Final Recommendations and Conclusion

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun . Can't you just have fun for an hour and not try to diagnose your mystery boy le think, you we've earned it. Just sit back, relax , and enjoy a moment of distraction from that weird growth . You're worth it . Alright , tomorrow is about to books one, two, one delay for So we came and Rossi pharmacy with Duina's blasting out through the broken glass and had ourselves a luck the medicines, the medicines, that ascellent macro the most . Hello everybody and welcome to Sawbones, a viritual tour of misguided medicine. I'm your co host Justin McGroy. And I'm Sidney McRoy. I feel pretty excited by . Are you feeling excited about this episode? The Caprice sun you're opening. Yeah, it's the Caprice sun. Yeah. I looked in there and I saw a Caprice on Moon Punch and I was so overwhelmed with thirst. And so I mean, all I could think about was how refreshing it was about to be. I got a second one. You got a second . Because I knew that this episode was gonna be about cradem and I knew that I was going to ask if I could have it and you were going to say no so many times you wouldn't have be able to tell me no about the two Mono Bunchers. Are you so you would be like, you feel bad about the how you told me know so many times about Kratom? That I'd be like, I might open a second Caprice on Moon Punch. I knew you wouldn't be like, No . Did you tell Cooper we had more of the Moon Punch 'cause she loves the Moon Punch and I told her we were out. it downstairs. You have a secret supply. I won't drink the second Mon Punch though. She settled for tropical punch, but she wanted Moon Punch. I will swap that Moon punch out mid mid episode. I like that commercial break. I'll make this first moon punch last until the act break. Then I'll refresh my Capri sun for the second half. Do you think this is do you think this is some sort of like trademark violation? Oh my gosh. even harder. He'd even harder Charlie thought it would. Charlie started with the punching the moon. Yeah . And this is Moon Punch. Oh, it is Moon Punch. I didn't even realize that. What the heck? I feel like we got a lawsuit on our hands right here, Justin. You're some probably unilever Speaking of legal gray areas, let's talk about Cradem . What do you know about Cradum, Justin? It's very popular. Yeah, I don't actually know anything about Cradum. You don't know anything about cradem? No, I remember when we were at we had some people over recently and everybody was like, Sid can, we do cratom and you were very much like no listen, y'all? No cratom. No, I said don't do cratom. It was like a big friend family gathering. So there were kids around. So I was like, listen, kids. Don't do crat om . So I first became aware of Kratom. It's been a while. It's been around for a while. It's not new. It's just all of a sudden becomes super popular and there's a good reason for that. But it's been around for a while and it was first brought to my attention by some patients of mine. Really, who would talk about it as because of we live in the middle of where the opioid crisis has, I think, hit the hardest here in West Virgin ia. And so I have a lot of patients who have struggled with trying to use less pain medication or trying to find alternatives for their substance use disorder or just because they haven't been diagnosed with substance use disorder, but they have had pain meds in the past. They're not on them now, but they're looking for something that works similar. You know, so I had a lot of patients ask me about cratum and I had read about it and at the time I thought, well, this is like an herbal thing that works a little bit like opioids, but it doesn't seem like it works a lot like it . Probably not a good idea because if it works like an opioid, it could be addictive. But at the time, when I was being asked these questions, we really didn't have a lot of data. It's always wild when you start to see these things pop up, like it feels like it's always like truck stops first. You start seeing it. You're like, wait, is that like a real drug or is that like, you know, poppers or something . And then you start seeing 'em pop, then all of a sudden it's in a drink and you're like, hold on a second. Is this like what am I drinking here? Is this Chuger speed? What's happening? Well and then Joe Rogan just takes a handful on his podcast. Yeah, I got some up, put some on a pita. What was that dose? I don't know some . So it the big appeal that people will tell you about Cratum and we're going to get into where is it from? What is it? What does it do? And should you do it? Which my answer will be no. It is derived from a tree. So it's from a plant and everybody's really big on that. They're always like, It's from a plant, it's safe, which is especially weird when we're talking about the opioid space , because Justin when I say opioid, you might think of the word opium which comes from poppies. A plant. A plant. And there's nobody out here saying we should all do more opioids because they're from plant