And now,
as I mentioned, you know, moving moving
outside of this space into semiynthetics
and products that are no longer
products are no longer traceable back to
the plant material. They're actually
semiynthetically produced. That means
they're chemically modified um into
other things that they're calling in
some cases product. Again, this is that
trash can or they're actually calling
themratom derived products.
>> Two things that I'm taking from what
you've said thus far is that anyone
considering
products of any kind needs to carefully
consider serving size. And it's uh
interesting that those small bottles and
frankly the packaging of most uh things
is pretty small. And uh I don't think
it's just my age. uh you need a compound
microscope to to read some of the the
print like literally fine print has
become so fine that that that I think
it's below the the threshold of a of a
you know a
>> air force um fighter pilots's uh high
acuity vision 2015
>> in all seriousness you need to look at
the serving size and and know how many
servings are in there absolutely
>> so check serving size
>> and the other thing is uh to look
forratom derived orratom extracted
versus actual catratom plant product
>> because
>> while we're not recommending usage here
there are a number of people using these
products there are a number of people
that are going to use these products we
just have to be honest about that and I
think it's very important to understand
how to navigate this space because as
you've pointed out it's not one thing
it's just not and um maybe just for the
moment let's step back in light of that
and let me just ask you said earlier
that when people use the plant at lower
dosages it's a bit of a stimulant
right?
>> Might even have some aphrodisiac um
qualities to it which suggests to me I'm
not a a medicinal chemist as you are but
suggests that there might be some
dopamineergic
>> um maybe some chonergic maybe some
vasoddil dilation activity given the
aphrodisiac part etc. Okay. Um but then
at higher doses it starts to become more
of a sedative.
>> Yeah. When people take
derivatives or these more manufactured
or processed products in the United
States, the small blue bottle, let's say
one or two servings, or um the the ones
that are in the energy shot, let's say
they take one or two servings, which
would be basically a quarter of a sip of
one of those little little thimbleized
things. Are they seeking the stimulant
aphrodesiac effect or do you think that
most do we have any data rather as to
whether or not users in the US are
really going for that kind of set
sedative numbing out effect because
those are two very different things
>> very very different and and I don't
think we have good strong definitive
data. So I will say that um with my
colleague uh Dr. Kirsten Smith at Johns
Hopkins um and and others on our team.
We've done pretty extensive surveying of
of users. Um these users, you know,
volunteer themselves into the studies.
So, I think we have to we have to look
at that from a standpoint of, you know,
we're not we're not just putting out
random people on the street and asking
them questions. These are people that
choose to answer. Uh, but what we found
in the largest study that we've done to
date is most users are using it in a
very responsible um and directed way
where they're not using it to get this
high or euphoria or or seditive feel.
>> Really?
>> Okay. I want Could you repeat that? You
said it very clearly, but I think the
world needs to hear this. the estimated
number of users right now we we don't
really have a good thumb on this right
so the most recent literature report was
around 2 million 2 and a.5 million users
but if you look at sales of products and
you talk to the manufacturers
the estimates are well over 20 million
users in the United States and if you
look at the availability of product it's
got to be closer to those numbers so
>> on a daily basis
>> on a daily basis daily basis. So this
isn't you know 2 to 20 million people
per year ingest a cratom product.
>> This is 20 million people a day.
>> This is what is the estimate right now.
>> Wow.
>> Based on the amount of material that's
been imported or if if you will exported
um to the US and then manufactured. And
so in 2019 when we actually had solid
data is 1950 metric tons per month
coming in.
>> Do you think and there are many people
in the US that are ingesting products
like them for the effect it produces and
are not aware that they're actually
taking.
>> It's a very interesting question. So I
work with a a whole plethora of of
different people, right? So from
emergency room physicians to medical
toxicologists to basic scientists like
myself and everything in between. And if
if people have heard ofratom, they know
what it is and they they've if if
they've heard of it and
they are um experienced in trying
things, they've probably tried it. Um
and then there's a whole group of people
that have no idea what it is, never
heard of it, just
completely something that they drive by,
they see it. Like you said, you see it
everywhere, but you don't you don't have
any idea what it is. So, I think I think
most people that are ingesting it or
utilizing it know that they're utilizing
it. I think they know they're
specifically going after it. But again,
what I'll say is what we did,
>> it was a ecological momentary
assessment. And so this is a EMA study
where you're actually monitoring people
with smartphone apps in every single
dose they're taking. They're reporting
what they're feeling. They're reporting
why they're taking it, when they're
taking it, right? And the majority of
those people that were involved in those
studies were using it in a appropriate
sort of not to get high weight.
>> What are they using it for?
>> Mostly for energy, mood elevation, um,
and pain treatment. So, uh, people like
to use it, uh, as an alternative, um,
particularly to opioids. So, what we
were surprised at, we thought we would
see a lot of people using it to get off
of opioids, right? Because that's sort
of the general um, theme that it's had.
Indeed, people are doing that. And I I
get emails almost weekly of people
writing to me saying that this got them
off the couch. You know, they they
getting their families back. They're
getting their lives back because this
really helped give them that energy that
they didn't have when they had opioids.
>> Really? Okay. We'll definitely double
click on that in a few minutes.
>> Yeah. Yeah. And so that's an interesting
group of people, but I'm not sure that
that's the largest group that are out
there. It's really these mood
elevations. You touched on a little bit
too with the exercise um uh that the
people are using this as a preworkout
stimulant to give you more endurance.
very similar to that traditional use,
right? These people in the outdoor hot
environment being able to work better,
harder, faster. Um, and and people are
using as a post-workout uh pain
treatment, right, to help kind of soothe
them through that all that lactic acid
buildup and that pain feeling. So
there's a variety of of groups or
reported groups of users, but the
biggest one is really that mood
elevation, that sort of kind of energy
boost, um just overall general good
feeling, not a high feeling. And we we
specifically ask for those those
questions, you know, are you using this
to get high? And yeah, there is a
population of people that are purely out
there to say, "This is my thing. This is
what I use it for. I get high. I know
people that on Friday nights, they're
like, "This is this is my Friday night
jam and this is what I do." And it makes
me feel, you know, euphoric and relaxed
and and that's it. And so
>> I think there's just various user
populations and and we can't even get to
a granular point in that to say, you
know, are these populations
um that are trying to get high, are they
using those really concentrated
products?
More than likely, that would be the
assumption. and are the people that are
using it more on a daily basis, are they
doing it with more of the powdered leaf
material and those types of products?
And that's generally what we've seen.
Um, and interestingly enough, I mean, we
we looked at the time of day. When are
people using these products, right? They
they wake up and within the first half
hour they have it.
>> Would you say they have it or they need
it?
>> It could be they need it there. It does.
It absolutely causes a physical
dependence. You said it absolutely
causes a physical dependence. Do you
mean it absolutely causes a physical
dependence at every dose and every
desired effect?
>> I would I would say not. So if you take
it one time, you're not going to be
physically dependent on it. But if
you're utilizing it over a course of
time, and I can't tell you what that
time frame is because we don't have any
chronic studies in humans. We don't have
and sadly we don't even have chronic
studies in animals. Although animals
aren't going to be able to tell us I I
need this, right? So the physical
dependence feeling um that most people
will report is very similar to that. And
and I I I
get caught making this comparison many
times because people that are using leaf
material,
excuse me, if they get up in the morning
and they want to go get their leaf
material, they're not drinking coffee,
they're drinking credum orratom and they
they have a headache or they feel
miserable if they don't get that into
them. very similar to what we would get
with a caffeine withdrawal um or
physical dependence on caffeine. Now, I
can't speak to how much intense that
gets as you start to ramp up into those
various products because we don't have
good reports around those. But I can
tell you that anecdotally people have
said they get more restless leg
syndrome. they get more severe type
physical dependence signs
which restless leg is much more related
to a opioid withdrawal type issue than
it is to a coffee withdrawal issue. So
there there's not only is there a
spectrum of of physical dependence
symptoms um you know you you you have
this spectrum of products and which ones
are causing which we don't we don't have
a handle on yet. I'm gathering at this
point that there are basically three
paths ofratom usage in the United
States. One group of people is using
products to achieve an energetic lift,
not dissimilar from the lift they're
seeking with caffeine or an energy
drink,
>> right?
>> Sounds like they're using products
pretty regularly to achieve that.
And if they don't use theirrratom
product, they feel a little bit more
lethargic, maybe a little bit of minor
headache, not as energized and clear as
they would otherwise. Sounds a lot like
caffeine to me,
>> right?
>> With one caveat, I should add.
When somebody consumes a lot of
caffeine,
at some point the the effect starts to
drop off because they they gain a
tolerance. that the effect of caffeine
doesn't shift from a stimulant to an to
a more opioid-like effect the more you
take. It tends to just make you less uh
sensitive to caffeine over time. It's
more of a inverted U-shaped function as
opposed to two different curves. Right.
>> Right. But you will you will become, you
know, you'll get jittery with caffeine
and you get it actually causes anxiety
when you get into higher amounts of it.
And so, yeah, I mean, point well taken.
It's just a matter of where you are in
that sort of U-shaped curve, right? You
got to get over that sort of jittery
anxiety point before it really starts to
you. It doesn't bother you, right? I
mean, when I was a young assistant
professor, they would see me come in the
restaurant with our our guests and they
would immediately put a pot of coffee on
because they knew I was going to sit
there until 9 10:00 at night and drink
coffee the whole time. Right. And I go
to bed, no problem.
>> Yeah. I was saying that today recently
on a podcast I was a guest on, I shared
that I drink, and I do not suggest
people do this, but I legitimately drink
somewhere between 600 and probably 900
milligrams of caffeine per day. Wow. And
people say, "Well, that's impossible."
But I'll drink five
>> zero sugar cold brew yerba mates. Each
one of those 120 milligrams, plus a
strong coffee, probably another half
cup. I limit it to the early part of the
day or up to about 2 p.m., but no
problem. But most people who get their
commercial vendor coffee, let's say uh
venti coffee,
>> take that away from them from two for
two days and they will be complaining of
headache and maybe even nausea because
it there's so much caffeine in those.
>> Okay, so we got this first case uh
caffeine- like usage. Let's just bin
that. Um, second path of cratom usage
seems to be people who use fairly high
doses or or concentrates to achieve an
opioid-like effect, a mild seditive
effect, um, euphoric effect. Um, this
sounds a lot like opioid use or higher
dosage alcohol use for instance.
>> Right. And then we've got this third
category that you mentioned that are
using to get off opiates or to stay away
from opiates
>> and for whom you told us
is a is a real benefit for them because
otherwise they would be strongly
addicted to opiates. And I should just
mention that this third category of
people are the ones that I heard from
when I mentioned on X formerly known as
Twitter. I said something kind of
negative about I just put out a a then
tweet now post um which alluded to the
darker sides of
>> and I got attacked actually by this
community that said hey were it not
forratom uh we'd see a lot more uh
opioid dependence we'd see a lot more
fatalities and actually I learned about
you in large part through the dialogue
that emerged from that response and so
hopefully what listeners of the of this
podcast are starting to hear is that
this molecule is uh complicated,
super interesting and that the usage
patterns are complicated and varied and
very interesting. So we can't just
sayratom badratom good
>> we really have to explore how it's
delivered and what people are using it
for.
>> And again we can't just sayratom because
it's that's just like just saying
alcohol, right? So there's there's a
variety of different forms of product
>> that are that are out there and that are
being utilized and and it could be that
those those are being utilized in in
very different ways. Um as I mentioned
we don't have good strong data to
suggest one way or the other but you can
assume and anecdotally say that it would
make sense. Right? So I think two things
that will really kind of probably blow
this open a little bit more. Um one is
is that uhratom itself contains multiple
compounds multiple chemical compounds.
So it's not just one thing.
>> It's an alkyoid.
>> It has at least 20 to 40 alkyoids in it.
>> Can you um explain to people what an
alkaloid is and some other examples of
alkyoids they might be familiar with?
