Talk:Mitragyna speciosa/Archive 2

Archive 1

Archive 2

Archive 3

Recent changes to this article

It seems that this article has recently been flooded with edits, many being poorly worded and uncited, and with a vehemently pro-kratom tone to the point of reading like alternative medicine promotion. While I personally have no problem with the plant itself or its use, this type of material doesn't belong in a Wikipedia article. After some trimming and rewording, some of it could be toned down and placed in appropriate sections with proper references. Opinions?--184.43.58.252 (talk) 17:18, 11 March 2013 (UTC)

You removed content that was cited and sourced. You removed the sentence pointing out that Kratom is part of the Coffee family and similar to coffee. This isn't disputed and is a basic fact. The article itself contains the relevant sources for that. You also removed info on the history of Kratom from the intro. Why was this done? The Intro itself does not use citations generally on wikipedia. Citations are provided in the article, the introduction of articles simply summarize the article itself. If you want to find the citations then please see the article itself. Every thing that you deleted was, in fact, referenced in the article itself. You also removed info about Kratom in the media. Kratom is, in fact, often portrayed in a negative light in the media. This is also sourced thoroughly in the article from both the media articles and articles commenting on the media portrayal. This is sourced, so removing it doesn't really work. You also removed the following sentence from the intro:

"Kratom is currently frequently used as a natural alternative to treat depression, anxiety, addiction, diabetes, chronic pain and fatigue. The leaf has also been proposed as a means of treating high blood pressure and sleeplessness. "

This is all sourced and referenced in the main article and in the body of the article. Every single disease that has been used to treat Kratom, mentioned here, is sourced. Also, why did you remove the content about the Kratom Association? That is relevant information considering it is an official organization dedicated to Kratom. If you look through numerous wikipedia articles you will find lots of organizations detailed if they are relevant to those articles, even of those organizations put forth a specific POV..They are nonetheless relevant in the context. See the environmentalism article which lists pro environmental organizations, or please see the coffee article which lists pro-coffee organizations, or please see the tea article which not only lists Tea organizations but lists tea companies, which sell tea. Does this make the tea article bias? Of course not.

Furthermore, Please see WP:EW for more info about discussing reversions prior to edit warring. Now, If you have a problem with the wording of the content then please feel free to improve it, but erasing content that has been referenced doesn't help the article. Please remember, as I mentioned above, the introduction to the article (the top section) contains no references because it summarizes the article. All of the references are found in the body of the article. If you feel that the article is "pro Kratom" then please read the large number of plant articles which list, in detail, the medicinal benefits of such plants. It isn't bias to explain the benefits of plants and trees. Kratom, unfortunately, is implicated as being dangerous but the scientific evidence and the large amount of testimony shows this to be false. Wikipedia articles can, and should, mention controversy about subjects but should never be artificially made to be "neutral" on issues where there is no legitimate fire where the smoke is. Please see the evolution article, which is a good example. Despite the fact that there is a huge amount of "controversy" concerning evolution and if it is true or not, the article does not attempt to be "balanced" between evolution and creationism for the simple fact that no reputable sources can be given showing creationism to be true and evolution wrong. Thus, Wikipedia must reflect reality and not reflect popular perceptions or controversies. The same applies to the Kratom article. Certainly if there are found to be reputable peer reviewed scientific studies showing Kratom, and Kratom alone without influence of other substances or illegal drugs, has specific side effects then that should be included in the article just like the Coffee article contains side effects of Coffee. ThorPorre (talk) 20:58, 12 March 2013 (UTC)

This shouldn't end in an edit war. The wording was blatantly partisan and doesn't belong in the article lead. It could be broken down, organized, and placed in individual sections such as medicinal uses, regulation, etc. but it shouldn't be crammed right into the article head with no inline citations. Also, the 'kratom association' section is a blatant violation of Wikipedia policy. We do not outright promote third parties by giving them their own sections in articles. Using them as a reference, however, is fine. I posted this on your talk page as well. Feel free to issue a request for comment--76.177.89.200 (talk) 04:44, 13 March 2013 (UTC)

This article has major WP:POV issues at present. Kratom is mostly notable because it has recently become popular (outside of Thailand) as a recreational psychoactive drug. There's nothing wrong with recreational drugs, but as the article currently reads, USA federal agencies, state legislatures, media sources, and the Thai government are seeking to ban a medicinal plant used to treat diarrhea, depression and addiction for no good reason. Sorry, but kratom is a "Drug", and the single most important fact about this plant is only tangentially mentioned in the article. In my opinion, outlawing plants is a bad idea, so best of luck to the Kratom Association, but Wikipedia is not the place to push your WP:POV. News reports about kratom are often sensationalistic and implicate kratom when other substances may be involved in reported incidents. Rather than rebutting these stories, consider deleting sections like Media Attention and Adulteration entireley (WP:NOT#NEWS])))/Plantdrew (talk) 06:16, 13 March 2013 (UTC)

You'll have to explain how the article contains POV. For I see none currently. Kratom is a tree, it has chemicals that are considered "drugs" technically but then again so does Coffee. Does the Coffee article refer to coffee as a "drug"? No, because the constituent chemical doesn't make the plant what it is. The truth is that the federal governments and legislatures ARE seeking to ban a medicinal plant for no good reason. Please see the sources in the article which explain what Kratom is and how it works. Kratom is most comparable to coffee in effects, not comparable to illegal drugs. The Section on the Kratom Association explains what it is, nowhere does it push a POV. Please read WP:POV closely for clarification. The Anonymous IP has also been deleting referenced sourced material which explains the benefits of Kratom. ThorPorre (talk) 14:31, 13 March 2013 (UTC)

I've reworded and added sentences explaining both the Thai history of banning Kratom (all sourced), the Media issues with Kratom (sourced and referenced) as well as Kratom's medicinal uses (all sourced and referenced). In the future, please refrain from removing sourced content because you feel it is POV. If you feel it is POV, then please reword it. Read my initial post above explaining conventions of not adding sources to introductions. And currently I'll leave the Kratom Association section out of the article, but this is only until we can have a clear discussion on why it should be left out. So far I see no valid reasons. It is both relevant and sourced. Adulteration of Kratom is an issue. People eat the leaves of the tree and adulteration exists, so it has a place in the article as far as I can see. ThorPorre (talk) 14:42, 13 March 2013 (UTC)

Furthermore, Plantdrew, please read WP:NOT#NEWS]. That policy is about people offering first hand reports on news stories. For instance if I'm at an event I can't add to wikipedia "there are thousands of people at this event" or something. It also means that small news issues like routine reports on celebrities shouldn't be included. This article does none of that. It doesn't violate any of the 4 criteria for the "not news" guidelines in that it 1. isn't a first hand news source. 2. Doesn't include non-relevant news. 3. Doesn't promote a non-relevant individual (the K.A. is indeed relevant to Kratom) and 4. Isn't used as a diary. You seem to be confusing "Not news" and misreading it as not including relevant news articles in Wikipedia. Wikipedia must stay current and up to date, this is part of how wikipedia works. ThorPorre (talk) 15:00, 13 March 2013 (UTC)

The relevant part of WP:NOT#NEWS is #2. The incident in Kelso, WA is not notable in an article about the plant. I can't see the full text of the reference for there being no lethal overdoses, but the other references linked "Media references" section do not support the phrasing used in the article.

"Furthermore, very few of these negative articles interview the Kratom Association."

[1]The Kratom Association is indeed, not quoted. Nor is anybody else who might be considered an expert on kratom. This shows that ONE news article did not interview K.A. Perhaps NO articles have interviewed the K.A. (although this would be difficult to prove). If there are any articles where K.A. has been interviewed, they could be used to support the notability of K.A. itself.

It is common for journalists to make assertions that Kratom causes a litany of side effects including hallucinations, addiction, anger, psychosis and many other claims.

[2]Again, ONE journalist is asserting that kratom is "life threatening", and quotes others who assert that it caused a death, and may cause "psychosis" and "permanent damage". This single article does not demonstrate that this portrayal of kratom is "common for journalists", and "hallucinations, addiction, anger" are not even mentioned in the reference provided.

"These articles are very common and tend to appear every few days."

[3]The link provided goes to a series of blog posts tagged with "Kratom in the Media". Assuming that the post appearing highest in that link is intended, that post talks about "misconceptions about kratom, that appeared in the media the last few months". There's nothing to support media articles with misconceptions being "common", or that they appear "every few days"

"These articles never cite scientific evidence, but rather interview a single person who they use as an authority on Kratom."

"Despite this fact, Media articles which attack kratom, make scientifically inaccurate accusations and assertions.

These sentences are not followed by a reference, but none of the references provided in the "Media attention" section explicitly support these statements.