s. Somebody's probably saying that, somebody. So like the argument that wherever Cratum started was a plant, although what you're getting today may well not be a plant . But whatever it started out was a plant and so therefore it's safe is we know that's not a good argument. There are plenty of things in plants that when you synthesize them and purify them and concentrate them and then put them in your human body can hurt you or have some sort of effect that could be bad, good, toxic, dependent on the dose. Plants are wild. Plants are wild. Bad poison, not poisoned. They got a whole poison garden over there near the was it 's near the Barney Castle. Barney castle, right? Yeah. There's probably others. Yeah, I think there's lots of them. Because there's that many plants that are bad. For you. Yes. And so plants certainly can be active and that can be positive or negative, but the argument you should eat it because it's from a plant is not a good argument . So this cratum is derived from a type of tree that's related to the coffee tree so people are like, it's a coffee related substance, you know? It's like coffee. It's not you know, like a cup of joke. Metragona Speciosa Is it Metrogina? Mitchergyna, speciosa, not metragona. I don't want to say Mitrogina, that feels weird. It sounds like gynecology and it has nothing to do with that. Yeah. Mitchergyna, speciosa. That's the plant. Yeah. It's native to Southeast Asia. It sounds like a spell you learned a hogwarts in the teacher. As a joke, you will be removed from the school. It's a serious spell. Don't do it as a joke. It contains this plant contains a lot of alkaloids, forty . And what are alkaloids first of all? Because that's what everybody says. Well, I mean it contains forty alkaloids. And then if you don't know what an alkaloid is, that could sound bad, good, scary , wonderful, you don't know. We like alkaline and water, right? We were like good. That has a lot of the same letters. It's an organic compound that has at least one nitrogen. That's all an alkaloid is. That can mean a lot of different things. Sometimes we also will call if we can take whatever the substance was naturally occurring in the plant and then synthesize it in the lab we might call that an alkaloid too. Is Ooid, does that mean like as is that artifici ated or like a derivative? No, or this is the original like the O I the OG The Oid ending. The OID means this is the naturally that you 're the thing. I'm with you. Yeah. So but we could make a synthetic thing that we might also call an alkaloid if it essentially is the same thing. We just didn't get it out of a plant leaf. We made it in a lab, but it's the same thing. Got it. Got it. Typically it's indistinguishable. Yes. And this is going to become relevant when we talk about modern cratum preparations. So alkaloids are made by a lot of different things, bacteria, fungus, plants, animals , and they can do a lot of different things. We know that alkaloids have a wide range of activities within human bodies, probably animal bodies too, we know . And so eating plants can have an impact on you from a pharmacological perspective. This is not groundbreaking, but this is where something like Cratum comes into the conversation. Does it do stuff? Yeah . So should we just eat all plants that do stuff? No . And will eating a plant that does stuff have the same effect on you as if you take the substance in the plant that does stuff and concentrate it and put it in a gummy. No . And that's really key to understand. It's the reason why we don't tell people who we want to put on Digoxin , go eat that Fox Glove . Well yes the substance that is the we made Digoxin out of is in Foxo Glve. I have no way of knowing how much would be in the Foxglove plant you chose to eat today. Right. We have to refine these things. We have to process them. We have to Yes , right? Now, cratom has been used in traditional medicine for centuries. And the good reason it has stuff in it that does stuff. And so we talk about on the show, like one of the most prominent things when you get to like sort of full traditional medicine . The stuff that tends to actually work is usually like a laxative , laxative diuretic or what's the word in a medicine? A medicine? Yeah, something that you can see the outcome. You know if it worked or not. Yeah. There's no question. You might not wait. In the proverbial pudding prior to us measuring blood pressure, you would never know if a medicine was lowering your blood pressure. You know if it made you poop or not. Yeah, right. So it's probably been popular and used for a long time because it does something , particularly in Thailand, Malaysia, Indonesia, parts of Papua New Guinea . This plant has been it grows wild. It's also been cultivated because it is used for several different things. So at small doses of cratum it is usually thought of as something to give you energy. And this is part of what you'll see advertising gas stations. People would chew the leaves while they were out working or fishing to try to like keep them awake. Okay . You see the