>> Sure. So alkyoid is a organic molecule
that has at least a nitrogen in its
structure. So it it has to be nitrogen,
carbon, hydrogen. It can or cannot have
oxygen. Um but those are essentially the
the template for what we would define as
an alkyoid. And then there's various
classes of alkyoids. Um many things that
people are familiar with. Dopamine,
serotonin, these are alkyoids. Um but we
could go further. We just talked about
caffeine. Caffeine's an alkyoid. Uh
cocaine's an alkaloid. Morphine's an
alkyoid. Um, so all of these molecules
contain a nitrogen um that that is core
to part of their activity. What we
believe is essential for them to
interact with the proteins in the body.
>> Can I ask a question about nitrogen and
protein interactions given this is a
science/halth podcast without getting
too far down in the weeds.
>> Uh, a number of people will hear, okay,
it's got a nitrogen. Okay, they probably
have uh vague or or clear memories of of
chemistry class, but the fact that you
have this this N this nitrogen
>> and you have cells that have proteins,
it for the non-chemist, could you
explain how the nitrogen allows the that
molecule to do something? Does it bind
with more affinity? Does it change the
gene expression? What is it about having
a nitrogen that really changes the
properties of a molecule? Yeah. So
there's there's a couple of important
pieces here. Nitrogen is a element that
can act as a base. So it can in a
technical term can accept a proton. So
it can also develop a charge. Charges
are important because if you think about
magnets, right, we have a positive
charge magnet face and a negative charge
magnet face. And those two things will
attract each other. You can set them on
a table and they'll find each other,
right? Depending on how strong or close
they are to each other. That's a very
similar thing that happens between a
nitrogen that can gain a positive charge
in our body and say a caroxyic acid or a
a negative charge that would be present
on a protein. And so that nitrogen being
charged, I always call it when I teach
my pharmacy students, it's almost like a
tractor beam. That molecules floating
around and it it's trying to find that
negative charge to interact with. And
when it finds the right one in the right
space, and the right fit, boom, it's
into that protein and it causes whatever
it's going to cause, whether it
activates that protein or whether it
blocks that protein from doing its
function. It is a key element of life.
All our amino acids, amino is nitrogen.
All of our amino acids are building
blocks of life have that nitrogen and
they have the acid part to it. So they
have a positive and a negative charge by
nature. Um and that's what makes up all
of our proteins. And so the proteins can
have positive charges from the nitrogens
and they can have negative charges from
the acids. And what we generally see
with plant materials is they have
alkaloids within those plants and those
alkyoids um have helped define really
our chemical neurotransmitter systems.
Nicotine perfect example. It's an
alkyoid. We have an entire
acetylolineric nervous system and which
is the exclusive nervous system in
insects. But nicotine binds to nicotinic
acetylolinergic receptors. That whole
system was defined by nicotine.
>> Right? And people just to take a step
back um what uh Dr. McCertie is
explaining is that there are receptors
throughout the brain and body that are
responsible for everything from muscle
movement and contraction to uh your
ability to focus um to your memory um
neuroplasticity that are so-called
nicotinic acetyloline receptors. They
didn't evolve
because we thought that people would
take nicotine. It just so happens that
this plant that a tobacco plant that
contains nicotine was used as a
experimental probe to understand where
these nicotinic receptors are in the
body. So this reflects the fact that
humans have been uh nibbling on plants
and seeing what happens for a long time.
There's a um explicative version of this
which is f around and find out kind of
uh experimentation, but this is really
what uh old world primates including
humans have been doing for a long time.
And then just seeing whether or not uh
your buddy that ate the plant died.
>> Yeah.
>> Got energized,
mated,
um fought, slept,
>> right?
>> And I mean, this is kind of still what
we're doing. It's just that we do this
now with lab coats on,
>> right? In in many ways. And and you're
100% right. Right. There's the old joke,
there's two types of mushroom hunters,
good ones and dead ones. Right.
>> Good joke because it's going to keep a
lot of people safe.
>> Yeah. And and I mean it's that's the
point and and in fact I' I've done a lot
of work with ethnobbotnist and
ethnopharmacologists and somewhat am
uh being in that work we've been doing
and actually going into the you know
native places to learn more about it. um
which is what ethnobbotnist or
ethnopharmarmacologist would be doing.
Um and you know we we we have um a lot
to learn from the things that have
existed on this earth for a long time.
Many of those are animals. Animals were
probably the first pharmacists and the
first physicians because they learned
which plants to utilize when they were
ill or sick and they use which plants to
avoid to stay alive. So they they
learned these things long before humans
were capable of looking at and
understanding what the animals were
doing and then mimicking the animals,
right? And then this is sort of how
modern medicine started to develop was
all by observational, all by anecdotal.
Hey, that that looks interesting, right?
This this is happening.
>> And you still do this now in your
laboratory. We study animals and we
advance to human clinical trials. Right.
>> Animals have a certain advantage in this
regard because they don't um subject
themselves to the placebo effect as far
as we know.
>> Correct.
>> And in addition to that, animals, most
animals, including insects, but many
non-human mammals have a much more
powerful sense of of smell than we do.
And many of the compounds in plants if
they have uh like some people will um be
familiar with the discussions about
testosterone and estrogen as you know
steroid hormones having um and then the
aromatase properties. Aroma they they
literally make
>> have an aroma that chemists in the lab
know. Oh, you could smell if something
has a has a steroid like chemical
structure by virtue of the way it
smells. But animals are very good at
seeking out plants that have estrogen or
testosterone in them just by virtue of
their ability to smell those compounds
uh very very um sensitive.
>> And you take it a little step further,
it's also the taste part that's
involved. I had my original mentor, he's
he's gone now. Um one of my original
mentors, he actually would come into the
lab was so old school that he would dip
his finger into whatever I made and
taste it and say, "Yep, you got your
product." I knew that was coming because
I I knew one of these old older uh he
was a neuroanatomist and
>> I never I can't believe that these guys
did this.
>> These guys did it.
>> Uh he's dead now by way of age, but he
was a member of the national academy and
everything that we had a shipment of
>> please do not do this of of non-human
primate and human brain tissue being
shipped in for his brain bank. Friends
of mine will know who this is. And he
>> opened up the jar that it was shipped
in. It was in liquid and he took off his
glove which itself is crazy. Dipped two
fingers in
>> and he goes 30% sucrossse but this could
have prons in it. Now it was fixed also
being parapaldahhide.
>> Yeah. Exactly.
>> No no no no regard whatsoever. Rescrewed
it put it on the shelf and then you know
people got to work and it was obviously
a demonstrate. This was kind of bravado
in in laboratories too.
Self-experimentation terrible habits. Um
but uh it was not uncommon. I mean this
is the way chemistry was done.
>> One of my great meners and I'll I'll
spare him sharing his name but his his
um his master's thesis was making
analoges of methylenidate which is rolin
>> and so he rolin is a um methylester. So
it's a caroxyic acid that has one carbon
attached to where the acid part is. So
this makes a what we call an esther. Um,
and if you extend the carbon chain of an
esther, you can one, increase how it is
absorbed in the body, and two, you can
potentially increase how long it lasts
in the body. And so his whole project
was making from the methyl, now we take
two carbons, which is ethyl, we take
three carbons, which is propel, we
branch those carbons to make isopropyl
or whatnot. And he would try each one of
the compounds that he made himself to
see if pharmacocinetically and
pharmacodnamically
it's improved on methylenity. Well,
guess what's still on the market today?
Methylenadate. So that ought to tell you
the the result of his work. But but when
he told me those stories, um it just
blew my mind because I I'm so averse to
even smelling the chemicals we work
with. Good.
>> You can blow out your factory
epithelium. Absolutely.
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at checkout. What's clear to me now is
that uh what we're talking about
scientists and um everyday uh apes uh
that we call humans um smelling stuff
and tasting stuff and experimenting
on one end of the spectrum and that on
the other end of the spectrum somebody
going into a convenience store we're
looking online and buying a little
bottle and slugging it down.
>> Yeah.
>> And getting some effect. And I actually
think that in in between those is some
important experiential stuff that's
missing that perhaps is explains a bit
of where we are withratom at this point
in time which is
historically or what you call the
traditional use. People would harvest
the plant. They have knowledge of kind
of the the coloration of the plant, the
texture of the field. A lot of
unconscious knowledge too. Um maybe it's
passed down through generations. Maybe
they just learn it, you know, in a
couple of years and next thing you know
they're brewing it, they're drinking it.
As they're brewing it, they're smelling
it. There are many more um avenues of
information coming in about the
concentration. You're not just going
from product purchase, ingestion effect,
>> right? And I think that perhaps this
explains a lot of how we end up with um
the highly processed food industry where
you know much of what we're talking
about today is paralleled. You know
sugar is we have an innate desire for
sugar. Uh who doesn't like sugar? We
have an innate desire for protein and
amino acids. But the highly processed
food industry has figured out how to put
all this into a package where there's
two servings worth. Right? you're
ingesting far more calories, far more
preservatives, etc. in trying to get
some effect, but what happens is your
threshold changes and the next thing you
know, you're going to the highly
concentrated version. In other words, we
don't go through this process of
stepping through and and getting
familiar with a molecule and and I think
that could explain why people, you know,
you're prescribed an opioid, next thing
you know, you need that opioid, right? I
mean, good good people have been very
willing, it's clear, to do bad things to
other people
>> in effort to try and avoid the
withdrawal symptoms of opioids, right?
>> And often the person they're harming the
most is themselves.
>> I think what you hit on is is a really
deep philosophical conversation on a
whole another level because I just had
this conversation with a a colleague.
We've lost totally in our culture where
it is that medicines have come from. If
you look at prescription medications,
FDA approved medications,
in the neighborhood of 75% of those that
are available today were either
discovered because of a natural product
or modified
natural products that made it into
our drugstores and our hospitals.
Aspirin.
>> Aspirin is one perfect example.
>> Salicy acid.
>> Salicylic acid. It comes from salicin
which is in the bark of the willow tree
and people used to chew on the bark of
willow tree and that salicin is the
active form. You know you get salicylic
acid makes it more stable. And there's a
long story there, but um uh it's it's
important because um
we've lost that sort of connection to
nature, that connection we just talked
about with the animal world, right? That
watching the animals do things and
learning from the animals.
>> Metformin, bourberine, a tree bark.
>> Yeah.
>> That lowers blood glucose
>> and works for all the world as well as
metformin. Well, look at look at the
biggest selling weight loss drugs right
now, the GLP1s. You know, you know that
story. They actually came from the
saliva of the the helila monster. So,
this is a lizard that eats only a few
times a year.
Um, but in its saliva, it has uh GLP-1
peptides. And um this was this was
learned to help control glucose and help
do all these things. And that was
modified. And now we have Wiggoi and
whatever zones uh out there as as
blockbuster drugs that are really
changing um you know the shape of of our
society for hopefully for a a good
benefit and and getting people away from
some of these sugary things you
mentioned earlier too. But yeah, there's
there's just this history, rich history
of how drugs have gotten to where they
are. And most of us, including myself,
uh you know, we run in and we pick up a
prescription or we pick up something
over the counter and don't even think
twice about it. We know it's going to
give us this effect and boom. And so,
you're you're 100% right. And like I
say, it's a very long deep philosophical
discussion to get this whole thing
circular, but we've we've lost that
whole understanding of where things are
coming from. And that's that's one of
the things that I've always loved in my
training originally as a pharmacist.
I've always felt like for every disease
that presents itself in this planet,
there's got to be a solution. There's
got to be this balance in nature. and
natural products has always attracted me
because of that.
>> I'm just struck by the um
by the number of examples that are just
like popping to mind about how we've
gone from plants and food and compounds
out in nature to through experimentation
and observation to medicine. and then
how that those same medicines are
extracted and concentrated and in some
cases diabolically hidden in other
things like food. Um because I don't
think sugar is poison in the same way
that um heroin is poison but sugar
clearly can be destructive in a way that
makes it poisonous and the way it's used
and packaged and marketed etc and kids
cereals and things like that I think is
absolutely clear. And so the arguments
about whether or not sugar is addictive
in the same way that heroin or cocaine
is addictive are um they're kind of um
empty arguments until we really define
what we're talking about. And it is that
the dose makes the poison. It's also
whether or not people are aware of what
they're doing. I think this lack of
awareness that we're using medicines
when we consume products and that we're
using medicines at high concentrations
that are not typically found in nature
is a big part of this. I also heard you
say that you believe that for every
human ailment and disease, there's
probably a a treatment and/or cure out
there in nature.