I do not doubt that the content in the "Media attention" section describes the usual media treatment of kratom. There are probably news articles which could be cited for "hallucinations, addictions, anger" as side effects. However, the references provided are being misused. The references could be combined to cite a statement like "many recent news articles cast kratom in a negative light" or even "many United States journalists write articles with an anti-kratom bias"Plantdrew (talk) 04:05, 14 March 2013 (UTC)

Give me 1 day and ill fix the references and make the statementsore clearly reflections of the references. Ill also put

More references in there which support the current content. Everything stated is true, but ill need to put more references in to fully emphasize the statements. Ill do it by tomorrow afternoon. There are dozens of news articles to use as examples. Maybe rewording from "it is common" to "several journalists have claimed" followed by multiple sources would work best. ThorPorre (talk) 05:02, 14 March 2013 (UTC)

Also, note that the only major edits in the last few months have been from me. Everything else has been edits which deleted large chunks of cited material. Please help find more articles to reinforce the statements made if you have time. There are plenty out there, so its just a matter of finding them and adding them in front o the statements. This includes the media sections. The Kelso incident is relevant because kratom, being so obscure now, becomes relevant with the smallest mention. Relevance is determined by context. In the context of world news is that relevant? No. In the context of kratom itself is it relevant? Yes. ThorPorre (talk) 05:10, 14 March 2013 (UTC)

"several journalists have claimed" is an appropriate phrasing that could be supported by the references. Will the Kelso incident be remembered 10 years from now? Will the link to the news story still function 2 years from now? If it is being talked about in Kelso in 10 years, it might be relevant to an article about Kelso. In no way is every media incident relevant to an article about kratom. You can cite several news articles to make a general case about negative media portrayals, but mentioning and rebutting every incident in the media is not relevant. I really don't understand; I think we both believe that the journalists are behaving as sensationalistic hacks. Why do you want to give their stories prominence/page views? They do not need to be mentioned.Plantdrew (talk) 17:16, 14 March 2013 (UTC)

Relevancy is always determined by context. For instance, If you google "Kelso" then will the incident come up? Doubtful. However if you google news "Kratom" then that news report will be one of few news reports about Kratom that do show up. ThorPorre (talk) 18:37, 14 March 2013 (UTC)

Requested move

The following discussion is an archived discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the proposal was not moved. --BDD (talk) 22:40, 20 March 2013 (UTC) (non-admin closure)

Mitragyna speciosa → Kratom – WP:COMMONNAME, to aid our readerbase who are not familiar with botanical Latin. This plant has a common name which is already used throughout the article, so we should use it - filelakeshoe (t / c) 09:15, 13 March 2013 (UTC)

Survey

Feel free to state your position on the renaming proposal by beginning a new line in this section with *'''Support''' or *'''Oppose''', then sign your comment with ~~~~. Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's policy on article titles.

Oppose, for the same reason Cannabis sativa hasn't been renamed 'marijuana'. The article is primarily about the plant species.--Metalhead94 ^{T C} 14:14, 13 March 2013 (UTC)

Oppose, per above. The scientific name makes more sense. ThorPorre (talk) 14:26, 13 March 2013 (UTC)

Oppose, per WP:FLORA, which is endorsed by WP:AT. Usage of "kratom" in English is a recent phenomenon. It's not clear that this plant will continue to be widely referred to by this common name; there is a very real possibility that it might be widley banned, in which case it may fade into popular obscurityPlantdrew (talk) 20:00, 14 March 2013 (UTC)

M. Speciosa may be banned but it will never fade into obscurity. It will amass a movement behind it like so many banned things have and it will eventually be decriminalized everywhere. It's too beneficial to fade into obscurity. ThorPorre (talk) 01:00, 15 March 2013 (UTC)

Discussion

Any additional comments:

What evidence do you have that "kratom" is the most widely-used name in English? And what makes Thai more familiar than "botanical latin"? Guettarda (talk) 12:09, 13 March 2013 (UTC)

Google ngram seems to favour Mitragyna speciosa slightly, over period 1960-2000. Guettarda (talk) 12:17, 13 March 2013 (UTC)

yes, "Kratom" is a common slang name. ThorPorre (talk) 14:33, 13 March 2013 (UTC)

If it's slang, why is it used everywhere in the article? If we can talk of "Kratom trees", it clearly isn't quite like calling amphetamines "speed". Is "sycamore" a slang name for "Acer pseudoplatanus"? - filelakeshoe (t / c) 14:53, 13 March 2013 (UTC)

The use of "kratom" everywhere in the article can be changed. ThorPorre (talk) 14:55, 13 March 2013 (UTC)

"M. Speciosa" would work. ThorPorre (talk) 15:02, 13 March 2013 (UTC)

I don't see anything wrong with calling it kratom - it might seem like slang if you're a biologist who speaks in Latin, but it doesn't to me, at least. - filelakeshoe (t / c) 18:00, 13 March 2013 (UTC)

Filelakeshoe, do you have any information that indicates "kratom" is the most commonly used name in English for this plant? Thanks. Guettarda (talk) 18:50, 13 March 2013 (UTC)

I hate counting google hits, but 2.3million hits for "Kratom" vs. 247,000 for "mitragyna speciosa"; just in case "kratom" is somehow ambiguous, 461,000 for "kratom plant" vs. 107,000 for "mitragyna speciosa plant"; 533,000 for "kratom extract" vs. 80,900 for "mitragyna speciosa extract". Also, when you search for "mitragyna speciosa", many of the results call the plant/extract/whatever "kratom" first. And as I said, I disagree that it is "slang", just a common name. - filelakeshoe (t / c) 19:15, 13 March 2013 (UTC)

No, Google hits aren't a useful tool here. I mean real evidence of usage in English. As I said, ngram is pretty much even. Google Scholar favours Mitragyna speciosa. And is "kratom" really used for the plant, or for the drug? And is it not used for anything else? If you're proposing a move, you need to show that the move is appropriate, based on usage. Otherwise, per WP:FLORA, the current name would be the obvious default. Guettarda (talk) 20:38, 13 March 2013 (UTC)

kratom is no more a drug than coffee is. There is no difference there but only that coffee is a stimulant while kratom isn't. There are 2 separate articles for coffee one is or the genus and the other for the drink. Kratom doesn't have that much info on it so we can't make an article about kratom tea separate from m. Speciosa. I view the current name as suitable. It doesn't confuse anyone. The article is clear about it. ThorPorre (talk) 20:59, 13 March 2013 (UTC)

hah, best comment I've read in a long time! Google hits mean nothing, so here are some more google hits. As for "real evidence of usage in English", why do the myriad of websites which mention kratom, and mention "mitragyna speciosa" only as "kratom (mitragyna speciosa)" not count as real usage? - filelakeshoe (t / c) 00:38, 14 March 2013 (UTC)

I don't understand what you're saying here. Maybe I wasn't very clear. Raw google hits aren't meaningful results. To begin with, Google customises it's hits to you...so depending on where you are and what you search, Google gives you a customised set of hits. And in some cases the numbers of hits produced appear to just be made-up numbers.

That aside, Google results are difficult to interpret. Did you limit your search to English? If not, it tells us nothing about use in English. In addition, since this is something that websites selling, you have all the usual spammer tricks (try running a discussion board - if it's been around a while it will get literally thousands of spam posts a day, all of them selling something). This doesn't just make Google hits difficult to interpret, it makes them altogether misleading. Guettarda (talk) 13:33, 15 March 2013 (UTC)

and "is kratom used for the plant?" Someone, at some point, editing this article, added the words "kratom trees", and no one has speedily removed it, so QED. - filelakeshoe (t / c) 00:42, 14 March 2013 (UTC)

No, not "QED". Not by a long shot. Article content isn't evidence for anything. At all, really. Guettarda (talk) 13:33, 15 March 2013 (UTC)

"Kratom" refers to the tree itself. It is the Thai slang for the tree. Just like the coffee has many slang terms. Kratom is colloquial and refers to the tree itself. People say "kratom leaves" or "kratom roots" and also "kratom tea". ThorPorre (talk) 02:34, 14 March 2013 (UTC)

The above discussion is preserved as an archive of the proposal. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

The lead section and citations (wp:leadcite)

The lead section of the article has no citations because it summarizes the article and each statement in the lead is mirrored in the Main body article. Putting citations in the lead is uncommon for Major articles because of the redundancy. Please read wp:leadcite for clarification. Or, for better understanding, Please read any major article and notice that citations look tacky in the lead. Thus, erasing sentences or paragraphs from the lead section and claiming that they are "uncited" will result in a revert. If you knowingly erase content from the lead and wrongfully claim that it isn't cited then further resolution will be required because it is counterproductive. If you have a problem with the style of citations and feel that they should be in the lead then a better option would be to...add them. NOT deleting info claiming it isn't cited when it actually is. The lead section is cited in the main article. If you have an issue with a specific fact in the lead section or want to know where it is cited then just ask, don't delete it because that is damaging to the article and may amount to vandalism if it is done over and over without justification. ThorPorre (talk) 04:09, 14 March 2013 (UTC)

For more info on why inline citations are discouraged in the lead section please read : https://en.m.wikipedia.org/wiki/Wikipedia:Citing_sources#When_and_why_to_cite_sources

ThorPorre (talk) 04:11, 14 March 2013 (UTC)