coffee relationship here where you could promote this as like, oh, it's just you drink some coffee, you chew a cradle leaf. Yeah, no big deal. And they also found that it was good for pain relief. So it would be used for pain relief, for stomach issues , again, fatigue . And there were a lot of different preparations you could use it for you could just chew the leaves. So you just pick 'em right off and chew 'em. You could turn it into some sort of tea. That's a very traditional preparation of it, brew it into a tea. Which there are a lot of things like that. Like I have gotten into foraging recently and we collect that old and brewed into a tea sure. Not really because I think it's doing something, but because Cooper likes the taste of it and it's out in the yard and that 's fun . But there also were some historical accounts where people who were addicted to opium started touting the benefits of cratum as a way to alleviate withdrawal symptoms. Same way we'd use like methadone or something like that. Similar, but not exactly. And I want to make sure to make that clear Cratum as we know it at this moment would not be a replacement for methadone buprenorphine commonly known as Suboxone. It would not work in that same way because a key a key factor with those other medications is that they are not the goal is not to produce euphoria. You're not trying to do that anymore. It's actually the series finale just aired. So you can't produce any more Euphoria. Thank goodness, legally speaking . I can't say I'm sad about that one . So it is yes, that is the way people would sort of say like, hey, you can use it, but they're not really saying, use it to help yourself stop using opium as much as like if you can't get opium and you're going through withdrawal. Here's another here's some cratum. Okay. So like and again, I just want to make that distinction because this isn't the same as like, let me put you on a standardized medication that will help reduce your substance use. That's not what this is. Not this. Okay . And again , you can chew it, you can make all kinds of different products that would cause these kinds of results and has been used for very long time. We first figured out the chemical that probably was doing stuff, the alkaloid that was most responsible for the effects back in nineteen twenty one , mitrigin . So this is the active substance that we think primarily makes whatever you feel like cratom is doing for you, it's primarily the Mitcher Guiding doing it. And there's some other stuff in there too, but this is the, this is the top alkaloid, okay? And you will see that sometimes advertised today . And it's often like abbreviated as MG two. You'll see that out there . But Mitcher Gining was advertised separate from cratom. Like locally, it was just known as Cratom or sometimes Tom Tom, but it would also be called metrogynine on some packaging. Okay . Through later studies , they started to isolate like, okay, metrogynine's the thing. And this was back in the sixties that seems to have an effect on people . And specifically , they started to find a very small amount of seven hydroxymitrogynine , which is a very potent version of that metrogyning is the best way to think about it. I mean, it when it comes to like chemical compounds , sometimes we can make one little change, add one little thing to a ring and make it way more potent or way less potent And what they found is that through and this may be naturally occurring in the plant itself, or it may be through our interactions with metrogynine in our bodies we create seven hydroxy, metrogynne. But one way or another, what we know is that while it only makes up less than two percent of the alkaloids in cratom , it is the most potent piece in terms of having any effect in the human body. Okay. Does that make sense ? Yeah, okay. So what we know about Mitcher Guinine and even more so about the seven hydroxy, which I'm going to go ahead and say, if you've heard of seven hundred H, this is what I'm talking about . And that is also now advertised at drugstores, gas stations, anywhere that they're selling cratum products, you'll see kind of like with CBD, they did the Delta nine. It was like new . It's just a spin on it. It's the same idea. seven hundred H is the new Cratum . Is that Cratum? Fined in Layman's terms, would you could you describe as a refined version of cratom? If Cratum is, let's imagine crumit asi the leaf. Okay. You're imagining a leaf, just a green leaf. Yep. We pulled out of it metrogynine, which is the most potent part of it . This is just a chemical molecule . And then we purified that into seventeen or seven to hundred H and then we made a ton of it. I just never knew when to leave well off alone, you know? That's seven hundred H. Yeah. Yeah. We took the thing that did the thing and it more. Made it more. Yeah, yeah. The effects are dose dependent . In low doses of mitrigidine or seven hundred , you are going to feel more energy. So it does tend to have some stimulant property when you take a little bit, which is probably why people working in the