>> That that's an exciting thing to hear
from a medicinal chemist who runs a
laboratory. Um, which by the way, folks,
um,
looking over, uh, Chris McCert's CV,
they publish at an absolutely staggering
rate and all high quality papers. I
mean, there's never been a single
retracted paper. They're just be
beautifully done studies that just the
amount of work coming out of your lab in
terms of trying to parse what these
molecules are doing is just like
mindblowing.
So, I just want to point that out. It's
clearly clear that you're very
passionate about this. I I
have heard the the concept of slow food.
You know, this idea that instead of just
consuming prepackaged food and, you
know, we're going to slow down, we're
going to cook our food, we're going to
get in touch with the food and that will
give us a better understanding and
health relationship with the food. I
almost feel like we need a slow medicine
movement.
>> Yeah. Almost.
>> Might as well.
>> I like that idea. you know, as somebody
who has been using supplements since I
was in my teens, um, and I know it's a
less well-regulated um, industry, I've
I've long been interested in in herbs
like I I use and I'm open about the fact
that I've used Tonga Ali um, as a like
for vitality for a long time. Things
like Fedogia. Um, I continue to use
these and my blood works as a it's fine
and I I enjoy them and and it it works
well for me. But if those were put into
a um pharmacologic agent at very high
concentration,
I can bet that it's an entirely
different molecule and experience and
might cause shutdown of the of uh
certain hormone pathways and things like
that. There seems to be something kind
of um unregulated
and yet uh more nuanced
and um stayed about the use of of
medicinals in their more natural form.
And this is kind of the the the yin-yang
of it. It's like yeah, you can't get an
exact milligram dosage and
concentration, but you're also not
playing at very high concentrations.
>> Right. Right. I I I look at it like a
natural products.
It they have evolved in mother nature's
kitchen for,
you know, millennials. I mean, they've
they've been there for thousands of
years. Um it it only took humans coming
along to figure out how to manipulate
all that, right, and mess it up. So,
mother nature's kind of got it right in
many cases. Um couple examples just just
to bring this back to more of a
discussion around alkaloids.
um opium opium poppy long been used and
yes it's problematic addictive and all
these things but it's nowhere as bad as
once morphine which by the way was the
very first alkyoid ever isolated
characterized identified
>> morphine when that happened the poppy
became sort of not that important
anymore because we found the magic piece
the Same thing happened with the second
alkyoid ever isolated, cocaine.
Cocaine comes from coca leaf, which has
been used for thousands of years in
South America and in indigenous tribes
and cultures there. It's still used
today. It's one of the only places on
the face of the earth that it's legal.
Um, when cocaine was isolated and
discovered, the the rest of the leaf was
criminalized and thrown out like the
baby's bath water. Um yet there seems to
be great medical potential with coca
leaf. Uh and and this is something that
my lab is getting ready to embark on
next as kind of like our new our new
challenge. We still we still have a lot
of work to do um withratom and
understanding that. But um you get you
get to a point where a lot of the
initial excitement starts to wear off
and yeah we know we need to do these
other things but we want to come back to
some of that initial excitement project
type work again and that's why we're
embarking on that. Um we world health
organization is actually doing a
critical review of cocoa leaf again to
consider removing it as a globally
banned substance and returning it back
into potentially the food supply um
which is a very nutritious plant. It's
utilized by um tribes in the in the high
mountains high elevations in South
America where they don't have much dairy
in their diet. There's tons of calcium
in in this um in the cocoa leaf. There's
tons of vitamins. It's so nutrientrich.
Um and and just a remarkable plant in
and of itself. But again, we've
forgotten about this because we found
this, you know, smoking bullet uh
cocaine. And we don't want people to
mess with that plant because there's a
chance they're going to get that out of
it. And this has been a somewhat of a
cautionary tale bringing this back
toratom because what we're seeing now is
theseratom derived products where
they're actually taking compounds that
are rich in the naturally occurring leaf
and they're manipulating these into very
potent opioids.
They're chemically changing these
molecules. Um, and these are now
products that are out in the market that
are available, easily purchasable. Um,
and unfortunately in the same places you
can buy the more, you know, benign leaf,
if you will, and it's not benign. And
please don't think that I'm saying is
benign at all because the leaf material
can be dangerous. And we know that
people have problems with even just the
leaf material over time. And so we don't
understand where those things come from.
Uh we don't have a good scientific
history of of how that evolves. But what
we do know is that if we go down the
same pathway that we have for things
like identification of morphine,
identification of co of cocaine
to a product that we started from nature
againratom
uh and now we're whittling down and
figuring out actually it's a metabolite
in our bodies. it's a a metabolite.
Controversially, that may or may not
exist in the plant. We've never found
with all the work that we've done um
with expert biosynthetic
um biosynthetic
uh plant folks, we've never found
enzymes that will produce this compound
7 hydroxy metroin and that's a
metabolite of metroin which metroin is
the major alkyoid within the plant uh
and as I mentioned there's more than 20
alkaloids within this plant and I I I
really want to come back to this
discussion about the differences in some
of these alkaloids because they're
they're very very different. I I I look
at this plant as almost a pharmaceutical
shotgun. It's got
different alkaloids that are targeting
different systems in our body. And this
is what makes different. You referred to
it in the past as it's opioid, but it's
different opioid, right? It's a
different because it's interacting with
multiple other systems in our brains.
And so we need to come back and and
revisit that. But before we do that,
what we know is that this seven hydroxy
metric and this metabolite that our
bodies produce naturally from the major
alkyoid is being chemically produced now
and sold in commerce. And the these are
now catam derived products or isolates
or synthetically derived products. Um we
know that that molecule is pure opioid
in its activity.
>> It only interacts with opioid receptors.
>> You said these are catratom derived
orratom isolates. If they're going to
experiment with or use products, they
need to pay attention to serving size.
Yeah. And also pay attention to whether
or not the product is contains derived
products within it orratom isolates
because those more closely mimic
powerful opioids
>> pure drug
>> a pure drug
>> and I actually am of the belief that
many people taking products are not
aware that they're not taking the leaf
type product.
>> Correct.
>> Even if they're drinking it they they
it's because we just call it one thing.
I agree and that's where you know we've
we've we've published commentaries
um on this because we feel it's just
really important to get this message out
and it's important to get this message
out to the medical community because the
medical community um that are dealing
with patients humans firsthand they show
up in an emergency department um you
know they they don't know to ask did you
take leaf did you take
uh uh extract Did you take a
concentrate? What what product is it
that you actually take? Because most
people, if they know if someone was with
them and they
got intoxicated by a product, they're
they're probably just going to
generically say it's not going to
specify what what it was. And so this is
a big thing that we're trying to as many
of the researchers in the community are
really trying to get out is this
differentiation of not allratom is the
same. Right.
>> Well fortunately uh we have the ear um
on this podcast from some of the folks
like Jay Badacharia NIH and and others
who are um thinking seriously about
revising uh laws around packaging of uh
food and drugs. Um I don't have any
direct relationship to them but we have
their ear. So, um, uh, I think one thing
that I can't imagine anyone would oppose
would be the careful wording of warnings
about this contains derived products or
isolates in the same way that um, you'd
like, you know, cannabis is legal in
many places now or at least
decriminalized. As I learned from a
guest on this podcast who's expert in uh
cannabis science, um people who smoke
cannabis are pretty good at regulating
the dose
um based on number and duration of
inhales, but people that take edibles
are often the ones that end up in
psychotic episodes um or anxiety attacks
due to overconumption because you can
eat something very fast before it hits
you. There's like there's this delay. I
want to parse each of the things that
you raised, but I think there's likely
to be a couple of basic questions that
are on people's minds that maybe we can
tick off really quick as we as we head
into that.
>> And I know it might be hard to answer
these with a yes, no. So feel free to
say maybe or it depends. Kids 18 or
younger, avoid, don't avoid, or it
depends when it comes to and and here
we're talking about leafratom or
products. And we're talking about kids
in the US. So, we're we're not and and
in Europe, we're talking about outside
of Malaysia where they have a have a
more innate um historical understanding
of of the of the plant.
>> I'll preface it by saying I am not
familiar with anybody
young using this in Southeast Asia in a
traditional sense.
>> Well, that's good to know.
>> So, it's it's mostly used by people that
are laborers that are out doing this,
you know, more adult, if you will.
Most of the regulations that have been
drafted and put into place in some
states
are either limiting age of 18 and older
or 21 and older.
>> Do you agree with that?
>> I agree with that from the standpoint
that the brain is still developing until
we're 24 25. We know from studies with
cannabis that, you know, that can slow
brain development and people can have
lower IQs if they start at a younger age
versus people that never smoked and
developed their brain fully. So we have
no idea what the impact is ofratum
developing brain. A lot of people will
hate me for saying this, but my feeling
is, you know, the drinking age should be
24, 25, just like when your insurance
rates go down for your car, it's 25.
It's because you have a prefrontal
cortex, right? And I think when you
hijack that system with any substance
that can be psychoactive, you run into
problems. And so the best
recommendations are, in my opinion,
getting all the way up to that 24 25.
But I would be okay with people saying
18 or 21 um because that seems to be
more acceptable in society as to where
we've set barriers in in you know
historical precedent. So yeah, I don't I
I
have great fear
um as a parent that my own child would
go into one of these gas stations not
knowing what what they're getting
because one of their buddies told them,
"Hey, this is cool. try it. Um, you
know, and consume it and and something
something happens. Um, and and as you're
well aware, there's a there's a big
difference between someone who's naive
to any substance and takes it for the
first time um versus someone who's
gained some experience um with those
substances. And so,
uh, young people are,
again, because there's not that
executive control of the prefrontal
cortex are are much more likely to take
those risks, but not because they're
being dumb. They just don't they don't
understand.
>> Well, they're not getting the
information and and thanks to you,
they're getting the information. Now,
the second cohort that I'll ask about
would be, you know, people, let's just
say, you know, 18 to uh 25 and older who
are seeking a caffeine um stimulant-like
effect. Um assuming they can get a hold
of the more plant-like product, so the
uh you know, where it it's not a
catratom derived product or isolate. Are
most people able to use product in the
same way that they use caffeine? So on a
daily basis, but were they to not be
able to get it, they they would have a
couple days of of mild discomfort, but
they'd be okay. They could drink
caffeine instead and get over the the
hump, so to speak.
>> Yeah. So, it's a that's a definite maybe
question.
>> So, it depends on the person.
>> It depends on the person, as you know,
that we're all so different and we all
respond differently to different or the
same thing. Um, but I I think that
let's just say um the the most frequent
thing I hear from people that are using
and particularly leaf products on a
regular basis, they always say less is
more. They always say that the lower
amounts they take, they seem to derive
more benefit from it.
And I've I've struggled with that from
the standpoint of just understanding
pharmarmacology and understanding
tolerance and understanding, you know,
after you've been taking something for
so long, you naturally think you got to
take more to to benefit from it. And I
think it comes again back to the group
of users that we talked about. What is
their goal at the end of the day? But if
they're just taking it as this sort of
mood lifting elevating um energyderived
uh thing then then the recommendation to
and I would say this for anything is
stay low and stay slow and and you know
never increase things. what I've been
told because again this is not something
that I use is is that
um people benefit from this on a
consistent basis just like most people
benefit from a cup of coffee or two a
day. Um and yeah, if you go a couple
days without it, you're going to have a
headache. where people start to develop
problems is
if they are using this for um pain
treatment or something else like that
and they initially start out and this is
great everything's good. It does seem
that a tolerance develops to the pain
relieving properties of this. We don't
know what that time scale looks like so
we have no idea and it it'll differ for
everyone. Um we've not done these
studies in animals to tell you that uh
you know a mouse or a rat is going to
take this much time and therefore we can
you know scale this to what it would be
on a human. We've not even done those
types of studies to understand. But I
can tell you anecdotally from talking to
people that's what happens. They'll
they'll develop these these tolerance
and they'll suddenly have to take more
to get that relief. And as we take more
of anything, we get closer and closer to
a problem because it's not the benefit
that we're getting that generally gives
us the problem. It's something offtarget
or off
off of that original frame that we're
focused on that gives us into the
problems. Um, you know, opioids for just
a clear example, opioids are fantastic
pain relievers,
but humans develop tolerance to the pain
relief properties of opioids quickly.