I am not 84.43.58.252, but I agree with their edits. WP:LEADCITE states "necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus." You have stated that "We don't put citations in the intro". This is note what LEADCITE says, and editorial consensus has not been reached. The only recent edit to the lead has been 84.43.58.252's removal of the uncited sentence "Being part of the coffee family, Mitragyna speciosa is similar in many ways both evolutionarily and chemically to Coffee.". Kratom is a member of the coffee family, but Mitragyna parviflora, among other plants, is much more similar to kratom evolutionarily and chemically than coffee.Plantdrew (talk) 17:09, 14 March 2013 (UTC)

You anonymous Ips will have to start making names. It's not hard to tell if someone is a sockpuppet. Editor consensus has been reached since the article began several years ago. Inline citations have never been in this article and there is no reason for them to be in the article. You may not be familiar with the issue here but the anonymous IP removed a significant amount of cited info from the intro and their justification was "removing uncited content". They did this multiple times despite being notifie of the fact that this articles lead has no citations for a reason. This, the real issue here is not "should the lead include citations". The real issue is "why did the anon ip continually delete cited content?" We don't know. Please read the link i posted pointin out that cotations in the lead are "discouraged". Thus, if you or the other ip thinks that the lead SHOULD habe citations then neither of you have explaine why. Now, the issue with the coffee family is cited in the article. Also be aware of common taxonomy and binomial naming based on evolutionary phylogenetic trees. Kratom is related to coffee evolutionarily. Thus, it belongs to the same "family" for that reason. This is basic evolutionary biology, thus the statement reflects the fact of the relation between kratom and coffee. Certainly it is more related to parvoflira, but both of these trees are in the larger coffee family. ThorPorre (talk) 04:55, 14 March 2013 (UTC)

Oops, above comment was me, but I got logged out. Signed properly now. The content the anon deleted was not cited in the lead. Yes, there are references in the article body. Nothing in WP:LEADCITE says that citations are discouraged; on the contrary, "controversial subjects may require many citations". Clearly this is a controversial subject, so put the citations in the lead. The lead already states that kratom is "in the Rubiaceae family". Linking to coffee is inappropriate. If you'd like to change the existing sentence about the family to "in the coffee family (Rubiaceae)", I would not object.Plantdrew (talk) 17:09, 14 March 2013 (UTC)

Please read the link I posted. Here is a quote:

" Citations are also often discouraged in the lead section of an article, insofar as it summarizes information for which sources are given later in the article, although such things as quotations and particularly controversial statements should be supported by citations even in the lead."

Link: https://en.wikipedia.org/wiki/Wikipedia:Citing_sources#When_and_why_to_cite_sources

In this article, I don't see anything as being controversial. The fact that 2 editors have an issue with the content doesn't signal to me that the article is "controversial". Its lack of traffic and edits suggests that the real issues here aren't with the article's fact but with the IP's misunderstanding of how the article was written (he didn't know that the statements in the lead are already cited). The Coffee family is the Rubiaceae family, so clarifying to readers that Kratom comes from the coffee family is necessary for context. What is the justification for not mentioning "coffee" in addition to Rubiaceae? Is there a reason we shouldn't? Because, a reason that we should is to inform readers from the get-go that it is part of the coffee family. It is important to use common terms to inform readers when possible. ThorPorre (talk) 18:32, 14 March 2013 (UTC)

I object to the link to coffee. I have nothing against the phrase "coffee family" as a common name for Rubiaceae. The evolutionary and chemical similarities of the members of the family are discussed in Rubiaceae. The coffee article is about a beverage produced from a plant that is rather distantly related to kratom; while they are closely related enough to be in the same family, the other species of Mitragyna and other genera in the tribe Naucleeae are kratom's closest evolutionary relatives.Plantdrew (talk) 19:55, 14 March 2013 (UTC)

I notice that you added a citation to the lead section. I still have no idea why citations belong in the lead section if the same citations exist in the main article. The lead should never include information that the article doesn't contain, the lead sections should be a summary of the main article. Adding inline citations to the lea section is redundant and tacky. So why should we have them? The best Wikipedia articles don't have them, even the most controversial articles. An articles controversy also doesn't justify inline citations in the lead because as long as the lead is a true summary of the article and as long as everything is properly sourced in the main article, there is no reason for lead citations. Thus, they don't belong there. ThorPorre (talk) 00:40, 15 March 2013 (UTC)

Also, the lone sentence "it is a psychoactive plant" doesn't fit and isn't worded well. It isn't a real sentence but a particle sentence or a a response. It is not encyclopedia quality phrasing. ThorPorre (talk) 00:43, 15 March 2013 (UTC)

Controversial articles do have citations in the lead. Armenian genocide cites 24 separate sources in the lead and was a Featured Article candidate. I'm also used to seeing them in plant articles; a plant may have a half dozen common names, which are only mentioned in the lead, but which should be cited. I made sure to cite "it is a psychoactive plant" because I expected it to be controversial statement. However, I'm fine with removing the inline citation in the lead if kratom's status as a "psychoactive plant" is discussed further (with citations) in the body of the article. The article needs to acknowledge that the not everybody in Thailand, or the rest of the world, is using this plant to treat a medical condition. Would you object to a section titled "Recreational use", covering some aspects of use in Thailand in and the recent rise in use in other countries? This article went from 49 page views on May 1, 2012 to 858 on May 30 [4], and has been consistently viewed 1000+ times a day in recent months. This is rise in interest is entirely due to the (IMHO despicable) "legal drug industry" selecting kratom as the latest entry in their ongoing game of whack-a-mole with the US government. The reason for the current interest in kratom needs to be developed in this article, not supressed.Plantdrew (talk) 03:29, 15 March 2013 (UTC)

The "recreational use" is the traditional use. People have traditionally used Kratom for the calming soothing effects. Kratom is advertised as a "legal drug" but it is, in fact, no more a "legal drug" than Coffee. Generally it is impossible to discern between medicinal use and non-medicinal use. Most people who use Kratom use it for medicinal purposes (depression, anxiety, pain, fatigue, etc.) and some will refer to any non-doctor prescribed use of something as "recreational" but this has never historically or traditionally been the situation. I don't oppose to referring to Kratom as psychoactive as Coffee is also psychoactive. Kratom peaks interest because so many people are being abused by the pharmaceutical industry and want to turn to a safe and natural alternative to common remedies to ailments which, themselves, cause even more side effects than they fix. It is unfortunate that the "legal drug industry" has advertised Kratom as a "legal high" or a "legal drug" and no doubt this has led to a lot of confusion. The article could clarify the problem with that and delve into it in a neutral manner, but it would have to be done carefully or else it will just play into the hands of the companies or into the hands of the lawmakers (whichever way it goes). So it would have to be done properly. ThorPorre (talk) 03:49, 15 March 2013 (UTC)

Prohibited for tax reasons?

I'm skeptical of the claim that kratom was first prohibited for tax reasons in Thailand. There is a source for the claim, and loss of tax revenue may have contributed to prohibition. But it seems very odd that a government that would tax and regulate (not prohibit) opium would prohibit (not tax and regulate) kratom. Both options, prohibition or regulation, are equally hard to enforce for a plant which grows wild.

I have an alternate theory explaining prohibition that I find far more plausible, but I have yet to find a source for it. The Prime Minister during WWII, Plaek Phibunsongkhram was an ethnic nationalist aligned with Japan. He changed the name of the country from Siam to Thailand to emphasize the Thai ethnic majority. He passed a series of Thai cultural mandates dictating proper Thai behavior (including suppression of minority languages in favor of Thai). Kratom was traditionally used in parts of Southern Thailand with a predominantly Muslim, ethnically Malay population (not the ethnically Thai, Buddhist majority in most of the country). I find it far more likely that primary reason for prohibition of kratom was related to the WWII-era government's Thai nationalism than being prohibited solely for reason of tax revenue.

Again, I have no source for this theory, but I did manage to find what I believe are the official Thai texts of the:

• [5] 1943 Kratom Act
• [6] 1943 Ministry of Health Kratom Directive on Kratom

I can't read Thai, but it would be very interesting to know what justifications, if any appear in the Kratom Act. Are there any Thai speakers who can summarize?Plantdrew (talk) 00:42, 19 April 2013 (UTC)

You both may be partially right, it seems illegalization of plants is often a cooperative effort between different interests, for instance Marijuana being made illegal was at the behest of the Timber Barons, yet the establishment also wanted ways to control the populace and drugs gave them an excuse to arrest people they considered a danger and increase the size of the police departments. The pharmaceutical companies may have cooperated as well. Nowadays the pharmaceutical companies seem to be the major players against medicinal plants, and the FDA uses any company marketing a plant as medicinal as an excuse to seize shipments, even if that product was not sold as a medicine. Under this reasoning tea or garlic could be seized.