fields would chew the leaves and wouldn't be harmed by it, but would feel subjectively more energized. Okay, right? Yeah . But when you take more of it, what we've noticed is that it can start to have the opposite effect. Oh , sedative . Yes, like knocks you out, puts you to sleep . It also does, we know, help with pain at higher doses or we think when I say we know, let me be really clear . There are no great clinical studies on any of this right now . Not cratum, not seven, not seven hundred H, not mentrigining. There are no large double blind placebo controlled trials where we have exposed individuals for various you know , we have not done that. A lot of this data is preclinical or small groups of people who are using unregulated products with variable amounts who's funding it and everything . Yeah. So I do not have good data to tell you for sure. But what we think , based on what we know so far, mainly on preclinical data , meaning like in a lab and in animals , we know that at low doses, it might make you feel more energized and then at higher doses, it helps with pain and sedates you. There are there's a ton of like preclinical research that's been done on other things that it was used for historically, like inflammation, antibacterial . You will see stuff out there about weight loss in addition to pain, depression, anxiety . And what we know so far is that in a lab we see some effects , but we don't know in humans because we haven't done it.. Right, right So it's like a lot of when we get into some of the herbal realm, it's like a lot of those substances, right? The science isn't there. Yeah. Like in a petri dish, it seemed to do this. We don't know what it'll do in a human body . But the key thing is the mitriginine and the seven hundred H to focus on those , those probably do have the effects in humans that we're seeing in a lab. And the reason we know this is because as we began to study specifically these two compounds , what we found is that they interact in the human body with a kind of receptor called a mu opioid receptor. Muing . I thought it might lead here. There are different kinds of opioid receptors. Okay , but the important part is that something that interacts with those receptors in our body will have the same effect as other opioids would when they interact with those receptors in our bodies. It's just an opioid basically. It's an opioid . The reason that it would make you feel like you took an opioid is because it could be classified as an opioid. Now at this exact moment, I don't know that that formal classification has happened because if you did, could you sell it at the gas station ? No, probably not , right? But it does it does bind with opioid receptors. Now, there was some initial and there's been this like flurry of research on metrogynine and seven hundred H just in the last couple of years as we're trying to figure out , whoa, this stuff seems really popular. A ton of people have started taking it. We have no idea how many people. And then when it enters like popular media and you hear people like Joe Rogan talking about it, you know more people are, going to start using it. So what the heck does it do? And at first there was some hopefulness like, well, you know what? It does tend to bind with some of the opioid receptors , but the specific ones that are responsible for respiratory depression, meaning the ones that would make you overdose , it doesn't interact with those as strongly. So, oh, well maybe it will give you pain relief and help withdraw symptoms. Maybe it could be, like you mentioned , like a methadone thing with causing respiratory depression . But the problem is a lot of those initial studies were looking at metrogynine and cratum. seven hundred H itself , that is going to need to be studied a lot more before we know what it's going to do, right? Right . Okay . So that's exactly what would need to happen before it became super popular if it was going to be used safely. Right. Because then if it was a new medication that could be used in the same realm as methadone or buprenorphine, excellently wouldn't be in a can at the truck stop. Let's do trials. Let's figure out let's figure it out, you know , and that's not what happened. So it did happen with Creedam . I'll tell you after the billing department . It's good timing. Let's go. The medicines, the medicines that escalate my cab the mouth . Hey Justin. Yeah, baby. You know, my days at work are long. Yeah . Yeah. Yeah, it is . And I work long hours on my feet and in variable temperatures , I'm outside, I'm inside, it's hot, it's cold. I need to be comfortable. You know? Yeah, for sure. Yeah, you got to take it easy. And figs keep me comfortable, do you know about figs? I have heard about figs, but I'd love to hear I love the way you say it. You love the way I say figs? I love the way you talk about figs. The way you say . Figs make scrubs for modern medicine. We need scrubs that not only fit well, but also like they feel comfortable and they breathe and they got lots of pockets. That's what we need. They're form