Unfortunately, we don't develop
tolerance to the constipating effects
and the respiratory depressive effects
of these as well. And those are the two
things that limit um clinical
utilization of opioids. If you're
getting constipated, then we have to
stop using opioids from a clinical
standpoint to treat your pain because
it's you you can get too stopped up and
this could be worse. Same thing with
respirations. Of course, the mo main
reason that individuals die from opioid
overdose is because they stop breathing.
Um, and that respiratory depression is
nothing to do with the analesia. Has
nothing to do with the pain relief. It's
just this off offside target.
>> Yeah, it's these receptors in the brain
stem. I mean, I think
>> um
>> it raises the question whether or
notratom can cause respiratory
suppression.
>> It's a good it's a good segue to our
paper that should be coming out in the
next week or two.
>> Oh, great. Well, since it's already
accepted, uh yes or no,
>> it's complicated.
>> Is it dose dependent? So I will say this
inratum
as a whole we've not studied in
respiratory depression. So the products
that are in the marketplace we don't
know. I don't know an answer to this.
It's long been said that there's much
less respiratory depression fromratom
than there is from clinically or illicit
opioids. I think that's pretty well
accepted in an anecdotal way.
Scientifically, we can't say
definitively what that is. The paper
that we have that's coming out
um it should be in the journal of
pharmarmacology and experimental
therapeutics. Um it's already on
bioarchchive right now, but bioarchchive
is not a peer-reviewed site. Uh we just
wanted to get this information out as
soon as possible because we think it is
vitally important for public safety. um
these seven hydroxy metroin
um products that are now being sold as I
mentioned as semiynthetics or isolates
um are actually causing respiratory
depression equivalent to opioids.
>> Wow. Okay. So these are the the um the
specific alkyoid metabolites. So to back
up again folks the alrratom contains
somewhere between 20 and 40 alkyoids.
Um, one of them is most abundant. The
metabolite of that um is what's active
in the body. Chem chemists have figured
out how to manufacture that metabolite.
People are taking products of the pure
metabolite mixed in with some other
things and that can cause respiratory
depression um on par with uh opioids
>> in in a rat. So, I will I will caveat
that. But, you know, it's one of these
things that we we talk about all the
time. If it walks like a duck, if it
quacks like a duck, if it looks like a
duck, it's a duck.
>> Yeah, I think when it comes to
translating animal studies to humans, it
um it's hard often to take a dosage by
kilogram of body weight and translate
because metabolism is different, etc.
However, I think when it comes to neural
circuitry, which is what we're talking
about when we talk about respiration,
these two nuclei in the brain, pre-bot
singinger and paraphial nucleus, which
have abundant receptors for these things
that control breathing, um the that
machinery is so highly conserved from
mice to rats to non-human primates as we
always say rat, cat, monkey, bat, um and
human um that it would be
it would be remarkable and extraord
extraordinary to for the system to work
much differently
and I think in humans it's going to have
exactly the same effect you know but I
can't say that definitively and and it's
not an ethical thing to really do right
but we know that that effect even in the
animals is completely reversible with
narcan or nlloxxone so it's it's also
highly opioid
um receptor involved
I'd like to take a quick break and
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the FDA, and I'm not, um,
>> that makes two of us,
>> but if I were, I would say, okay, based
on everything I've learned thus far, um,
the plant basedratom products that were
still close to the plant seem like it's
a maybe scenario. Kids and people up to
18, maybe 21 or even 25,
it's a hard no. Stay away from it.
People older than that are going to have
a varied response. Could be like a cup
of strong coffee um or two or an energy
drink or two. I mean, some of these
energy drinks now, I mean, they pack a
serious punch. And you look at the total
caffeine count and it's not that high,
>> but then you look at the serving number
and you look at the other things that
are in there
>> that serve to amplify the the
neuromodulator effect like increased
dopamine, epinephrine. I mean, they've
got hooperine, um, alphagpc, they've
got, um, things to enhance the serotonin
pathway, they've got things to take away
the jitters like eltheanine plus the
caffeine plus some additional
stimulants. And pretty soon you go,
yeah, the caffeine count isn't that
high. But what you've got is a is a
neurom modulator cocktail in there. So,
um, and you'd say, okay, for adults, use
with caution, figure out minimal
effective dose, and be aware that it
could be habit forming in a serious way.
it something like that. But then I would
probably also create a third category
which is and I'm gonna get the
pronunciation wrong but the seven
hydroxy metabolite of metro metroinine
>> metroine
>> metroine um
>> or metrogenine something
>> metroine seven hydroxy metroenine um
tragenine tragedy okay should be um if I
were FDA commissioner I'd say this just
sounds all bad just flat out make it
illegal
>> so you're not making illegal you're
making the the opioid like derivative
uh illegal or extremely hard to get or
maybe you need some additional um
barriers there. Why isn't it that way? I
mean, why did we sit down here today
ready to ask you should cratom be
illegal when we're really talking about
two different use categories, younger
and adult people, and we're talking
about basically two completely different
compounds.
>> Yeah. Well, even very different
products, period. Right. So,
uh, it's it's it's extremely complicated
because under the FDA's dietary
ingredient rules, a metabolite of a
dietary ingredient can also be
considered a dietary ingredient.
>> I see.
>> So, this is kind of the loophole, if you
will, that's allowing this to be in the
marketplace. But there's several group
of advocacy um nonprofit organizations
out there. Um there's Americanratom
Association, there's a globalum
coalition, there's a holistic
alternative recovery um group.
>> What's the role? Are these people who
are looking at this as a as a good
alternative to opioid abuse?
>> So in in many of the cases, yes, all of
the cases, yes. So I should say that um
the the American cratom association and
global uhratom coalition are much more
um advocating for science-based
information and knowledge around
andratom products and putting actual
guidelines in place that will give some
regulation to the industry
um that they claim the FDA is is not
doing right now. The FDA is just letting
it exist in the marketplace in whatever
form, shape, size it wants to. Um, some
of these groups are are really trying to
put guard rails around what a product
should be, what should be on the label,
what a serving size should be, what
limits of alkaloid content should be. Um
there's this other group, the heart
group, which is really uh a proponent
for this 7 hydroxy product and saying
that it's out there to reduce harm. It's
out there to help people benefit from a
product that is not an opioid, right?
But it is purely an opioid, but it's not
a prescription opioid. And they're
saying it's reducing harm weight. I
don't know that anybody has evidence to
demonstrate that yet. There's no solid
evidence. There's some again anecdotal
evidence. They released a statement
recently um suggesting that there's no
mention of these in the FDA's databases
of adverse events, the fears database.
Um, but then again, it makes you wonder
if these products have only been in the
marketplace for a couple of years, um,
is there even a coding to put it into
the fears database so that can even be
recognized?
>> If somebody were to take um, a catratom
product, either an isolate or the plant
product, and then drink alcohol, are
they at greater risk for uh, dying from
respiratory failure? in the same way
that if somebody takes an opioid and
drinks um they can die. Actually, sadly,
I know a lot of cases of this of people
who even took a prescription opioid a
day before um an afternoon or night of
drinking and were pretty good drinkers
if I'm if I'm say it wasn't was not uh
someone real close to me, but from what
I understand were good drinkers and then
end up dying in their typically in their
sleep after the night of drinking. is
not uncommon. Yeah.
>> And this is independent of all the
fentinyl issues. Correct. Right.
Correct.
>> Um doesratom have the same potential
risk.
>> So as a whole, it's hard to say. No,
nobody's done any studies combining
this. In fact, interestingly enough, the
studies that have been done with alcohol
are looking at reduction of alcohol
intake. So it has been reported
anecdotally again thatratom actually
reduces alcohol consumption.
>> Interesting.
>> Um and this has been anecdotally
mentioned by many people that use it. Um
you know I just don't have the interest
in drinking anymore or or I can have a
couple drinks and I'm not trying to get
drunk. Now, there's a lot to unpack
there because there could be all kinds
of different things happening
pharmaccoinetically, drug interaction
wise, if you will, just like you're
mentioning. Um, there are groups that
are funded now. We're not one of them,
um, from the National Institute of
Alcohol, Alcoholism, uh, alcohol abuse,
um, and IA to study specifically, uh, as
a harm reduction agent in alcohol use
disorders. Interesting. Such an
interesting molecule, right? We're
talking about a molecule that can be
potentially used to help wean people off
opioids, maybe even limit alcohol
consumption for people with alcohol use
disorder, what used to be called
alcoholism,
>> and at the same time can serve as a
stimulant and maybe even an aphrodisiac.
Is there any uh are there any data,
excuse me, um about the binding sites in
the brain and some of the pathways that
would make this molecule an aphrodisiac?
Not specifically.
So it you know I I earlier said it's
kind of nature's Viagra but it's not
interacting with the phosphodiestase
pathways.
>> It's not causing vasoddilation that we
are aware of which is what Viagra
basically does. Right.
>> Limits the enzyme that that um uh that
would lead to vasa constriction.
>> Correct. Correct. So you you you have we
don't really have clear evidence of
that. And what it it it may be is that
it's this increased um sort of
stimulants stamina activity. But but
let's back up to one of the very first
goals when we were funded by the
National Institute on Drug Abuse to
study this. Um the the main question
that was asked was can you isolate as
many of these 20 to 40 alkaloids as
possible
purify them and tell us what each one
does individually.
Okay. So the the easy one to get was
Mitrogon and and and if you look at the
majority of the literature around and
there's almost a thousand papers in
PubMed now. I looked this morning uh
just on we we account for almost 10% of
that from my lab by the way.
>> You guys are prolific.
>> Um and the vast majority of the studies
that are in the literature now have been
done with the major alkaloid metroin.
And I always remind my lab and my team
and my collaborators, metroin does not
equal.
Is a complex natural product with all
these other alkaloids in it. And so
let's I wanted to come back to this. So
let's just unpack those alkaloids very
quickly um just to tell you what's going
on. So metroin the major alkaloid
actually has affinity for opioid
receptors but very weak affinity and
doesn't do much from an analesia or
painkilling perspective which you would
think the major one that's what it's
there for that's what's going on. It
also interacts with a couple other
important neurotransmitter systems. And
there are other alkaloids within the
plant that are majorly exposed when you
ingest the whole plant product into our
bodies that are heavily interacting with
serotonin system. So our sort of satiety
center um our our mood elevating center
if you will. most of our
anti-depressants are targeting uh
increased levels of serotonin and
increased levels of norepinephrine in
our bodies. Um and so we know that we're
engaging and activating the serotonin
system, which by the way is also
involved in pain processing. Um, and
then some of these alkyoids are heavily
hitting the adinuric receptors, which is
our stimulant sort of activity centers.
Uh, our fight orflight sort of system,
if you will. Um, and
it makes it into this very complex
alphabet soup, what I like to call a
complex symphony orchestra that's that's
playing multiple instruments in our
brain at the same time.
And some people say that this is the
best pain relief they've ever had. And I
come back to it as a science and now
saying, okay, we've looked at all these
different mechanisms that are involved.
We've never treated pain
from those three prongs at once
in a single drug or in a cocktail of
drugs in a human. Can you list those off
the three?
>> Yeah. So those three are opioid which
obviously we use to treat pain,
serotonin,
>> which we sometimes use now for chronic
pain.
>> Um drugs like amatipptalene which is a a
serotonin uh reuptake inhibitor old
school triccyclic anti-depressant used a
lot for neuropathic pain before things
like gabapentin neurontin came along or
pregabalin. Uh and then the adinuric
system. the adinuric system which is
actually one that we target in some of
the side effects of opioid withdrawal uh
with drugs like clonodine which are
alpha 2 receptor agonist that help shut
down neurotransmission in our brain.
This is really fascinating because all
three of these neurotransmitter systems
are intimately involved in pain
processing. And we've always looked at
um and I'll I'll say this from a
medicinal chemist standpoint. Medicinal
chemist goal are to make the best
compounds, the most selective compounds
for one target so pharmacologists can
figure out what that target is doing.