Good job on the article, some mention of the FDA seizing shipments at customs under the auspices of drug regulation may be something the public should be made aware of on this wikipedia article, do you editors think it would be a proper addition to this article, that the FDA is seizing shipments (on the west coast not east) at customs stating they are being sold as drugs even when they were not? I'm going to add it if there are no reasonable objections. — Preceding unsigned comment added by 64.134.134.44 (talk) 00:58, 8 May 2013 (UTC)

Source review

I took a look at the sources, here are the PMIDs of the sources that specify one, date of publication and publication type:

• PMID 3419199 - 1988, maybe review? (unspecified)
• PMID 9190321 - 1997, review
• PMID 11960505 - 2002, in vitro study
• PMID 18482427 - 2008, case report
• PMID 18550129 - 2008 Aug, (pub type unspecified)
• PMID 18846471 - 2011 Sep, (pub type unspecified)
• PMID 19731590 - 2009 Jul, (pub type unspecified)
• PMID 20371282 - 2010 Jun 16, In Vitro
• PMID 20411370 - 2010 Dec, Case Reports
• PMID 20869223 - 2011 Mar 15, (pub type unspecified)
• PMID 21050173 - 2011, Review
• PMID 21112167 - 2011 May 20, (pub type unspecified)
• PMID 21294331 - 2010 Dec 15-21, (pub type unspecified)
• PMID 21513619 - 2011 May, (pub type unspecified)
• PMID 21528385 - 2011 Sep, Case Reports
• PMID 22133323 - 2011 Dec 1, Review
• PMID 23212430 - 2012 Dec, (pub type unspecified)

Hope it's helpful... Zad68 18:40, 26 June 2013 (UTC)

• PMID 18482427 - 2008, case report - removed as insufficient per WP:MEDRS
• PMID 18550129 - 2008 Aug - primary mouse study, removed as insufficient per WP:MEDRS
• PMID 18846471 - 2011 Sep - removed diabetes connection, purely speculative interpretation of mouse study
• PMID 19731590 - 2009 Jul, (pub type unspecified) - lab study, removed "antioxidant" health claim
• PMID 20869223 - 2011 Mar 15, (pub type unspecified) - primary mouse study fails WP:MEDRS results speculative at best, removed

I've tried to handle the problems introduced by these questionable sources. The rest of the sourcing in the article should really be reviewed thoroughly, and also source-text integrity needs to be checked carefully, as I saw several problems in that area. Zad68 19:30, 26 June 2013 (UTC)

It is important to go through these issues one by one and not engage in a revert war. The proper thing to do would have been to post here prior to making the changes which have already been hashed out in the past. Let us go through the edits that you made:

1. I removed the part in the intro claiming psychosis, bowl obstruction, confusion, etc. The source says that these reports have been "haphazard" (criticizing them) and the only other reference to confusion or psychosis is in reference to cough syrup not Kratom. Bowel obstruction is not mentioned. This is a clear. misrepresentation of the source.

2. Mouse / Invitro studies. The quote from WP:MEDRS is:

In vitro studies and animal models serve a central role in biomedical research, and are invaluable in elucidating mechanistic pathways and generating hypotheses. However, in vitro and animal-model findings do not translate consistently into clinical effects in human beings. Where in vitro and animal-model data are cited on Wikipedia, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that the reported findings necessarily hold true in humans. The level of support for a hypothesis should be evident to the reader.

Use of small-scale, single studies make for weak evidence, and allow for easy cherry picking of data. Results of studies cited or mentioned in Wikipedia should be put in sufficient context that readers can determine their reliability.

This makes it clear that animal studies can be used and should be used in articles. While they do not 'consistently' translate into clinical effects in humans, it says that when cited we simply need to make clear that they are animal studies and not done specifically in humans. By ERASING or REVERTING these studies you are effectively silencing this scientific data which will tilt the article in one direction. While this may not be your intention, this is what is happening. I will be re-adding the studies on a study by study basis to clearly reflect the data..

3. You have also removed case reports in the article which, also like animal studies, provide important data concerning Kratom. While these studies are not as important as large population studies or other medical studies they none the less serve an important role in the article because of the small amount of studies that exist relating to Kratom. In the context of Kratom, every study makes a difference if it can be correctly interpreted.

ThorPorre (talk) 20:50, 27 June 2013 (UTC)

Bowel obstruction is, in fact, mentioned in the source:

Some anecdotal reports indicate that potential intestinal blockages can occur from repeated daily chewing of kratom. The veins of the kratom leaf are reportedly high in one type of alkaloid that reduces intestinal motility to a point where a kratom paste can accumulate in the intestinal tract. ([7])

I'm on the fence about whether to cite the mouse study, but if we do then it needs to be made clear to the reader that it was a mouse study. The original text falsely implied that the benefits had been shown in humans.

The source is quite clear that psychosis and other such neuropsychiatric side effects exist, although they are rare and "haphazardly reported". I've clarified in our text that these side effects are rare, but we can't just pretend these side effects don't exist when even this (very sympathetic) source indicates that they do. MastCell ^Talk 00:25, 28 June 2013 (UTC)

Please see the below post I have made in reference to this. If you are going to include, in the intro of an article, a sentence which stretches the sources claim and is inconsistent with WP:MEDRS then you will need to explain why this is acceptable. Especially when a dozen sources and content was deleted because it was "case studies" or "animal studies" when the claim itself is based on case studies and the source claims "haphazard reporting"... ThorPorre (talk) 02:02, 28 June 2013 (UTC)

Article Tagged

Note, I have tagged the article to reflect the dispute in the use of the sources and the deletion of other sources which are case studies or anecdotes just like the ones continually being re-added. ThorPorre (talk) 02:15, 28 June 2013 (UTC)

For the record, I will not be removing content from the article to prevent an edit war. I will, however, expect valid justifications for content that is there already. ThorPorre (talk) 03:20, 28 June 2013 (UTC)

Staying consistent with Sources (Intro)

I'm posting this because there seems to be an inconsistency in how this article is being written. Scientific sources are being removed because they are claimed not to adhere to the WP:MEDRS guidelines (which are not hard-rules but rather community guidelines). Regardless, Content was deleted because the medical sources were "case studies" or "animal studies" and are deemed insufficient for Wikipedia. That said, Let me quote WP:MEDRS:

Knowing the quality of the evidence helps editors distinguish between minority and majority viewpoints, determine due weight, and identify information that will be accepted as evidence-based medicine. In general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. The medical guidelines or position statements produced by nationally or internationally recognized expert bodies often contain an assessment of the evidence as part of the report... ..Case reports, whether in the popular press or a peer reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of reliable medical sources..

The source states this:

Some anecdotal reports indicate that potential intestinal blockages can occur from repeated daily chewing of kratom. The veins of the kratom leaf are reportedly high in one type of alkaloid that reduces intestinal motility to a point where a kratom paste can accumulate in the intestinal tract. ([8])

So, By the same logic that numerous sources that were case studies were deleted, so too must the claims about intestinal blockage by the same logic. If these reports are to be allowed then so must the other case study reports showing benefits for Kratom.

We must be consistent or else there is a bias.

The issues concerning the sentence "although rare but serious adverse effects such as psychosis, convulsions, hallucinations, and confusion have been reported" is that the source cited actually states that these reports have been reported "Haphazardly". Does this stand up to WP:MEDRSwhen it clearly criticizes the reporting of such cases? Of course not. The fact that the section continues to be added back to the article is inconsistent with the removing of other sources as violation of WP:MEDRSand contradictory. ThorPorre (talk) 01:53, 28 June 2013 (UTC)

This looks like review published in 2011 Kratom in Thailand. Page 13 states they performed a desk based review. Is there an issue with this study? It should be used in preference to primary research sources and animal studies. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:38, 29 June 2013 (UTC)

Doc, 2 days ago we had an editor remove about a half a dozen studies because they were case studies, anecdotal reports or animal studies. However the bowel issue and the other side effects are from case studies or anecdotes. The source itself is a review of the literature but in the source the study cited is a case study and the other an anecdotal report. My argument: if they remove all of the studies showing benefits of Kratom because they are case reports or anecdotes then WHY should we keep the anecdotes and case studies showing the supposed side effects? Take a look at the revision history and you will se what I mean. The tni.org source is a compilation of many studies and the ones that suggest the bowel issues and the other side effects are case studies or anecdotes, which according to the people who keep adding it back are "unreliable". It seems that anecdotes and case reports are reliable when they show side effects but unreliable when they show benefits. ThorPorre (talk) 21:41, 29 June 2013 (UTC)

The issue is, at least in part, that the tni.org source is a secondary source while the mouse studies are primary sources (see WP:MEDRS). That said, I'm open to mentioning the mouse studies, so long as we're honest and clear with the reader that they were in fact mouse studies and not conclusive demonstrations of benefit in humans. The previous wording was misleading in this regard. MastCell ^Talk 21:57, 29 June 2013 (UTC)

The TnI source is a secondary source that uses a primary source. The sources it uses for the Bowel issues and the other side effects are anecdotes or case studies. So can we use use scientific studies based on case studies and anecdotes or can we not? If we can then we need to add the benefits section back with the scientific studies from case studies and anecdotes. If we can not then the bowel and other side effects must also go. ThorPorre (talk) 22:05, 29 June 2013 (UTC)

A direct quote is less neutral?