fitting, they're soft, and they're made for people who are actually working all day long on their feet in healthcare or like me. Like, I'm up, I'm down, I'm climbing on things, I'm down on my knees on a sidewalk. And these are lightweight, they're durable, they're super functional, they're antimicrobial. They have all kinds of different styles , including the cade pants. Those are one of my favorites because of the cargo pockets. Oh, I always need more pockets. Absolutely. Figs is going to give you all the pockets you need for all of your accessories that you carry through the day. They have scrubs, they have outerwear, they have footwear, they have everything you need to look good and feel good while you're at work. Wow. That sounds amazing, Sid, how can I get some? Well right now twenty twenty six is here. So let's do this. Take fifteen percent off your first order at where figs dot com with the code figs RX . That's wherefigs dot com code figs RX . People always come to me and say, Justin, I want to start reinventing my wardrobe, but I don't know how. You know, you don't do it all in one swoop. You know how you do it said one word for you? Separates. I love that. You find a separate, one item, pair of shorts, pair of shirts speaks to you . Pair of shoes? That's two items. I guess technically. Well, you wouldn't want to start with a single shoe. Don't buy a single sho e. That's a sucker's playing right there. That's not going to pay off in the long run. Quints is the reason I'm bringing this up because they have a lot of really cool individual items where you're like, I don't know if that's going to work for your nin or not, but I'm going to give it a shot because the price is really good. The stuff is all made ethically with providers that you can feel good about . And it feels good. It feels like it's been well made. I got some cordoyiller shorts from Quints that I wear all the time. I'm currently wearing I think a pair that I have been basically in and out of those and the Cordilleroy shorts since the warm months started. I think that's true. Yeah. And these are fantastic items. I haven't got a single thing from there that I have not been impressed by. So elevate your summer wardrobe, go to quints. com slash sawbones pod for free shipping on your order and three hundred and sixty five day returns. Now available in Canada too, that's Q IN CE dot com slash sawbones pod for free shipping and three hundred and sixty five day returns quince dot com slash sawbones pod . Sunscreen companies calculate SPF by testing it on volunteers' butts. There is a can of spam in the Mariana Trench. A Nobel Prize winning physicist from the Manhattan Projects invented modern speed bum ps. Mesoamerican native people invented kidney medicine that glows in the dark. On the podcast secretly incredibly fascinating, we explore this kind of amazing stuff. Stuff about ordinary topics like sunscreen and spam and speed bumps. Topics you'd never expect to be the title of the podcast. Secretly incredibly fascinating. Find us by searching for the word secretly in your podcast app and at maximumfun dot org or if you like too many podcasts, you'll love Sao Teep with John Link Roberts. It's got clips from all your favorite podcasts such as Diary of a Tin y CEO, Leonard Sprague, tell me how you make your money. I go to the beach and I steal people's towels. Remember Armor. Do remember the trend of everyone whacking themselves in their head with hammers and mallets when they wanted to lose weight and Elti John's Lobberly songs. I'm here today with Kinky Dee Hello Kinky Dee Hello Elton . There's dozens of episodes to catch up on and brand new episodes going out right now , so if you want far, far, far too many podcasts, then look for sound tip on maximum fun. Boop, boop . Okay, Sid, so what did happen with cratum? Okay , what did happen with cratum is that people started using it and because it works on the same receptors that opioids do , they liked it because in higher doses and especially when we go to the seven hundred H, which is again the most purified form of the active thing that does the thing it can create the same symptoms , if you will, of opioid intoxication. It will make you high. You will feel euphoric . You might yeah, you could hallucinate. It can it can cause delusional beliefs. The drug stuff. Yes, it can and again, small doses may be stimulant and those would also make you feel great. Yeah . Love . But then the larger doses it's an opioid . And so if something create euphoria, you are more likely to want to go use it again. And then the other thing that we figured out about Cratum pretty quickly is that because it does bind with opioid receptors, it has addiction potential. So while we're trying to cure, you know, replace our methadone and we maybe become addicted to something else . Exactly . So Kratum in commercially available preparations has been around since the early two thousands . And I think it was probably it's one of those things where like , you know, people will travel to Americans go to other parts of the world . They find