And here's another example from nature
that's saying, "Look, if we hit all of
these targets at once,
you don't have to step on the gas quite
as hard on each one and you get some
kind of relief." And that's why I'm
saying what I hear from a lot of people
is less is more.
So, a lot of people that are reporting
pain relief or mood elevation, they're
not reporting psychoactivity.
They're getting the benefit without the
psychoactivity. But if you have the goal
when you take these products that you
want to get high or you should feel like
you're on a drug, then that's I think
where people are starting to push in
saying, "Well, I've I obviously can't be
benefiting from this if I'm not feeling
like I'm on a drug." Right. Senator I I
want to say first of all thank you for
that description of this tripartite um
uh effect of of theratom plant and how
pain relief in its ideal form not too
much sedative effect pain gone but still
the noradinurgic effect where people
aren't sedated to the point where they
can't do anything is ideal and that what
you said also really highlights and you
and you said it better than I ever could
that what we do in science and medicine,
reductionist science and medicine is
we're trying to isolate receptors and
pathways and dose response curves and
we're trying to come up with essentially
pills of isolated compounds,
>> right,
>> that hit one maybe two of these
different pathways. Um, in fact, it's
interesting that whenever a drug um
impacts multiple pathways, we call them
offtarget effects, right?
>> Right? that just that language alone it
tells you everything you need to know
which is that you're trying to target
specific receptors but the and pathways
but the way that the brain works isn't
like that right the the earlier we were
talking about breathing I mean the the
cardiorespiratory system are intimately
involved and and it's no surprise
therefore that you have some of the same
receptors and systems involved but you
mentioned uh increasing serotonin for
the treatment of depression SSRIs these
days a lot of people are are down on
SSRIs because of the negative side
effects, reduced libido, appetite, or
increased appetite. Um, I will say in
fairness to SSRIs, uh, SSRIs have helped
a great many people, especially with
people with, um, true clinical OCD.
>> These are not people that are obsessive
of nature. These are people who are
really stricken by their OCD. So, there
are places where SSRIs are valuable. But
um I think the the interesting thing to
me is always that a really good
scientific study isolates variables so
that you can assign any observed effect
to that compound at that dose or um that
behavior uh at that frequency um in that
population. But that's just the nature
of reductionist science. Um plants on
the other hand as you've pointed out
before um
you know the fact that they hit multiple
pathways and that when the dosages are
appropriate it seems like they can be
very beneficial in certain areas right
I'm not suggesting people use but you
know um theratom leaf it sounds like
could be very beneficial for people in
certain contexts not just people trying
to get over opioid addiction but maybe
pain relief etc. But you have to kind of
wonder, this is kind of a um
philosophical
spiritual question. I mean, it's kind of
amazing that these plants contain a
compound or set of compounds that can
activate the pathways that we're seeking
them to activate in a desired way.
>> Plants, by the way, can also kill you
folks or make you crazy if you take too
many of them, legitimately crazy, um or
dead. But you kind of have to wonder
like
you can ask the why question but you'll
never get there. I wasn't consulted at
the design phase and neither were you.
Um but it is kind of beyond statistical
probability to assume that a plant would
contain the solution to pain by dosing
each of the impact on these different
pathways at just the right way. And yet
>> it sounds like such a plant exists.
Yeah. And that plant is
>> this has been the fascinating part and I
I have to just say one of the biggest
changes in my entire research program
was when we moved to the University of
Florida and the University of Florida is
unique in that we have our college of
medicine and we have all the health
sciences on one campus including
veterinary medicine which we also work
with and we're doing clinical trials
with them and companion dogs, which is a
whole another discussion.
>> Animals need pain relief, too.
>> That's right.
>> Yeah.
>> And we have very poor pain control in
animals, particularly in dogs. Um, we
can come back to that if you want. Um,
but
most universities in the United States,
state universities,
have either the medical college or they
have the agricultural college.
The University of Florida has both 800
lb gorillas. if you will in the same
system. So, University of Florida is
extremely well known around the state of
Florida and around the country for their
unit called IFAUS, which is the
Institute for Food and Agricultural
Sciences, which has a service um
facility in every single county in the
state of Florida to work with
agricultural industry. Um and we've
worked with plant scientists on to
understand what is this plant doing and
what's it why is it producing what is
producing why are these chemicals there.
So to get to the answer to your question
we think we've figured out why the
plants are producing this. It's
definitely not for our benefit.
So plants produce chemical defense all
the time. Right? The alkyoids are by the
way bitter compounds by nature. So most
of the time they're anti-feedant to make
sure that the passing by uh deer,
giraffe, whatever is not going to eat
all the leaves off of that tree. They're
going to have a couple and realize this
is nasty. I don't want to do this. I'm
going to move on to the next plant. Um
however interestingly enough metro
speciosa thermome tree does not grow uh
in a place where it's going to be
attacked by herbivorous animals. These
grow in very swampy
um conditions and in those swampy
conditions it's very humid. It's on the
equator.
It's incredibly hot. Um, and what grows
in hot, humid environments? Fungus.
These compounds that the tree is
producing, which yes, they seem to
interact with our neurotransmitter
systems for whatever reason, are highly
effective antifungal agents for the
plant to ensure its ability to survive
and stay in that environment and thrive
in that environment.
>> Is it a good antifungal potentially in
humans as well? So that's a great
question, right? We've we've we decided
we would look at this from human
pathogenic fungus. So what fungus
disease-causing
fungi in humans? So far we haven't seen
anything. But as far as agriculturally
important fungus, it seems to be able to
be very potent on some of these. And so
we're actually looking heavily into uh
this area. So there's there's there's
parts of the chemical structures that
are conserved on all of the alkyoids
that we see this tree producing. And
that chemical structure actually the the
way that it tipped us off was we we
equated that back to a naturally
occurring antifungal that's already used
in the agricultural industry.
um has the exact same chemical pattern
what we call a moyet or a function u in
the molecule and those are uh called
strobalins
the molecules that are used and they're
used in USDA agricultural industry as
anti-natural antifungals
so we always kind of made the joke that
if this gets put into the controlled
substance act well we we'll just go to
the agricultural chemical pathway and
see if we can develop new antifungals
for the egg industry, particularly in a
state like Florida that's very hot and
humid, um that could benefit from from
good antifungals. So, there's a reason
that plants are producing the molecules
they're producing. Um, but through trial
and error, as we've talked about before,
through watching, um, and historical
just trying things, uh, the f around and
find out, you know, figure out there's
some benefit to humans from these
plants, right?
>> Plants are protecting themselves and
trying to evolve.
>> Yeah.
>> Just like any other species. uh years
ago uh I had a friend who's a very
serious about Chinese medicine like
practitioner um and I said what sorts of
goodies does Chinese medicine offer for
somebody who's interested in uh you know
supplements and medicine and formal
medicine also um and they gave me don't
do this at home kids they gave me a an
alkyoid that's from um gecko skin that's
been shed
>> and uh it's a stimulant
And um it's very bitter. I know cuz I
opened the capsule and I taste it before
I took it.
>> And it was a pretty pretty decent
stimulant. Um I prefer caffeine,
>> but it was a you know a nice arc
stimulant and it had it was clearly a
stimulant. And you think, okay, well,
how did they arrive at this? Well, um
somebody observed that geckos are able
to survive in a area where there are a
lot of birds that feed on reptiles and
other small critters. And that's the way
that the geckos have learned to um be
less tasty, be bitter.
>> Yeah.
>> Because if you're sweet or you're a
great protein snack, which most every
moving organism is, well then uh you
you're better off being bitter than
being sweet.
>> Species won't be around long.
>> Exactly. So, so there's a lot of this
out there. Um couple of days ago I asked
my ex audience, does anyone have any um
questions about uh a lot of praise for
you and your efforts to really be uh
discerning and and nuanced about the the
the messaging aroundratom and for your
work. So um someone asked something that
I had no idea what it means but that but
this person is a researcher. I know
them. and they're a well-known
neuroscientist and they asked, "Is there
really a difference between white vein,
red vein, and brown vein?"
What are we talking about here?
>> I'll answer the question very quickly.
Most of this is marketing. Um but what
what we realized um is that there's on
the tree itself, the treere's leaves
have veins and those veins are red in
some cases or green in other cases or or
white. You can think about this like
rainbow chard at the supermarket, right?
You you know they got beautiful colors
or rhubarb or whatever you want to
>> blood oranges versus Yeah. Yeah. Sure.
Sure. So, so what we have seen and I and
I'm going to caveat this answer too
because a lot of a lot of marketing goes
into this white vein, red vein, brown
vein, green vein, um, yellow vein.
They're actually five colors of products
that come into the United States.
And it has to do with how those have
been cured or dried after they've been
harvested.
So, green leaves, fresh, not dried very
much,
dried in a cool environment indoors.
They're going to retain the greenish
color. Um, and they're ground and
pulverized and that powder comes in
green.
Then, that's it. That's your green vein.
Many in many cases and vice verss.
It it really depends on how the color of
the leaf material was. We grow these
trees at the University of Florida and
and it's interesting because if they
they can get sunburned and they can
they're they're undercover canopy crop.
So the trees naturally exist sort of
underneath a higher canopy of trees. So
they're shade grown. Okay. if they get
direct exposure into the sun, they'll
actually burn and the leaves will start
to turn brownish red. Um, we've done
that with specific wavelength light
studies and green houses and whatnot,
too. Um, but they'll also get damaged
when it gets cold and they'll get
brownish color or they'll turn reddish
color again that. So, it's some sort of
response, chemical response, but it is a
chemical response. And this is where I
put the caveat in because when we've
isolated when we've not isolated but
we've analyzed
the different strains and colors of
powders for their alkaloid content.
They're all very similar. So the
alkaloid is is not changing.
So we always said it's kind of a
marketing deal and it's a more of a
potential placebo thing like oh this is
more relaxing. This is more pain.
>> This is very reminiscent of the indica
sativa. Yeah. Question that I got around
cannabis. And yet when you
>> talk to users of indacica versus sativa
and different strains and different
amounts of tarpen and types of tarpen
and cannabis, people will swear by the
vastly different effects of these
things. But it became clear to me anyway
that some of that, not all of it, some
of it is related to the fact that you
have different um uh you call them
chains of custody as you go from the the
plant to the product.
>> So people will associate a particular
effect with a given product.
>> That product might be labeled green vein
or red vein. So the effects may indeed
differ, but it's hard to trace back to
the actual differences in green vein
versus red vein. That's what I'm
gathering from
>> in terms of their alkyoidal makeup. So
when we analyze things and and let me
just let me take a step back here. So
plants produce many classes of chemicals
right alkoids are the ones that
traditionally people think of with
pharmacological activity that are
interesting that are going to have
psychoactive activity. So most people
focus on alkyoids as being the
biologically relevant
>> plant materials. You mentioned cannabis.
Cannabis has no alkyoids.
So those are tarpen which is another
chemical class of molecules. They do not
contain nitrogens. Um and they we now
know interact with specific proteins in
our body as well like canabonoid
receptors. So
it plants are producing many classes of
of compounds. They produce steroids what
we call phytostereroids. They produce
tannins. Um, which anybody who's like me
and likes wine, you know, you talk about
tannins and all the different types of
tannins that can be present in a wine
>> or tea
>> or teas. Yeah. Um, and to that point,
there's antioxidant type compounds in
there. Um, you know, all kinds of
classes of of chemicals.
No one to my knowledge has studied
anything other than the alkaloids in the
cranium plant. Likewise with cannabis, a
lot of it hasn't been explored besides
THC and CBD.
>> And many of it is is because it's s in
such low quantity. And coming back to
the point when we talk about most of
those studies that have been in the
literature have been done with the major
alkaloid because that's the thing that
people can get a hold of. It's easy to
isolate purify and if it's the major
alkaloid by default it should be causing
the activity.
>> It makes for good science, right? It's
hard to risk somebody's uh PhD career on
on a uh gene or molecule that's in low
abundance yet you you want to air
towards probability of success.
>> Okay. So there's your answer on white
vein, red vein, brown vein. Sounds like
it's more product dependent and source
dependent in terms of the for the user
the potential user and maybe you
shouldn't trust the the marketing.