In reference to this edit: http://en.wikipedia.org/w/index.php?title=Mitragyna_speciosa&diff=562071730&oldid=562056530 This edit removed a direct quote and then changes it so It didn't reflect what the direct quote said and States that this is more "neutral". Please elaborate. ThorPorre (talk) 12:55, 29 June 2013 (UTC)

If you're insistent that a direct quote is better, then state the two opposing viewpoints as separate sentences without qualifiers. The way you've attempted to present that section of text is blatantly an attempt to skew the reader's opinion towards your own. We shouldn't be trying to introduce opinions. Let's look at the source. It states merely that "some mild negative side effects have been reported". It makes no statement about what "most side effects" are. In terms of serious side effects, it simply and neutrally states "Kratom psychosis (or overdose) has been reported haphazardly and remains a rare occurrence in the medical literature". What you're trying to do is to take those sentences and infiltrate them with craftily placed prepositions and punctuation marks to beguile the reader into thinking that, given the benefits, the side effects are ignorable. That's not a fact, it's an opinion (yours).That's not your call to make, it's the reader's. Just present the facts. Basalisk ^{inspect damage}⁄_berate 13:32, 29 June 2013 (UTC)

Then we need to quite it directly or not at all if no one can properly state it. The source implies that the reports are rare and haphazardly reported. This is clear to me that the source intends to make this a point against major side effects since the source elsewhere makes it clear that the side effects are almost nonexistent. With your phrasing you are taking away from the full sentence as a direct quote and rephrasing it in a way so it reads other than how it is in the source. That is why I had it fully quoted to begin with. The whole sentence. ThorPorre (talk) 14:52, 29 June 2013 (UTC)

read the direct quote and compare it to the article intro. It is not relating the same point at all.

"Kratom psychosis (or overdose) has been reported haphazardly and remains a rare occurrence in the medical literature. Where such events take place, the symptoms can include convulsions, confusion, hallucina- tions, dizziness and headaches." ThorPorre (talk) 14:55, 29 June 2013 (UTC)

That's the precise cause of the problem here - all you're interested in doing is inserting your interpretation of the source into the article and using your subjective opinion as fact. What you think the source "implies" or "intends to [point out]" is irrelevant. Basalisk ^{inspect damage}⁄_berate 19:32, 29 June 2013 (UTC)

I'm suggesting we quote the source directly. The full sentence if we can not agree on wording. Because the way I see it is that it is not expressing the sources wording. Even why is in quotation marks is not what the source says. It is incorrectly quoted. Let us show the reader exactly what the source says. Direct quotes shouldn't be used a lot but in cases where proper wording is difficult to express by paraphrasing. ThorPorre (talk) 21:34, 29 June 2013 (UTC)

Take a look at the source and what it says in context and compare it to your wording of it in the intro. It is not only quoted incorrectly but it also is out of context and relays a point different than what is said in the source. All we need to say is, and quoted directly to avoid misinterpretation,: ""Kratom psychosis (or overdose) has been reported haphazardly and remains a rare occurrence in the medical literature." Just like that. A direct quote from the source. ThorPorre (talk) 21:53, 29 June 2013 (UTC)

There are two problems here. One is that a pro-legalization advocacy group is not the ideal source for medical information, although I wouldn't argue that it's totally useless either. The second issue is that we're misrepresenting even this sympathetic source. The source says that kratom psychosis is rare, but has been reported in the literature. We can say that, right? MastCell ^Talk 21:55, 29 June 2013 (UTC)

It must be said in a way that reflects what the source says. So far that hasn't worked. That is why I support a direct quote but I honestly don't even see a point in including something that is "rare and haphazardly" reported in the article let alone in the lead. But IF it must absolutely be included then it needs to be said just like the source says it. Any rewording takes away from the source. Do other articles include something that the source says is rare and haphazardly reported? Sure it Can be mentioned but it must be in context and said just as the source says it. This eliminates any bias on either side or misinterpretation. ThorPorre (talk) 22:01, 29 June 2013 (UTC)

Thought I would give my view on the problems with the current revision. The article lead as stands is riddled with POV, giving undue weight to poorly-documented, and disputed, side effects (namely psychosis and hallucinations), and making vague allusions to "dangers" when mixed with common cough medicines and other drugs, without ever specifying what the supposed dangers are.--Metalhead94 ^{T C} 04:11, 30 June 2013 (UTC)

The part about mixing Kratom with dangerous drugs doesn't belong in the LEAD. It seems to be there only to slant the view for the reader by guilt by association. Sure it can be mentioned in the article but it is a Thai cultural tidbit about kratomnuse and not relevant to Kratom as a tree. I say it needs to be deleted per [[WP:lead]. ThorPorre (talk) 13:47, 30 June 2013 (UTC)

I've moved the part in question down to the 'Medicinal uses' section until a better solution can be found. IMO, it needs some major rewording before it can qualify as NPOV. Other editors please feel free to dispute this change.--Metalhead94 ^{T C} 18:17, 30 June 2013 (UTC)

I'm sorry, but I completely disagree and have reverted. One of the main things to document about a drug's usage are its side effects. There may be issues with how the sentence is worded but removing it altogether is not a neutral option. Basalisk ^{inspect damage}⁄_berate 19:02, 30 June 2013 (UTC)

Well, to be fair I didn't remove it completely. As I stated above, I moved it down. I feel strongly that such lopsided wording doesn't belong crammed into the article lead. Take the Phencyclidine article for example, where side effects are not mentioned in the lead but rather in a section titled 'Brain effects'.--Metalhead94 ^{T C} 21:52, 30 June 2013 (UTC)

I don't see how the wording is lopsided. The only source used states that these side effects exist but are rare, which is exactly what the lead currently states. Adverse effects are an important criticism of medications and there is no reason that this one should not be included in the lead. Basalisk ^{inspect damage}⁄_berate 22:09, 30 June 2013 (UTC)

No one has explained why 1. The "side effects" mentioned ahould even be used since the source itself says that tge teports are rare and "haphazardly reported". Why include haphazardly reported isses? This does not meet wikipedias standards. The aource says it is haphazardly reported. Maybe we need BETTER reported side effects of they exist. Thisnos graspin at straws. 2. Why does this kep being reverted? There is an equal number of people who see this article as anti-kratom so why do administrators keep reverting it? Why do i get warned for making 1 revert? This is simply not accetable. The wording in the intro now does not reflect what the source says. In fact, what is in the quotes isnt even what the source says. It is misquoted. ThorPorre (talk) 11:53, 1 July 2013 (UTC)

Is Pascal Tanguay's document sufficiently WP:RS-compliant to use?

I almost hate to bring this up, but it needs to be addressed: The article should not be relying on the Pascal Tanguay document "Kratom in Thailand: Decriminalization and Community Control?" as an authoritative reliable source, especially for scientific findings such as health effects. Issues are:

• Pascal Tanguay has no medical credentials or scientific bona fides that I can find. The document itself says that Tanguay was an "independent consultant" and makes no mention of any scientific or medical training.
• Tanguay has produced no other scholarly work outside of the Decriminalization and Community Control document and another lobbying paper regarding Malaysia
• Tanguay was associated with the International Drug Policy Consortium (IDPC), a lobbying group that exists to promote decriminalization of drugs
• Soon after publication, Tanguay became affiliated with another lobbying organization promoting the decriminalization of drugs.
• Tanguay's report was published by the Transnational Institute, which describes itself as "A worldwide fellowship of scholar activists".

So Tanguay's report is the product of a non-credentialed activist associated with several political lobbying organizations, and not any well-recognized medical society or institution. My initial position on this source is to remove it as entirely unreliable. At most it should be used only for the positions of Tanguay, and it is not yet established how influential Tanguay is such that Tanguay's positions should be included in this article. If the source is to be used at all, the relevant policy is at WP:SCHOLARSHIP, bullet "Care should be taken with journals that exist mainly to promote a particular point of view" and the policy regarding how the source should be handled is at WP:ATTRIBUTEPOV. Zad68 14:30, 1 July 2013 (UTC)

Every claim the source makes us referenced within the report. What should be done is to use the reports sources to replace the tanguay report. ThorPorre (talk) 14:45, 1 July 2013 (UTC)

The article shouldn't really be relying on this source for the bulk of content that it currently does, if your concerns are accurate. I don't think there's any reason to remove the side-effect information sourced to it, as the author's bias is unlikely to end up over-emphasising concerns over side effects. Basalisk ^{inspect damage}⁄_berate 14:51, 1 July 2013 (UTC)

Basalisk I'd agree with you if it could be established that Tanguay and the publisher have legitimate medical or scientific credentials, but we don't have that. I don't agree with using a layman's review of medical literature published by a non-medical activism publisher for any sort of biomedical claims at all. Zad68 14:55, 1 July 2013 (UTC)

Because it isn't quoted correctly. And it is misrepresented in the lead. See comments in other thread. ThorPorre (talk) 15:01, 1 July 2013 (UTC)

