Question:

I’m an Addiction Peer Support Specialist, and several of my clients who are veterans have been using Kratom, and they’re wondering if the VA urinalysis tests for this new drug?

Jim's Reply:

Kratom is a relative newcomer to the quasi-legal substance market in the United States. Elsewhere Kratom has been used for its sedative and pain relieving qualities for many years.
 

Derived from a plant source related to coffee, Kratom is said to relieve pain and enable users to avoid treatment with opiates although Kratom is itself said to be addictive and considered an opiate by many. Kratom is not currently illegal and since it's widely available and relatively inexpensive, more and more veterans are turning to the substance for relief of any number of symptoms.
 

The FDA lists Kratom as a drug of concern but has little else to say.
 

One reason for the favorable view of Kratom is that it's not detected on any standard drug screens. "Random" drug screens are often called 'panels' and may come in kits that test for 1, 4, 6 or more named drugs and of course the expense of the test increases with each additional drug screened. Since Kratom requires a rather fussy test in comparison, there is no reason to use it without a clinical reason.
 

The active substance in Kratom is mitragynine and while there are lab tests available for that, they are very specific and must be specifically requested by the ordering caregiver. So, no...VA is not testing for Kratom unless the caregiver has a very narrow reason to order that test.
 

It's worth sharing with your clients that VA doesn't care very much about substances the veteran ingests. There are no risks to disability or other benefits if the vet pops positive on any drug screen. If the veteran is currently prescribed opioids the prescriber may discontinue further opioid prescriptions or a mental health provider may DC competing substances but other than that, VA won't have anything much to say other than a referral to a rehab program.
 

I think it's also worth noting that for pain relief that isn't terminal (hospice/cancer) in nature, Ranger Candy (Ibuprofen 800 mg. tablets one every 6 or 8 hours) is as potent as anything else you can take unless and until you shift to the narcotics category. And since nobody gets a buzz off of Ranger Candy, (it won't get you high) and it isn't tested for, it's a much more effective medicine than Kratom.

VA prescribes huge free bottles of 800 mg. IB...I have one in front of me right now...it beats the unknown substances like Kratom for achieving the goal of pain relief.