>> I mean just just finalize that with the
fact that we don't know if there's other
changes in chemical composition outside
the alkaloids. So
>> there could be something there. Is there
a potential use forratom as an
anti-depressant?
>> I think that's probably one of the areas
that needs to be investigated
um much more thoroughly. Uh I we we got
uh a specific marching order. We were
looking at many things including
regulation of blood glucose. So we can
talk about a lot of potential things
that are going on. Um but the mood
elevation and and the um the sort of
overall well-being feeling that many
people report
um it it's all anecdotal, right? But at
certain point anecdotal is a signal
because it tells you once enough people
are saying this it must be something. So
we need to pursue that and we need to do
it in in very good controlled clinical
trials with humans so that we can
understand if there is true benefit.
Next question for you is and this was a
very common question
how to get offratom. Uh this person says
u my brother was on it um and is having
a dreadful time um with it. He takes it
now just to feel normal. He feels like
he's a slave toratom. We don't know what
product he's taking or how much. But I
will tell you even though that's just
one question. This came up numerous
times.
>> Yeah. And and it's a great question
unfortunately without answer right now.
But I I do want to I do want to stress
uh a very important piece of this
research and and what we're trying to
understand.
Um, I've talked a lot more about the the
chemical nature and the pharmacology and
differences in pharmaccoinetics and
potential benefits with this plant, but
it's clear that there's potential harm
as well. Um, and we've we've seen that
in many many stories. These are examples
of that. I have um a pretty routine
lunch with addiction physicians in
Gainesville, Florida. And um precoid
many of them said, "Hey, um this will be
interesting to you. One of our patients
came in uh an opioid treatment and said
they started using cratom and they're
they're doing much better and they're
benefiting."
And then we didn't see each other for a
couple years because of COVID and we
resumed our lunches and they said, "You
won't believe what we're seeing now.
People are coming in seeking treatment
to get off." We've unpacked a lot of
discussions over a lunch table
and trying to figure these things out.
Most
medical practitioners
go to the fact that this is opioid like
and they're using bupinorphine
or suboxone which is our one of our gold
standard treatments or even methadone to
get individuals off ofratom and they say
it's working
but my problem with that is we've we've
said already this is not a typical ical
opioid
is not a typical opioid. It's atypical
for sure. It's having these other
pharmarmacologies.
And so yes, we may have success in
converting people from taking by putting
them on an opioid,
which many of them might have been
trying to get off of in the first place
with this. But the pharmacology ofratom
is so complex and different that you're
only pressing one of those levers in the
system that we just talked about is at
least tripartide in its activities.
Right? So you're ignoring the serotonin
piece. You're ignoring the adinuric
piece by only giving an opioid like
methadone or buponorphine.
Is that the right way? I don't know. I
don't know the answer to that question.
We know that in certain cases when we've
tested animals and we've pushed them
into um toxic levels of certain
alkyoids, notratum itself, but we we
know that in many cases opioid
antagonist won't reverse some of those
effects
>> because of this these um nonopioid
pathway effects. So it sounds like for
this person's brother or sister or
somebody that wants to get offratum
suppressing the same pathways that are
used to get people off opioids like
buprenorphine
uh neoxone
etc could be useful but there could be
still other um aspects of dependency
related toratom that those won't
resolve. That's what I'm hearing. That's
that is and and the and the concern is
by moving someone from a cratom product
to a pure opioid product like are you
actually
potentially making things worse because
it's going to be hard for them now to
get off of those products? It's a
circular question, right? It's very
difficult to answer. And this is one of
the things we're really trying to get to
the bottom of what is what is a better
what is a more appropriate treatment.
But for right now, it seems that what is
working is opioid use disorder
treatments.
>> Buponorphine,
>> buponorphine.
>> Mhm.
>> I will say there were a number of people
in the response, and obviously this
isn't a formal study, who said best way
to get off it, not to start, right? Just
don't touch it. There were a lot of
don't touch this stuff. That's based on
observation, it seems. I'm, you know,
I'm I'm uh it's conjecture here, but
based on observation um that they know
people have had a terrible time getting
off it. Like the best way to to to avoid
dependence is to not start. Um there
were a couple um questions about uh that
specifically
um and the effect on the serotonin
system. Is there um you know is you
could imagine if you're trying to come
offratum
at because of an opioid like dependence
uh taking uh bupinorphine maybe doing
other things to support the serotonin
system at the same time like it doesn't
have to be just one treatment but
obviously this has to be overseen by
somebody that can prescribe these drugs.
>> Yeah. No. And I and I think the key
there is is is not ignoring and trying
to do it on your own, but getting
medical professional help and getting
someone that can give you not only a uh
you know medication assistance in
treatment, but giving you um support of
treatment, in other words, counseling um
and and social aspects of that as well.
>> I'm going to just tell you one comment
that somebody asked. I relay to you
because I think it's informative for
everybody and then I'll I have one more
question from um from the online
audience. Um please tell your guest I
quit prescribed topical boot trans
patches for lower back pain cold turkey
by switching toratom as an alternative
treatment. They wanted you to know that.
So this is somebody for whom it was
effective and apparently they wanted you
in particular to know that. I appreciate
that comment and it's not an uncommon
theme that I've heard and I've gotten
emails from from people that have had
that story. They've they've been able to
switch cold turkey and just just to
touch on what you said earlier too. You
know, we had a um first case report that
we published in the literature was in
2008 with a human case uh with my
longtime collaborator Ed Boy Ber uh
who's a emergency department physician.
Um and Ed called me and he said, "You're
not going to believe what I have in the
ED." He said, "I've got someone."
>> The ED is the
>> emergency department came in with a
full-blown seizure. And um but that this
is all in this paper. It's unpacked. It
was what we think happened is that he
took a medaphanil, which is a um drug
for actually narcolepsy. He was feeling
tired. His his wife uh had these drugs
and so he took this on top of his
wellestablished use of of this. A lot of
people use modafanil as a um stimulant
cognitive enhancer. Very very common
now.
>> You have to remember this this took
place in 2007. Okay. So the only product
that was in the market at that point in
time was leaf.
>> So leafratom and modafano.
>> Yeah. So um it caused him to have a
seizure. Uh
in the emergency department they had no
idea what to do. Um, luckily Ed knew me
and that we were working on this and we
were working on another thing called
Salvia Divinorum, which is a whole
another study about a hallucinogenic
mint plant. Um but
we started talking and when this guy
came conscious and and was fine by the
way he quit a habit of delotted which is
a prescription opioid cold turkey
switched toratom no issues
leaf and then after he had the seizure
and came to in the hospital um he quit
cold turkeyratom
the only thing that he had was a runny
nose and he said he had no desire to go
back and take it anymore. Now, at the
moment in time that that happened, this
was a N equals one case ever. Um, and my
friend Ed said, "This sounds like the
holy grail. If you can get off of it
>> off the
>> you never off the off of
>> and now you don't even have a craving to
go back to it." All right. Now, that's
a huge caveat in this story. The guy had
a seizure.
So,
significant event occurred that you know
he decided at that point in time he was
never going to touch him again. Speaks
to the precariousness of
polypharmarmacology done at home.
>> Yes.
>> Um and uh I once took modafanil half a
dose. I'm very susceptible to medication
and it uh kept me up for almost two
days.
>> Wow.
>> And I took it in the morning time. Some
people I know can take it just fine and
and use it as a stimulant when
traveling, especially to give talks
after whatnot and for narcopsy, etc. as
well. I'm wondering if we can have a bit
more fun um talking about plants and
some of the things that come from plants
and their interesting uses. You
mentioned the cocoa plant earlier. Uh, I
don't think anyone except a cocaine user
would say cocaine is a good thing. I
mean, it seems to destroy a lot of
lives. And I'm sure there are people who
can use it at low doses or low frequency
and not end up in the gutter uh in one
way or another, but it does seem to be a
fairly destructive compound on the
whole. Um, and yet, as you mentioned,
that the cocoa leaf has these
interesting compounds when it's um used
as as a leaf product. There's a
similarly sounding um leaf which is the
cocoa leaf um uh chocolate and then
there's cacao. And I'm not trying to get
down into the um the romper room version
of of plant medicines here, but
>> recently I started eating uh roasted raw
cacao beans for their polyphenol
content. I actually like the bitterness.
Uh they have a lot of fiber. You have to
not over consume them. You have to make
sure they're clean source so you don't
consume heavy metals, etc. Right.
>> But um there's a lot of interesting
healthy stuff coming from plants. So
let's talk for a moment um if you would
about uh the cocoa leaf.
>> Yeah.
>> And cocoa and chocolate. I like 100%
chocolate. 100% Venezuelan chocolate.
>> Delicious. People might be It sounds
like baking chocolate, but it's it's
smooth. It's got a bitterness, but a
little bit of sweetness. It tickles my
brain just right. It's healthy. It
doesn't have sugar. I don't overdo it.
And
>> wow. It's it's a um it's it's a real
thing.
>> Yeah.
>> And I and it's delicious and I look
forward to it and I don't feel like I'm
addicted to it because I haven't had any
for a little while and I'm fine, but I'm
looking forward to it. Tell me about the
benefits of cocoa and and some of the
alkaloids and other things that are in
in cocoa. This is not to send people out
to ingest a bunch of sugar sweetened
chocolate. We're talking about 100%
cocoa or cacao beans, right?
>> There's there's real medicinal power in
this stuff.
>> Yeah. Yeah. There absolutely is. And and
it's fascinating, too, because there's
there's a few things that are in there,
and this is not something that I'm an
expert on by any means, but um playing
around in these areas, you you start to
learn and you start to take notice. One
of the main components in chocolate or
cacao is um a compound called theob
broine. So theob broine
is an alkyoid. It is what we
specifically call a zanthine alkyoid
which is identically a cousin almost
maybe like a
a sibling of caffeine.
Okay. So, uh caffeine is a is a molecule
again a zanthine alkyoid and and it has
three nitrogens that contain methyl
groups on them. So a carbon with three
hydrogens on them attached to the
nitrogens. And and caffeine is a easy
one to remember in this class because it
is fully methylated. So I call it high
test full caffeinated
uh substituted zanthine alkyoin. And
then theob bromine has no bromine on it.
It has nothing to do with bromine. I
have no idea where the name came from,
but it's missing one of those carbons
that makes it different from caffeine,
but it causes stimulation. It actually
improves respiration
um when it's been studied very similar
to thing things like theopheline
um that have been used long time for
asthmatics before we got to the inhalers
and and things evolved uh in terms of
our understanding of that treatment.
But there's also compounds within uh
cacao that
very much um mimic our doperic type
system and turn us on to feeling like,
you know what, that was really good. I
want that again.
>> It's not like a dopamine release that
you get from a a hardcore drug like
cocaine or something like that. No,
>> never done cocaine, but I but I agree.
It's it's a subtle kind of um push
toward yeah I'd like more of that but I
feel pretty good and and the
anticipation of it is positive
>> and and you certainly can work and do
other things. It's not uh certainly does
not destroy as far as I know uh does not
destroy lives.
>> It's rewarding. Unfortunately, the
industry to harvest
is what destroys the lives, right? So
there's a lot of um very poorly sourced
and and many of the individuals that
that work those fields uh and places are
are really abused and it it's a problem
in the in the chocolate industry as a
whole. There's there's some really great
companies out there that are really
promoting good sustainably sourced,
ethically sourced uh cacao beans. And
and you know, that's just just a side
note for something to look for when
you're looking for a good solid um solid
chocolate source.
>> So, ethically sourced. And and you
mentioned cacao beans. So, the the the
raw cacao beans that I'm now eating
every morning. Um, usually a not
immediately in the morning, usually like
half hour before my first meal of the
day, which for me falls a little bit
late morning or closer to lunch, but
I'll have five or 10 of those things.