Thor can you help establish what training or credentials Tanguay has? I really made my best effort to review Tanguay's background and I found nothing, what do you know about Tanguay? Zad68 15:07, 1 July 2013 (UTC)

Tanguay is a secondary source which references other sources. It is a compilation of primary scientific sources. That's the purpose it serves. ThorPorre (talk) 15:10, 1 July 2013 (UTC)

I agree Tanguay is a secondary source, but it has not yet been established that it is a reliable secondary source, particularly not for biomedical claims. What can we use to establish the credentials of Tanguay and the publisher so that we know it is compliant with Wikipedia sourcing guidelines for biomedical information? Right now we have nothing. Zad68 15:12, 1 July 2013 (UTC)

We use its sources. ThorPorre (talk) 15:15, 1 July 2013 (UTC)

No, that's not what our content guidelines like WP:MEDRS say to do. Not just anybody can put together a document and have it be considered reliable and authoritative by Wikipedia standards. The credentials of Tanguay and the publisher need to be shown to meet WP:MEDRS or we can't use them, at least not like we have been using them. Zad68 15:18, 1 July 2013 (UTC)

I can't fix it on my iPhone now but I will show you what I mean when I get home from work. ThorPorre (talk) 15:41, 1 July 2013 (UTC)

No problem, Thor. Zad68 15:46, 1 July 2013 (UTC)

Based on evaluation of the source and your position, If I were to make the changes then all of the references would be primary sources (which the main source utilizes) and thus would be subject to immediate deletion I suppose... ThorPorre (talk) 00:32, 2 July 2013 (UTC)

Agree with Zad that this source fails MEDRS and should not be used for medical claims. Yobol (talk) 01:50, 2 July 2013 (UTC)

Thor, what we're saying is that after we develop article content using the good secondary sources mentioned above, we should remove the Tanguay source. Zad68 02:29, 2 July 2013 (UTC)

"reported haphazardly"

To re-state one of the major issues here, which has not been resolved or addressed directly yet, The contended sentence in the lead currently reads:

"Most side effects of Mitragyna speciosa are thought to be mild, although a report by Pascal Tanguay states there are "rare and haphazardly-reported" occurrences of serious adverse effects such as psychosis, convulsions, hallucinations, and confusion."

The Source states:

"Kratom psychosis (or overdose) has been reported haphazardly and remains a rare occurrence in the medical literature. Where such events take place, the symptoms can include convulsions, confusion, hallucina tions, dizziness and headaches."

So we go from (the source) saying essentially "Kratom psychosis has been reported haphazardly and remains rare" and (WHEN) it happens the side effects are....

However the lead says "although a report states there are rare and haphazardly reported occurrences of serious effects such as (psychosis).....

So the major issue here is that 1. The lead doesn't state it as the source does in that it the source says that kratom psychosis is rare and haphazardly reported and (when psychosis happens) there are the following side effects. The lead as it is now does not point out that the side effects occur when kratom overdose or psychosis occurs but rather mention psychosis as one of the side effects. 2. The lead uses the word "although", which is a word that shouldn't be used in this context. See WP: WORDS. The "although" implicates a contrast between the fact that kratom has few side effects and the psychosis, dizziness, hallucinations, etc. The source makes no implication of this contrast and also do not put emphasis on the existence of the side effects but rather puts emphasis on the fact that they are rare and haphazardly reported as can be seen by reading the paragraph it fits in. ThorPorre (talk) 00:31, 2 July 2013 (UTC)

This problem will go away after we replace Tanguay with the secondary sources mentioned earlier. Zad68 02:29, 2 July 2013 (UTC)

Removed intro medical claims again

Numerous other medical claims from the tanguay source has been removed claiming that tanguay is not reliable for medical claims. All happen to be claims supporting Kratoms benefits, thus it is not reasonable to keep the medical claims of supposed side effects up. Either tanguay is good for medical claims or it is not. If it is then we need to add the benefits back and other medical claims. If it isn't then we can't keep up the lead medical claims. It can't be both ways. ThorPorre (talk) 21:27, 2 July 2013 (UTC)

Agree, the removal of the medical content sourced to Tanguay was good. But what has to happen now is that the new medical content sourced to the new secondary sources needs to be summarized in the lead. Zad68 21:58, 2 July 2013 (UTC)

I disagree with this. The Tanguay source is clearly biased in favour of the use of this substance, and even it admits these side effects exist. This should remain. Basalisk ^{inspect damage}⁄_berate 22:12, 2 July 2013 (UTC)

Shouldn't we use the information about side effects from the medical secondary sources, now in the article body? Wouldn't that resolve the concern? Zad68 22:18, 2 July 2013 (UTC)

Ummm...Is tanguay suitable for medical claims or not?? If it is then I will add back the deleted info saying it is not suitable. If it is not suitable then I will delete the claims in the lead. You can't have it both ways. Either it IS suitable as a source or it is NOT suitable. Which is it? One or the other. ThorPorre (talk) 22:32, 2 July 2013 (UTC)

That isn't at all true. Some sources are suitable to support some claims and not others. For example, a band's official website is suitable to source biographical information but not criticism or praise. Basalisk ^{inspect damage}⁄_berate 22:37, 2 July 2013 (UTC)

What makes the source reliable then? Why makes that specific claim reliable? Why is that claim reliable but others not reliable? ThorPorre (talk) 22:41, 2 July 2013 (UTC)

While what Basalisk writes here is absolutely true (Some sources are suitable to support some claims and not others) I don't think it maps very well to this situation. Tanguay has no detectable medical or scientific credentials and the publisher is especially for activists, isn't a medical publisher and isn't even indexed on PubMed, much less on MEDLINE. Tanguay can be useful for some things but we can't have any confidence about Tanguay's selection and analysis of and synthesis derived from medical primary sources. We can't even have any confidence that Tanguay understands what a "side effect" is, or has enough training to think through whether confounding factors might be responsible for the result observed. Also we can expect that Tanguay would probably try to under-report results, but could also very easily over-report them if Tanguay accidentally includes poor-quality results in any analysis because Tanguay isn't shown to have medical training to allow Tanguay to tell the difference.

We now have genuine WP:MEDRS-compliant secondary sources covering adverse effects and side effects. Can we agree the way forward here is to use these sources now instead of Tanguay? Zad68 22:54, 2 July 2013 (UTC)

Seems reasonable. I still feel the information about side effects should be in the lead. Basalisk ^{inspect damage}⁄_berate 22:58, 2 July 2013 (UTC)

Why? Based on what ? And again, why is tanguay reliable to claim side effects and not benefits? Simply because tanguays study is not anti kratom? Can we cite all unreliable sources for some claims as long as those claims are contrary to that studies conclusions? How is this not POV? ThorPorre (talk) 23:01, 2 July 2013 (UTC)

I have updated the lead as described, using the information from the new secondary sources in place of Tanguay. I had been updating the body of the article but not the lead. I figured I'd get the bulk of the body content work before working on the lead because without the content done in the body it's hard to tell what should go in the lead. But based on this discussion I've done the update to the medical information in the lead. Maybe I should have been updating the lead at the same time, sorry for any unnecessary agita that may have caused! Zad68 23:14, 2 July 2013 (UTC)

"Side effects associated with chronic kratom use include anorexia and weight loss, constipation, and darkening of the skin color of the face". I'm sorry, I'm sure I'll be accused of bias, but these claims are ridiculous. Anorexia? To put it bluntly, what the hell. I've also read the bits about the "skin-darkening" side effect, and it appears to be based on a single outdated Thai study that focused on Thai control groups who were workers, in the tropical sun.. Say what you will, but a lot of this is junk science. With growing frustration, I'll just say it, the lead is full of nonsense.--Metalhead94 ^{T C} 03:31, 3 July 2013 (UTC)

You do understand that the medical term "anorexia" means "loss of appetite"? It appears reasonably well-sourced that chronic kratom use can cause anorexia (that is, loss of appetite) and weight loss. Are you disputing that? And if, on what basis (beyond the fact that you personally think it sounds far-fetched)? MastCell ^Talk 06:36, 3 July 2013 (UTC)

Anorexia is NOT equal to loss of apetite. Anotexia is a medical condition involving restriction of apetite die to a mental disorder. Kratom may cause loss of apetite in some people (and increased apetite in others) but it does not create a disease known as anorexia. I agree with metal head, that is an absurd claim which I find unlikely the source says. ThorPorre (talk) 11:32, 3 July 2013 (UTC)

Please read Anorexia_(symptom). Hal peridol (talk) 12:17, 3 July 2013 (UTC)

Actually the definition was linked to by ThorPorre themselves, in the first link at Anorexia, which states "Anorexia (symptom), the symptom of poor appetite whatever the cause". Sad. Yobol (talk) 13:31, 3 July 2013 (UTC)

Yes, I think ThorPorre and Metalhead94 have confused anorexia (a medical term for loss of appetite) with anorexia nervosa, an eating disorder. That's a fairly common point of confusion. Unfortunately, it's hard to constructively correct them when they're apparently heavily invested in a certain point of view here and thus unwilling to listen or read the sources. And it's hard to constructively co-edit an article when people would rather argue their preconceptions than read the Wikipedia articles they're linking to support their claims. MastCell ^Talk 18:50, 3 July 2013 (UTC)