some sort of traditional folk medicine use , and then we decide that it must intrinsically be better than anything that's a pill because it's natural. And there probably is a way for us to make it more profitable . Yes . And we're going to market it. Yeah. So it has been sold as a supplement since the early two thousands , I shouldn't say as a supplement. A supplement is a specific designation. It's a food Justin. It's a food . And it's for anxiety, mood, energy, weight loss, and to help you quit opioids, like many foods And it's been pushed that way for quite a while, like this is a natural alternative to opioid, to an opioid. But I mean, it is in the sense that like percusset is an alternative to Norco. Sure, you know, yeah. Heroin is an alternative to fentanyl. Yeah, they're alternate. They're different on the things you could do. So because of this, because as it became more popular in the early two thousands, more people were using it and there were and let me be really clear , it has been implicated as one substance present in a number of overdose deaths in the U. S. , however , these are almost always polysubstance situations. So to say that it alone is the problem would be an overstatement, right? Like we don't we don't know we didn't know that certainly back at this point but we were starting to see some potential for abuse. There was some concern . only It makes sense that if mitriginine and seven hundred H are opioids, then there could be all this concern. So in twenty twelve, the FDA issued an alert basically saying, we don't know what these are exactly, but they're unregulated. They're being sold out of truck stops . We need to look into this. Yeah. It is possible that we need to schedule this, effectively ban it, right? If you make something to schedule one substance in the U. S., there is no legal use for it. So you've banned it. Right. So there was a push to do this, and in twenty sixteen specifically , there was a move to schedule it . And the FDA was pushing this all along. The FDA, the DEA were saying, we are concerned about this. This is going to be a problem. Maybe it's not a problem yet, but it's going to be a problem. So there was a move to schedule it back in twenty sixteen and it was halted the lobbying group, the American Cradum Society. Ah, good, they sound good. I like the sound of this. I looked into the American Cradom Society. But they're cool. I don't, Justin, I don't really know. All I know is that they started back in twenty fourteen and they only made two hundred bucks in revenue. And if you look fast forward to their last year, twenty twenty four that's recorded, it was over four million dollars . They're doing like, you just look at these gra phs in the last few years. They have money in the cratum. The American Cratum Association is bringing in a lot of money to lobby for cratum use . And they must have been successful because they reached out to say, Hey, no, no, no, no, don't schedule this . And they were supported with a letter from fifty one members of Congress. A bipartisan group a bipartisan group from one fif metym bers of Congress who got together yeah to say please don't please don't schedule a It's really important that you not do this but this incredible miracle food is helping everybody . Don't let it say a drug. And here 's what they said. As our nation continues to combat the public health crisis of opioid abuse, the federal government has invested significant resources to develop alternative pain management strategies . And so cratum is part of this basically . This study led the researchers to apply for a patent identifying the cratum extract ine as a useful treatment for other addictive drugs besides opiate derivatives . And then if you do it if you schedule it, we won't be able to do this, right? Once you schedule it, you can't study it. You're done. And it's interesting because at this moment, as I'm reading this story of Cratom, I didn't know this was an effort because as a result of this in twenty eighteen, the FDA said, you know what? We don't have enough data to know what to do with this. We're just dropping it. So you let it alone . Let it go. Great. Let it go, let it grow, let it be sold. Yeah. Speedway. And this was which FDA was this though? Because I think we should be this is twenty sixteen to twenty eighteen. All right, yeah. All right, cool. There you go. So the problem here , I think that this is a nuanced issue. And man, that's tough, isn't it? Right, especially in this day and age, when you have a nuanced issue. Not near not a climate for nuance. No. Cratom definitely and specifically, let's be specific, seven hundred H as potential for abuse and we're there's studies I'm going to tell you about that say this . But have we had great success with criminalizing substances of abuse in this country? I would say no . Right. So when you see some of the names, some of who some of these fifty one members of Congress are, it might surprise you if you're thinking, well, why wouldn't you want to stop this? This is dangerous. This is addictive. This could hurt