Boy, do I look forward to it as I
mentioned. And and those raw cacao beans
are essentially the same as the 100%
chocolate in terms of polyphenol content
>> pretty much. I think I I mean again I'm
not an expert and I haven't done
analysis of those but I'm I'm pretty
sure that most of those would be
retained in the processing um into into
chocolate as a food. Um you know one
thing that strikes me is probably one of
the first things I ever learned of a
natural product was the shells for the
beans. So, uh, growing up as a kid in
Pittsburgh, um, there was a lot of rose
bushes around and people would use, um,
cacao shells as a fertilizer for the
rose bushes. And so, you would walk by
and as a kid, I would get this waft of
chocolatey smell
um, along with that smell of the roses,
you know, and it's like, what a
Valentine's Day.
>> It's like these things were meant to be
together.
So, it's just a weird side note, just a
memory that you brought back. But
>> I love that. And I really think there's
something uh pseudospiritual or
spiritual about these combinations of
molecules that exist in plants. And
sure, the plants are fending for
themselves and the fungi are fending for
themselves and the birds and the geckos
and the humans, but the same biological
um motifs
>> are used over and over again throughout
nature. Um, and of course some
species like insect species rely more on
one neurom modulator. We're more a
cocktail of
>> serotonin, dopamine, epinephrine, and
and acetylcholine. Uh,
>> but there there does seem to be um
something to it. Maybe AI will pull out
some of the um some of the thematics of
that going forward. So, cacao, great.
So, I'm not alone in my um love of raw
cacao beans and 100% chocolate, but look
for sustainably sourced. Um,
>> ethically sourced.
>> Ethically, excuse me, ethically sourced.
Now, that's an important distinction.
So, there's a myth that Coca-Cola at one
point had cocaine in it. Not just the
coca leaf, but actual cocaine. But then
you hear various versions of this
mythleend.
Uh what's the deal with Coca-Cola, the
coca leaf and cocaine?
>> Yeah. So, it's a it's a great old story.
John Peton was a pharmacist in Atlanta,
um home of Coca-Cola these days, uh and
developed a formula uh that that
contained the cocoa leaf extract from
the cocoa leaf and extract from the cola
nut. So, Coca-Cola
uh and put this together, sold it as a
tonic. It's an interesting just a quick
segue on soft drinks in general. So soft
drinks came about because they weren't
hard drinks. So it was an alternative to
liquor. So they weren't hard alcohol,
they were soft drinks or soft beverages.
They also generally had effervescence to
them or carbonation. Uh and most of
those were available at a pharmacist
soda fountain. So, Seven Up had lithium
in it in the past and it was um you know
for mind wellness. Um Pepsi had
pepsinogen which is a digestive peptide
in it. Um most of the soft drinks Dr.
Pepper was developed by Dr. Pepper in
Waco, Texas and was a special formula
that he had come up with for well-being
as well. So all these soft drinks have a
really cool history, but John Peton's
story of Coca-Cola
was
actually it goes way back further than
Coca-Cola in terms of putting uh Coca
Leaf into beverages. Um but we'll we'll
just stick with Coca-Cola. So Coca-Cola
um definitely had cocaine in it in in
its original setting. Um, and then as
time went on and we realized that
cocaine was problematic and addictive,
um, there was pressure for him to take
that out of of the process. And so, and
what they realized was the cocoa leaf
and and many people that chew cocoa leaf
talk about the different varieties that
are available within South uh, America
and different flavor profiles that are
there. Well, the the specific um one
that they use for Coca-Cola has a a a
definitive flavor profile to it. And
when they took that out, it lost the
flavor that people were used to. Um and
so they they decided to keep this in
there. And Coca-Cola is still the major
importer of cocoa leaves into the United
States to this day. They do it through a
company called the Stan Company in New
Jersey.
The leaf comes from uh Peru. Uh comes
from a state-run company in Peru that
oversees the production of the cocoa
leaf. Comes into uh this company in New
Jersey. They then process the leaf into
um two parts. So they take all of the
cocaine and all of the cocaine
metabolites essentially the alkyoids,
right? We talked about these alkaloids.
They take the alkaloids out and that
gets sent to a pharmaceutical company
and those are processed into cocaine
which is used as a pharmaceutical still
to this day. Um, a lot of people
probably don't know this but cocaine is
the best local anesthetic that's ever
been discovered. Uh, it was the template
for all the local anesthetics that we
use now like lidocaine or bivocaine.
um it was the template and it is still
the best one that we have and it's used
almost exclusively for nasal and eye
surgeries now where you have to stay
awake and you have to be functioning and
we can't intubate you and we can't do
these things. So this is the ideal uh
drug. Um it's also obviously put into
lots of drug testing kits and supplies
and whatnot for for the forensics
industries.
But what's the fate of what's left,
right? Well, that cocoa leaf extract,
the dekalinated extract, deccoonized
extract if you will, um, is the secret
sauce if you will, for Coca-Cola still.
So, that is a grass substance, G RA,
generally recognized as safe food
substance, and that is the flavoring
agent that gives Coca-Cola its unique
flavor. And there was a period of time,
I believe it was in the 80s, where
Coca-Cola
um really wanted to distance itself from
the cocaine industry. Cocaine became
hugely um the drug of of choice, sort of
drug of abuse. Uh len bias, one NBA
basketball player died from an overdose.
It just became a very nationally
uh aware drug of abuse and there was a
problem associated with cocaine. And so
Coca-Cola said, "We're going to cut our
ties with the cocoa plant completely."
They came out with this product called
New Coke. And it didn't last long
because the flavor profile couldn't be
replicated to the old Coke. And uh so
indeed they re uh re-uped their their
sort of contract uh and have been
bringing it in ever since. And to this
day, uh, Coca-Cola Classic
and Coke Zero are the two products.
Interestingly enough, um, you know, Diet
Coke does not taste very much like
Coca-Cola original. And a lot of people
complained about that for a long time.
Um, they got smart and made this product
called Coke Zero that has the flavoring
agent from the cocoa plant in it. And lo
and behold, everyone started saying,
"Gosh, this tastes a lot more like
Coca-Cola does." Well, yeah, it's got
the flavoring ingredient in it. And so,
everybody in the United States almost
has had a Coke at one point in a time.
So, you've all had Coca Leaf already in
your dietary chain. And I think it'll be
interesting to see where things develop
as we start to do more research as the
World Health Organization reconsiders um
removing uh cocoa leaf from an
international ban and and looking at it
as a potential product to work into food
products and develop um further. And so,
you know, it it supposedly has no abuse
potential as the leaf. Um, but again,
it's that story of isolating that one
alkyoid out and sort of destroying the
rest of it forever. However, Coca-Cola
was smart enough to keep sort of a
monopoly, if you will, on on keeping
that plant alive uh in their product.
And so, it's it's there. And um the next
time you have a Coca-Cola or a Coke
Zero, uh just realize that it's got
natural product in it.
>> That's incredible. And I'll keep that in
mind the next time I have a Coke Zero.
Is there any evidence that what's still
retained from the cocoa plant in
Coca-Cola is psychoactive and not just
there for flavor?
>> That's a great question and that's been
debated quite a bit. So the one thing
that we know um is that probably it is
not having any psychoactivity.
Um and the the other thing that we know
um back to my pharmacy days, we used to
sell Coke syrup. So when Coke is sold uh
for fountain beverages um it's it's the
syrup that's then blended with the
carbonated water uh to make Coca-Cola.
And that's why a lot of people say co
Coca-Cola out of a fountain is so much
better than out of a can or a bottle
because it is it is a sort of formulated
on the spot product if you will. Um yeah
on tap and um Coke syrup we used to sell
out of the pharmacy for uh nausea and
vomiting particularly in pregnant women
is one of the safest things you could
use and it really calms and settles the
GI tract. And this is interesting
because one of the big um
benefits that people report drinking
coca tea is that it soothes their GI
tract and it calms their GI tract and it
helps um them be able to be alert. Of
course, the coca tea's got all the
alkyoids in it, but that same GI tract
benefit is still still there. And that's
probably what's still remaining within
that extract that's now devoid of of the
alkyoids.
>> And you are not paid for by Coca-Cola.
>> No. In fact, we went to Coca-Cola to see
if we could work um with them on
developing uh some type of medications
or or something from the cocoa leaf. And
uh I have a former um colleague that is
in their natural products division at
Coca-Cola and they said they won't even
let us touch the the cocoa extract.
>> Well, and they've also got all that
cocaine that they've pulled out of the
cocoa leaf in this plant in New Jersey.
I can only imagine what the security is
on this place.
>> I don't I don't know. But if you you
know you can you can fact check me on
Wikipedia or which is not a great place
to fact check but uh got my agreement
there. But the but this the Ston company
is listed there in New Jersey and their
connection to Coca-Cola and this whole
this whole story is actually out there
in front of everybody to see. Um it just
takes knowing where to look and find it.
>> Love it. Last question about soda. Is
there still lithium in Seven Up? No,
lithium has gone from seven up. But that
was the whole idea, right? Up mood, lift
your mood up. Lithium. And we know
lithium carbonate is still used to this
day as a treatment for uh psychosis. So,
>> I'm curious a bit about you. You know,
like uh I know a few chemists. Um there
are a couple good jokes about chemists.
Um, but it's clear that you love
chemistry and you love the chemistry of
plants and you're also interested in
public health and you're interested in
I'm gathering I'm not a psychologist but
kind of this the the psychology behind
all of this as well. Um, when you were a
kid were you always were you playing
with a chemistry set?
>> Yeah, you would think, right? No, I
Interestingly enough, my my father was a
pharmacist and I I just never really um
I never really paid attention, but I was
always under tow. Uh and so I saw what
he did and I, you know, I'd see him
behind a counter at a store somewhere.
um and just never really thought much
about it. But I knew that he knew a lot
about medicines and he knew a lot about
um healthc care and and and what he was
doing was really trying to benefit
people and help people. Um and I I
always thought that to be noble. My
mother uh interestingly, she was a
stay-at-home mom, raised us kids, um but
was very much into education and was a
teacher prior to myself being born. I'm
the oldest. I have a sister um younger
sister Lisa who's uh a nurse by the way,
nurse practitioner. Um, so medicine has
stayed within the family and science has
stayed within the family, but my mother
once we were old enough uh to be on our
own, if you will, she went back and
became a comprehensive science teacher
at the high school level. And so just
watching her work through getting her
reertification education process and how
passionate she was about um educating
others uh obviously stuck with me as
well. And so those those are the things
that drove me. I have no idea where the
the sort of I really think innate
passion came for for the chemistry side
of things, but when I was in high
school, I did an independent uh
chemistry project to go coming back to
caffeine. Uh
>> I was just curious like what what's the
best caffeinated beverage for me to be
drinking so I can stay up as late as I
can and have fun. Well, at the time it
was Jola, which doesn't exist anymore,
right? But Jolt Cola, uh Mountain Dew
was second. Um,
>> yeah. Drank a lot of D Mountain Dew in
graduate school. I can't say I recommend
it, but
>> No. And I mean that was our I I was a
band geek in high school and um
>> what instrument?
>> I played trumpet and I played piano and
uh a bunch of buddies and I would get
together on Friday nights and we would
drink a case of Mountain Dew. You know,
it was like everyone else is out
drinking beer. We were doing musical
things and and drinking Mountain Dew.
So, it was kind of crazy. But um I just
wanted to know what was there, right?
And I wanted to see and I got Vibrin
tablets and I extracted the caffeine out
of the Vibrin tablets to quantify how
much caffeine was in those. And um still
I didn't really think anything of it.
And I I decided uh very late in my high
school career that I needed to do
something with my life. I was bored in
high school. I did not do well. I was
not a great student. I I think if I was
lucky, I graduated with a 3.0 from high
school. Um, and my father said, "You you
need to decide on something." And and so
we I said, "Well, pharmacy looks like
it's been pretty good to you and our
family. We've had a good a good life." I
went to pharmacy school and in pharmacy
school um taking biochemistry
and my first medicinal chemistry course
I got taught by a brand new assistant
professor someone very relatable uh you
know close in age um just thought the
world of this guy and he said hey I'm
looking for anybody who's interested in
working in a lab to to come work in a
lab and I was like chemistry he's cool
I'd like to didn't know him. So, I went
to the lab. Started working in a lab.
Um, and he told me, he said, "You know,
you you have some gift here or some
talent. You should really explore it."
I'm like, "Ah, I'm going to be a
pharmacist." What are you talking about?