I fear that many people will make that same mistake. You make my point for me. Kratom does mot cause the medical condition of anorexia but the study claims kratom resumes appetite. Readers will no doubt make the same mistake we both made. ThorPorre (talk) 02:35, 4 July 2013 (UTC)

Actually most readers click the wikilinks of words and phrases they don't understand; it's one of the fundamental benefits of wikipedia over a paper encyclopaedia. The fact that you neglect to do any background reading is your deficit. Basalisk ^{inspect damage}⁄_berate 07:55, 4 July 2013 (UTC)

Article lead is a mess

Hate to bring this up again, but the current lead is a damn mess. Let us discuss it here.--Metalhead94 ^{T C} 03:47, 3 July 2013 (UTC)

We should start a new section in it since it gets difficult scrolling down. I realize that the lead includes secondary sources but also it should be known that many of the side effects are based on faulty studies. Thus, this may be a perfect example of how some studies can be used to cite some things but not others. The darkening skin issue is based on old information which studies Thai workers and pointed out their dark complexions. In Thailand kratom has been used by manual laborers who work in the sun and have darker skin. The information is outdated and false, but I'm going to be working on fusion updated info for that. However let it be known that we likely never will because new studies won't try to refute old Thai studies and likely wont even mention the skin. ThorPorre (talk) 11:25, 3 July 2013 (UTC)

Also note that the studies being posted are only abstracts. We have no way to verify what the studies say or how the sources word the studies. Misinterpretation and blatant miswording has been a chronic issue for this article so we need verification that the studies say what the article says they say. ThorPorre (talk) 11:29, 3 July 2013 (UTC)

Actually I have obtained the full text of the secondary sources, not just the abstracts. The content updates I did yesterday were based on the content of the full texts of the journal articles.

We depend on the authors of the secondary sources to do the selection and evaluation of the primary sources, we don't do that ourselves. Zad68 12:44, 3 July 2013 (UTC)

We need verification of what the sources say. No one can see the full texts except for you and no one can verify how it is phrased or what info the source uses for the claim. ThorPorre (talk) 13:20, 3 July 2013 (UTC)

That is a complete misunderstanding of how verifiability works on Wikipedia. That you, ThorPorre, do not have access to an article right now doesn't mean it "needs verification"; if you want to verify it, there are multiple options to do so, including going to the library and asking to see the article. Actually everyone has access to these articles, if they just put the effort into getting them. Yobol (talk) 13:28, 3 July 2013 (UTC)

That's simply no the case. If we only have 1 persons statement that the wording represents the source then that defeats the purpose of Wikipedia. If I were to use an obscure book for citations when no one else could access then how can anyone prove that it says what it says or that my wording reflects what it says? My local library does not have access to the studies ( I've checked) and not does my university library. It has access to specific journals. So we are left in a situation. I personally have many books written about kratom decades ago that are not in print anymore which show many benefits for Thai users in traditional Thai use. Can I cite these even if they would be very difficult to find and verify?ThorPorre (talk) 14:05, 3 July 2013 (UTC)

You could not use books written decades ago to describe biomedical effects (either benefits or drawbacks) per WP:MEDDATE, especially when we have up-to-date WP:MEDRS-compliant secondary sources covering those exact topics to use. Zad68 14:14, 3 July 2013 (UTC)

your sources use studies that are decades old already. Like the "darkened face" side effect that hasn't been reported happening since that study from the 70s. ThorPorre (talk) 14:16, 3 July 2013 (UTC)

Just because a particular primary study is old doesn't necessarily mean its results are not useful. WP:MEDRS requires the use of up-to-date secondary sources, which are allowed to review even old evidence. If the authors of the secondary sources review the old primary study data and determine it is still useful to include, they will; if they determine that the old primary study's research technique is out-of-date or has been superseded by subsequent, better research, they won't use the old primary source data. This is exactly what we are supposed to use secondary sources for: to select primary data, analyze it, put it into context and synthesize conclusions from them. Zad68 14:21, 3 July 2013 (UTC)

Is there any way I or anyone else who does not have access to a university library that has these studies get access to the full texts without paying 60 dollars for each study?ThorPorre (talk) 14:50, 3 July 2013 (UTC)

Going to the medical library of a good university is a great way to get resources, and it's something I do myself. If you're serious about researching these topics to write up-to-date Wikipedia articles that accurately reflect the best-quality research, you need to consider doing it. Occasionally some research papers are available online and can be found if you hunt for them. Also you might consider asking at WP:RX. Zad68 14:58, 3 July 2013 (UTC)

My university has limited subscriptions. Only a few journals in fact. ThorPorre (talk) 15:22, 3 July 2013 (UTC)

Why not consider working on the Wikipedia articles of the subjects covered by the journal articles you do have access to? Zad68 15:26, 3 July 2013 (UTC)

I don't have access to most of the articles or studies for this subject. ThorPorre (talk) 15:28, 3 July 2013 (UTC)

Right, what I'm saying is: Consider working on the articles for the subjects you do have the studies for, if you don't have access to the sources for this article. Zad68 15:30, 3 July 2013 (UTC)

I'm sure to fall to the same problem regardless of the article. Aside from that, this article I'm familiar with and I see problems with this article as well. Problems unlikely to be addressed unless I get access to the sources and make proper changes. ThorPorre (talk) 15:51, 3 July 2013 (UTC)

I understand, you're very passionate about kratom, as was established earlier. In my opinion, you're actually better off working on articles for subjects you aren't already familiar with, and are not particularly passionate about. That way you'll be more willing to simply review the sources and reflect them accurately in the article, instead of trying to make the article fit any preconceived ideas you might bring to the article. It's a funny Wikipedia Catch-22: You'll do your best content work on articles for subjects you know little about and don't particularly care about.

If you're unable to obtain the sources needed to do content development work on this article and you're also unwilling to work on other articles, I'm afraid I can't see a way for you to be involved in article content development work on Wikipedia. If you'd still like to be involved in Wikipedia, consider fighting vandalism... not sure what else to tell you, honestly. Zad68 17:05, 3 July 2013 (UTC)

I will make an effort to find full texts of more articles and studies. Can you assist in some full texts for me?ThorPorre (talk) 02:32, 4 July 2013 (UTC)

Although some libraries will not have many journals, I think all libraries (and certainly every major library) have "Interlibrary loan" programs where they can get journal articles from other libraries (usually for a small fee). Again, getting the sources is only limited by you, not any other editor. Yobol (talk) 13:22, 4 July 2013 (UTC)

Reintroducing valid sources

Since there has been no explanation for the inconsistent criticism and removal of sources showing the benefits of kratom including case sources, animal studies or anecdotal studies and the persistent fight to keep up case reports and anecdotes showing the supposed side effects of kratom, I plan to reintroduce these studies back into the article. The following studies: UTC)

• PMID 18482427 - case study of treating opioid withdrawal using kratom. WP:MEDRS does NOT prohibit case studies. It says that case studies are lower quality evidence and should not be overemphasized but does NOT say case studies should be removed. Given the limited number of kratom studies, it is acceptable per wp:medrs to include these studies. They are valid scientific studies.
• PMID 18550129 - 2008 Aug - primary mouse study, this study is acceptable per WP:MEDRS. Animal studies are not prohibited and , as per above, they should not be over emphasized but deleting them does NOT coincide with Wikipedia policy. All medical articles include animal related studies. The only time an animal study should not be included is if there is a better human study with differing results. This is not that situation.
• PMID 18846471 - 2011 Sep - This study was deleted for being "speculative". The study conclusion is " This study demonstrated the effect of M. speciosa in stimulating glucose transport in muscle cells, implicating the folkloric use of M. speciosa leaves for treating diabetes". Editors are not speculating or drawing connections. The authors of this scientific study made the connection with treating diabetes. This study is this 100% valid per wp:medrs.
• PMID 20869223 - 2011 Mar 15, (pub type unspecified) - primary mouse study does not conflict with WP:MEDRS. There is no valid justification for excluding it. See above for more explanation.