people. People could die. All true . Making it illegal, though , doesn't always help . Right, right. Okay . And so that so when you look at that bipartisan group, some of them are just very much like this just say no crowd . But like I think like Bernie Sanders was one of them. So then you have people who are trying to be thoughtful about our approach to substance use and the legalization of drugs or not in this country , right? And so it is nuanced. The problem though is that by the time they're having this conversation, the cat's out of the bag . And if people were gonna get addicted to cratom, that's already happening . And it's growing in popularity. So we see there's all these studies that have been done about like they actually look to like Reddit forums to see how many mentions of Kratom. And in the last few years, it's just exploded. People everywhere are talking about Cratom and more specifically the seven hundred H. Now why is it more popular ? The reason it's more popular is the same reason that every other opioid they've made has been popular because it's addictive. They took the most potent part, the seven hundred H and they put it into pills and gummies and powders and drinks and all kinds of and if you look, there's tons of products. You can buy 'em online . They look pretty and they're flavored like they're everywhere . And they're usually sold as an energy supplement . Yeah . And weight loss is tied to it. So like they're hitting on the things that they think most people will want to buy . It's natural. That's what they all tell you. It's natural . So no problem. Now, that right away is a problem. I would say there's there's a lot of problems here. But the idea that it's natural being in its favor is already a fallacy, but it is probably not economically feasible for all the companies and there are multiple , I mean, this is a multiple billion dollar industry now . There are multiple companies making these various things with cratom in them and seven hundred H . There's no way they're going and harvest ing this plant and getting it from the plant. You know what I'm saying? Yeah, it's not feasible. It doesn't seem right. You couldn't. No. So instead you just make it in a lab. Yeah. So I mean, just like we did with fentanyl, right? Fentanyl isn't from a poppy. Fentanyl synthesized in labs . It's a very potent opioid that's sympathized synthesized in labs. That's what they're doing with seven hundred H. They're just making seven hundred H. It's not natural anymore. So even that claim has kind of fallen by the wayside. I don't know, it seems bad said. I don't think it's a good idea to do it. Well, so what we a bunch of studies have been done in a hurry in the last few years to look at seven hundred H in terms of abuse potential and addiction . And what we know is that it does have a very high affinity for those new opioid receptors. That's the stuff that will make you feel high when you do an opioid , right? Like they do this stuff . We know that there's several studies they do in animals and it was interesting. I was reading descriptions of all the different ways to see like a self administration study they do with rats. If a substance has abuse or addiction potential, then the rat will go back and try to put it in itself, like it will try to get the substance on its own . There are studies where they'll look for like pain it does appear to have in rats, it appears to help with pain . So if you're in pain, you may be more likely to want it . In drug discrimination studies where they were looking at it compared to morphine, the rats were going for this over the morphine . Meaning that its abuse potential is probably higher than morphine at this point. It looks like it has a stronger affinity than morphine. We think that as much as you might get addicted to morphine, you're more likely to get addicted to this. Wow. This is what we think we think this is all early . Basically it has a high potential for abuse is what we know based on these preclinical rat models so far . So when these supplement companies and they're not supplements, when these food companies, when these fun Fun truck stop favorite companies. Well, these party favor companies are talking about how their sales of this have exploded and people really love it and they're drugs. It's because you're selling drugs. It is. I mean, that's what you've done. You've taken something had a teeny, teeny bit of addictive potential. And I would say you could make the argument that when people are talking about pure cratum, the plant eating those leaves , I don't know that there's enough of the addictive substances in there to make you addicted to the plant. Do you know what I'm saying? Do you see the distinction I'm making? Yeah, nature and infinite wisdom provided the exact right dose for us to keep on trucking. Yeah. And so probably people in the fields would chew those leaves and then were able to go home and not go into withdrawal and desperately need more of the leaves. Yeah . But now we've taken the very active part and purified it. And so you will