Said, "No, I'm going to set you up with
my PhD adviser," which happened to be
the guy who tasted the stuff I talked
about earlier, um, down at the
University of Georgia for the summer.
And so I went down and did a summer
intensive research program um in
medicinal chemistry at the College of
Pharmacy at the University of Georgia.
And um left there, went back to Ohio
Northern University where I did my
pharmacy degree. Finished out all my
clinical rotations. I was getting ready
to graduate and take my boards and
become a pharmacist. And the phone rang.
This was back before cell phones. Uh, so
I'm dating myself obviously, but phone
rang at home and I happened to be home
because I was doing a a local rotation
near home so I could save money. Um, and
it was the department chair of medicinal
chemistry from the University of Georgia
and says, "We don't have your
application for graduate school. What's
going on?" And I said, "I'm not going to
graduate school. I'm about to finish
school." And 15 minutes later, he was a
great salesman. he had me going to
graduate school. And so, um, that really
changed the course of my life. And, and
I ended up going to Georgia, um, sitting
for my pharmacy boards in Georgia,
becoming a licensed pharmacist in
Georgia, practice pharmacy while I was
in graduate school, which today is
almost a no. Um, but I worked five days
a week in the lab and every Saturday and
Sunday in the pharmacy. Um, which made
me the party guy because I was making
money and all the other grad students
were making their stipen that
>> we all know what graduate school stipens
were like. Um, but we, you know, I would
be the ones that treated us every so
often to nice dinners and things like
that since I had a little extra to share
with my friends. But you know got got
done um with a PhD and uh was working as
a pharmacist during that time and I
realized that I had a passion for
education and and I had a passion for
the chemistry and the pharmarmacology
and talking to to customers or patients
um when they would come in. I worked in
a grocery store
uh pharmacy and they would come in and I
would tell them, "Oh, you're on this new
drug that's brand new to the market. It
interacts with this protein and it does
this and it does all these great things
and you're so lucky to be trying this."
Um, and I I'll be anxious to hear if it,
you know, how it works for you and and
they would just look at me and say, "Do
I take it with food or not?"
Right? And that was the it's like I
realized I was standing in the wrong
place to impact the public. Right. And I
and it came to me that if I'm going to
do something with my PhD, of course I
fell in love with the research along the
way, but I I realized that impacting
pharmacists
to then impact
their patients was going to be a much
more effective way for me to use my
talents and skills in the classroom and
education wise. And then obviously doing
the research and the following that
passion. Um I I was lucky. I mean my my
PhD was around synthesis of of analoges
of a natural product called loelene
which came from Indian tobacco native
American Indian tobacco not cigarette
tobacco. Um that was used actually as a
respiratory stimulant.
>> So this hape
>> no this was lolla inflatada was the
plant. Okay. And so lobalene was the
compound that we worked on and and made
analoges of. Um we were looking at it
interestingly enough coming back to the
conuric nervous system we were looking
at it as a potential treatment for
Alzheimer's disease because at that time
um a paper came out in science noting
that smokers did not tend to develop
dementia and Alzheimer's disease. And so
it also left the caveat of do they
actually live long enough to develop
>> dementia and we don't know. However,
>> since that time in the in the '9s, the
whole coneric hypothesis of Alzheimer's
disease evolved and those are the major
treatments we have for dementia through
the FDA approved process. No,
>> I'm so glad you you mentioned it. I've
gotten myself into real trouble
>> covering nicotine
>> with uh where I put the caveats after
the statement about nicotine being uh
potentially neuroprotective in
Parkinson's and Alzheimer's. People take
that, cut that, run with it, come back
later and say, "I'm addicted to nicotine
pouches." I always uh follow that
statement with it raises blood pressure.
It's highly habit forming/addictive
and um has a bunch of other issues that
might make most people want to avoid it.
But nonetheless, nicotine, which
stimulates the conergic pathway, as you
point out,
>> does seem to be protective against loss
of cognitive function at least somewhat,
and loss of neurons, dopamine andurgic
neurons. So,
>> uh that's right. And that's where
>> I don't get paid by big nicotine.
>> Yeah. And I and that's what drove a lot
of research back in those days to really
see could we could we find something the
the idea was the the hypothesis really
was could we find a nicotine that one
wasn't addictive two didn't interact
with the cardiovascular system and three
ideally that we could put in a vitamin
every day that people could take to to
ward off
nerve degeneration
>> and
>> no darn
>> darn otherwise I I don't think I'd be
sitting here talking to No, no. You'd be
on a yacht someplace. Actually, I take
that back. You'd probably be on a yacht
someplace that has a small chemistry lab
and you'd be probably uh you'd be
probably running mass spec
>> marine natural products. Yeah. But I I
think you know that that led to me going
to a posttock at the University of
Minnesota and working for opioid
chemists that really defined chemically
the opioid receptors through analoges of
of naturally occurring opioids like
morphine. Um and then um it kind of
launched me into my own career of saying
hey I've worked now on natural products
even though I didn't work directly with
those natural products I've always felt
what I said earlier about this sort of
balance in nature and I wanted to pursue
natural products and so when I got to
the University of Mississippi which
happens to be a natural products mecca
uh for for pharmaceutical natural
products research there's the national
center for natural products research
there. There's the National Institute on
Drug Abus's uh federal marijuana farm is
there. It was the only legal federal
marijuana farm for decades. Um and it
was like landing in the perfect place to
do what I wanted to do. And so that's
where I started working on Salvia
Divinorum. And Salvia Divinorum
generated a compound called Salvonorin
which is to this day thought to be one
of the most potent hallucinogens.
Um non- nitrogen containing durpine. We
talked about tarpen very similar not
very similar structurally to canabonoids
but in composition just carbon hydrogen
oxygen.
it interacted
uh with cappa opioid receptors and cappa
opioid receptors there's a huge
difference between muopioid receptors
cappa opioid receptors and delta opioid
receptors those are the three sort of
traditionally accepted um opioid family
receptors mu is actually the Greek
letter and was defined by Morpheus the
god of dreams which is morphine got its
name and that's where the mu receptor
sort of nomenclature came from And since
it was related back to Greek mythology,
they gave it the Greek symbol mu. And
then when they found these other
receptors kappa and delta, they just
maintained that Greek sort of
nomenclature. We all know that mu is the
primary target for clinically used
analesics. It also causes the euphoria.
Kappa opioid receptors also have
analesic effects. And it was for a long
time thought that targeting cappa opioid
receptors was the holy grail of
painkillers because you got the same
pain relief as you would get with
something like morphine or even more
potent opioids but the animals didn't
want to abuse it. So they moved into
human clinical trials and we learned
something in psychiatry at the moment
that kappa opioid receptors cause
dysphoria instead of euphoria.
>> So people don't like the effect. So
people don't like the effect. However,
there's a group of people out there
that's tend to like whatever that is
>> being miserable
>> or that makes them feel better. Maybe
they're miserable by nature and that
makes them feel. I don't know what is
there. But there was a whole group of
people using Salvia Divinorum um plant.
It's called Divor sage. It's a mint from
Waka, Mexico that was used by shaman
there to to diagnose people. When they
couldn't figure things out, they would
give it to the subject and then that
would open up their mind and hopefully
tell them what was wrong with them. And
then if the patient couldn't tell the
shaman what was wrong, the shaman would
resort to taking it himself to go into
the spiritual world to figure out what
was wrong. Right? So this is a
fascinating plant and that plant is the
plant that led me to metroana speciosa
and so I was funded by NAIDA National
Institute on Drug Abuse to study Salvia
Divinorum and my program officer who's
the person that manages your grant from
the institute contacted me and said hey
uh I'd like to invite you to this
neuroscience meeting and give a talk on
naturally occurring pain medications.
or substances. And so I said, "That
sounds cool. That should be easy.
There's aspirin, there's morphine,
there's this." And so I dove into the
literature and started looking for um
all these different sources of naturally
occurring pain medications. And lo and
behold, there was metroana speciosa
with an incredible track record of study
by Smith Klein and French which was now
Glacos Smith Klein back in the 60s. They
isolated metroinan out of the plant.
They did as much and to this day it's
still the most complete study in the
literature. So 19 I think it's a 1972
paper by Mako um at all uh I can't
remember the journal but it detailed all
the clinical development of Mitrogan
and at the end of the day they decided
to not pull the trigger on full
development because it was no better
than coding as an analesic and at that
time was the emergence of a new class of
drugs called the non-steroidal
anti-inflammatory drugs which had no
opioid activity which were much safer,
no habit forming properties. You know,
we've come to learn there's problems
with NSAIDs as well like ibuprofen,
>> liver issues,
>> liver, kidney, um GI bleeding.
>> Also, they're not that potent.
>> Yeah. No, they're for mild painild. And
metroyin was even recognized back then
as being very comparable to codin which
is really for more moderate pain. It's
it's not morphine. It's that's a whole
another discussion. But it's much less
potent than morphine. Codin is. Um it
has great antit properties for cough and
that's why they put it in cough syrups
and it works better for that than it
really does for pain control. Um but it
was just equivalent to that and they
said there's no point in trying to
compete with this new class that's safe
right or thought to be safer. So they
shelved the project at Smith Klein and
French.
Thank god they did because that's what I
found and that was when I realized
nobody's touched this plant.
>> Fantastic arc.
>> Yeah. and um one that really reflects a
a constant curiosity and and willingness
to see when a when a door opens and go
through it. So, uh it's it's really
wonderful that you did. Clearly, that's
in your nature and um I think one
consistent theme throughout um there
several u but what I heard were uh
themes related to uh intense curiosity,
a real practical grounding. You're a
practical guy. It's clear you you this
comes from your your pharmacist father
and your your mom who impressingly uh
impress my wife may not agree with this
but
>> well and your and and your mom who
impressively is what I meant to say um
went back and uh
>> you know after raising you guys and and
um became a scientist in her own right
um and teacher and then
>> this element of public education
teaching pharmacists teaching
neuroscientists went I've long wanted to
do an episode about
>> yeah Um and uh for a variety of reasons
uh the most important one being that
many people ask about it and and it's
out there and it's having an impact and
it's growing in usage. Um and that uh
there's these very polarized views. You
hear this is the greatest thing ever.
help me or someone I know get off
opioids and then you also hear this
stuff is dreadfully bad and
>> um
>> in the course of you know researching
it's not hard to find your name because
you're responsible for publishing the
you know an enormous percentage of of
the work on onratom but I would also
hear things from people like got to get
Chris Mccertie on he's the man I heard
he's the man a lot um and so I just
really want to thank you for coming here
today with um with the intention to
teach. I've clearly learned everyone's
learned so much from this from hearing
you uh today and your nuanced
perspective that when someone says
isratom good or bad, safe or not safe,
you you break it down. Look, here are
the different things we're talking about
when we're talking. And I list off some
of the key takeaways earlier. Um serving
size matters. Um derived products versus
isolates. Um why are you using them?
Maybe the f around and find out reason
is not a good reason, you know, but is
it pain relief? Is it to avoid or trying
to alleviate a much more serious um
condition or or uh addiction um in some
cases? Um drug interactions. There's
your pharmacist side. The inter this
>> case example of a of a seizure and on
and on. I mean, you've just done a
spectacular job uh of explaining the
nuance um that one has to address that
question with. I must also highlight
that as somebody who's very interested
in science and public health, but also
the natural world, um, you've done such
a spectacular job of explaining how
plants
contain these incredible compounds
interact with the animal world and with
the human world and medicine uh, for
better or worse, right?
>> And, uh, and that's a beautiful dance
and um, and you're clearly encyclopedic
about all of it. So,
>> thank you.
>> Thank you so much for coming here, for
sharing all this knowledge. So clearly
people are going to be safer and are
going to make excellent use of this
knowledge I'm sure and as things evolve
in the world ofratom and uh coca leaf
and cacao and uh uh please come back and
and share with us what you discover.
>> Absolutely. Thank you so much for having
me. Thank you for giving me your
platform as well to to get this
education out there. It it needs to be
out there and people need to understand
that there there may be benefits indeed,
but there's there's risks and and
there's potentially harm and and we've
got to figure out where each of those
lie.
>> Well, it's been a pleasure.
>> Thank you.
>> Thank you. Thank you for joining me for
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