need more of it. And that's what we've seen is that in those same studies, they definitely saw intoxication syndromes when you took it, withdrawal syndromes, when you stopped it, craving and seeking behaviors to get more of it. It's just everything we know about opioids. Yeah. Everything we know is true about seven hundred H . And anywhere from these are the studies that I found anywhere from one point seven to ten million people in the U . S. are trying it in a year. We have . So it's a lot. We have no idea because there's so many different formulations of it and it's so widely available . The people who are using it, it seems to be like the average user , the demographics are like white, middle class. Initial, it was slightly more women. I think because the initial preparations were marketed for like weight loss and that usually is targeting women over men and energy. And now, I think it's just white middle class people are using it . They also, I mean, anybody could, but that's generally the demographic. And they're usually using it multiple times a day . And they usually continue to use it because they get sick if they stop. Jugs . Right. So like these are, I feel like we're like walking backwards into something we already knew. It's really weird to watch this happen backwards. It works really quickly. That's another thing that people find attractive about it. Like within forty five minutes, you're probably feeling the high again . Yeah, because it's because it's an opioid . We have no idea how much of it is in any given product. So there are tons of TikToks you can watch where like pharmacists will go around and buy various cratum and seven hundred H products off the shelf, take them home and use their gas spectromet er to like measure how much Metroginine or seven hundred is actually in this product and it is wildly variable to you got ripped off because you just bought some gummies that have nothing to o no it, has it has two hundred percent more than you thought it did, which could lead to overdose . It also, a lot of the preparations are cut with other random things like benadryl is in there for whatever reason. Some of them have been cut with cod ing , which is you can't just legally buy that over the counter. Right. So we don't know what's in any of these supplements. You have no idea what you're getting or how much of it you're getting . Seven states so far have taken action on their own and banned it , and seventeen more have age restricted it, which means by the way, that everybody else hasn't even age restricted it. Kids , come get your drugs. I guess. And I get I really do, I think my initial reaction was ban this stuff, ban this stuff. Why don't we ban this stuff? And I had to really do some soul searching because the way that it is being sold and marketed , I disagree with vehemently because it's just a profit thing . They're selling over the counter opioids for profit. And so the motivation is going to be to sell as much as possible. There will be no safeguards, no guard rails on this . But banning it cannot be the solution either, right? Well, certainly not right now. I do not trust the U. S. government to be a , you know respectful sort of, you know, responsible instrument in terms of that. You know, I certainly don't trust them to regulate anything. And I think that if there was a pathway for metrogynine or seven hundred H to be used as medication assisted therapy for the treatment of substance use disorder, which I mean, perhaps there was at one time. It's going to be really hard to I mean how do we walk this back now that it's available everywhere . I don't know how you and how you do that. And I would also argue we have good MAT. We have buprenorphine. Yeah, we have other things that you do this. Right. And there is no advantage if your argument is, well, but this is natural. It's from a plant , that's not a good argument here. We have substances that help with this. And do not create euphoria, which is the goal, because then people can function on them. Yeah. If you're taking something all day long, that's going to alter you, it's going to intoxicate you, how can you , how can you have a family or a life or hobbies or friends or a job or go to school or any of the stuff that you might want to do with your life. You need not to be intoxicated. So that's the, that's the skinny on cratum. I would not recommend it. I would not recommend it to somebody who's trying to kind of self treat for substance use disorder to try to reduce their use of other opioids. I would not recommend this substance for that at all. I would not recommend buying any of these over the counter unregulated whatever they are. You have no idea what you're getting. I would encourage you if you do have young people in your life, if you have children or other if you're a guardian of some sorts, if you please educate kids about this. This is gonna be at parties . Yeah. I'm sure it already is. This is going to be the new party thing to do. This is Salvia. Do you remember when Salvia came out and everybody said this is the new le