ThorPorre (talk) 13:59, 1 July 2013 (UTC)

Per WP:MEDRS if these studies are mentioned at all, the mention must be very brief to comply with WP:UNDUE, and it must be made very clear that these are small-scale animal studies or individual case reports with no proven connection to human health. Zad68 14:05, 1 July 2013 (UTC)

I do not have any objection to these sources being re-inserted, as long as its clear in the prose exactly what the studies are and that they have no implication the effect on human health. The comments on side effects should stay. Basalisk ^{inspect damage}⁄_berate 14:19, 1 July 2013 (UTC)

I still have very serious reservations about including these mouse studies and case reports at all without a secondary source to establish the noteworthiness of such small-scale, speculative results. Zad68 14:33, 1 July 2013 (UTC)

In situations where there are no human study equal, animal studies are perfectly fine. Mentioning that they are animal studies is fine. Excluding them all together is not. ThorPorre (talk) 14:43, 1 July 2013 (UTC)

Zad, please stop reverting. There was never even a consensus to remove the valid scientific sources in the pray place. You never attempted to establish consensus before removing them. ThorPorre (talk) 14:54, 1 July 2013 (UTC)

I agree with thorporre. The sources are valid and coincide with WP policy. Jonathandavid13 (talk) 15:14, 1 July 2013 (UTC)

How many equals consensus? As of now I know no one beside Zad who argues to remove these valid scientific studies. He never posted before removing to establish consensus in the first place. ThorPorre (talk) 15:17, 1 July 2013 (UTC)

The recent contributions by IPs and single-edit accounts are, frankly, more than a little suspicious. Regardless, there are two issues: 1) whether the source should be used at all, and 2) if so, how should they be used. Certainly the previous content that misrepresented the sources cannot be re-introduced. If the sources are going to be used at all they need to be used in a very different way than they were before. The best thing to do now would be to propose new content based on the case studies and mouse studies here on the Talk page, making sure that the proposed content does not imply the idea that any human health benefit has been established by the studies. Zad68 15:43, 1 July 2013 (UTC)

If you find anything suspicious then please say it. If you want to make an accusation that the IPs are originating from 1 person or that the other names are sock puppets then please have it checked. You will see that the people opposing the changes are all individual people who have just as much right to edit Wikipedia as anyone else. Administrators have no more "vote" or consensus than a random Ip or a new user. That's not how Wikipedia works. As I said, since you never established consensus before totally deleting a large amount of sources content then no consensus is needed to add it back beyond what we have. There is already a consensus ( based on past edits and other users) that the sources Must be included. If you disagree with the way they are presented then please edit the sentences. Don't delete them. That is not constructive. Nor is reverting consensus. ThorPorre (talk) 15:53, 1 July 2013 (UTC)

I agree that the sources are more than adequately valid, stop this disinformation tactic, Zad, it's an old game!Nagual7 (talk) 17:00, 1 July 2013 (UTC)

Nagual7 — Preceding unsigned comment added by Nagual7 (talk • contribs) 16:52, 1 July 2013 (UTC)

• I'm just going to go ahead and point out that these SPAs are obviously socks and I'm not really interested in what they have to say. Basalisk ^{inspect damage}⁄_berate 17:10, 1 July 2013 (UTC)

I'm betting these new editors have been directed here from an advocacy forum, it's certainly nothing new for Wikipedia. As consensus is not the result of a vote but rather is based on the strength of policy-based arguments, "me too"s don't hold any weight. Zad68 17:55, 1 July 2013 (UTC)

These new editors are readers of the article who have noticed the major issues with it. Wikipedia is not a vote but you have not countered my arguments that the sources are valid. You state in your revert that a "consensus has not been reached" but you disregard opposing views that how the consensus is in the favor of including the scientific studies. Simply because they are new users does not mean that they are sick puppets. I encourage you to compare IPs or any other verification. ThorPorre (talk) 19:38, 1 July 2013 (UTC)

• It has been brought to my attention that Thor is the administrator of a website dedicated solely to the advocacy of kratom, and has started a thread there encouraging readers to visit this talk page and argue in support of its use. This is not appropriate. Thor, you need to take a step back from this. You clearly have a conflict of interest, and it's obvious at this point that you have an agenda and your only purpose here is to advocate kratom as a treatment, and not to build an accurate encyclopaedia. If you keep pushing this agenda I will take it to an administrator's board and request further action. Basalisk ^{inspect damage}⁄_berate 19:58, 1 July 2013 (UTC)

In response to Zad - I think it's fair to say that the inclusion of animal studies in this article could be misleading. I'm reminded of an old medical proverb - "the next time someone tells you something kills cancer cells in a dish, remember a gun does too". Kratom may have efficacy in animals. We cannot use this fact to draw inferences on what effect it may or may not have on humans. Thor's baseless assertion that "if there are no human studies then animal studies are fine" is completely false. Just because good evidence does not exist, that does not mean we should use poor evidence. Basalisk ^{inspect damage}⁄_berate 20:02, 1 July 2013 (UTC)

There is nothing wrong with encouraging friends to get involved in a Wikipedia article. It doesn't fit the definition of canvassing. Nor is there a rule against editing articles where you support the articles topic. Do you believe that most editors of the evolution article don't support evolution? Of course not. Wikipedia is a place for people who know about a topic to help edit that topic. But as you know that is not the real issue. The real issue is that evidence is being removed that supports Kratoms medicinal uses. And faulty misrepresented evidence of side effects are promoted. As I've said, I'm awaiting valid reasons why the studies should NOT be included. They violate no Wikipedia policies and they are from reputable sources. The fact that I'm bringing this issue to the attention of other people is beyond the point. Let u get to the point. Please address my initial post. ThorPorre (talk) 20:10, 1 July 2013 (UTC)

you removed the studies suing that they go against wp:medrs. The truth is that they don't. Shall we remove animal studies from all articles? Even though countless articles use them? Even though no policy prohibits them? ThorPorre (talk) 20:13, 1 July 2013 (UTC)

Thor, you are now demonstrating disruptive editing behavior in that you are not listening to the Wikipedia policy- and guideline-based arguments against the use of the source, certainly not in the way you have proposed using them. The combination of running a website promoting the use of kratom, not listening to the arguments based in content guideline and policy, and directing inexperienced editors from an advocacy forum to add voices of support without understanding Wikipedia sourcing and content policies all add up to disruptive tendentious editing. If it doesn't stop, it'll be raised at an appropriate discussion board like WP:ANI where the community will discuss whether you will be required not to edit in this topic area. Zad68 20:21, 1 July 2013 (UTC)

I don't run a kratom site nor am I an admin of a kratom site. In a member of a kratom site. I used to moderate a forum but not anymore. 20:27, 1 July 2013 (UTC)ThorPorre (talk) 20:28, 1 July 2013 (UTC)

I see. Either way, you need to read and be aware of WP:CANVASS and WP:MEAT. Zad68 20:32, 1 July 2013 (UTC)

Please note that I am the only editor not continually reverting back. I'm using the talk page. I'm also using real live people who know about the subject to chime in. This is consensus building. There are not enough editors here and so I'm at a disadvantage if 2 editors want to domineer over an article. I'm being very open to discussion and I am the one posting valid arguments as to why the studies are valid but you have not addressed my points. ThorPorre (talk) 20:38, 1 July 2013 (UTC)

You shouldn't be "using real live people", seriously, read WP:CANVASS and WP:MEAT, what you're doing is the opposite of consensus building. It's appreciated you're using the Talk page but you're not actually absorbing what's being said to you, this is the disruptive WP:IDHT behavior we've been talking about. WP:MEDRS prohibits the use of individual case studies and primary animal studies in the way you've been trying to use them. Zad68 20:45, 1 July 2013 (UTC)

This subject is very obscure. I am at a severe disadvantage when it comes to finding Wikipedia editors who know about the subject. If I can not bring friends in who I know through this topic then it is just me. That's not good for the style. There needs to be a balance POV. ThorPorre (talk) 20:42, 1 July 2013 (UTC)

What you don't need to bring is friends, what you need to bring are high-quality authoritative reliable secondary sources that meet WP:RS for the purposes you're trying to use them for. If there aren't reliable sources to support the proposed content, the article needs not to have the content. Complying with WP:NPOV means reflecting reliable sources, speculative mouse studies and case studies aren't authoritative enough and don't have notability established well enough to be an NPOV problem if they aren't cited. In fact it's probably an WP:UNDUE problem if the are cited without a secondary source to support them, as you've been proposing. This is the issue. Zad68 20:49, 1 July 2013 (UTC)

I see that some commercial entities are here with their multiple sock puppets, trying to add as much scary misinformation as they can. Full disclosure; why are some of the IPs frequently editing this article part of an IP block assigned to major pharma companies?142.68.199.69 (talk) 16:49, 12 August 2013 (UTC)

Where does wp:medrs prohibit the use of case studies, animal studies or studies based on anecdotal reports?ThorPorre (talk) 20:50, 1 July 2013 (UTC)

I said "...in the way you have proposed using them". See Wikipedia:Medrs#Avoid_over-emphasizing_single_studies.2C_particularly_in_vitro_or_animal_studies. Zad68 20:55, 1 July 2013 (UTC)

Thank you. How would you use them?ThorPorre (talk) 21:01, 1 July 2013 (UTC)

There is no need to use them at all. I suggest instead of using the primary sources, we use, as WP:MEDRS says we should prefer, up-to-date secondary reviews in reputable journals, such as:

PMID 22271566 - Here today, gone tomorrow…and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines.

PMID 22133323 - Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy?

PMID 20683389 - Chemistry, pharmacology, and metabolism of emerging drugs of abuse.

As there are indeed secondary sources available there is no need to cite primary sources and case studies. Zad68 21:02, 1 July 2013 (UTC)

Adding: How about:

PMID 23725528 - An Evidence-Based Systematic Review of Kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration.

PMID 21050173 - Mitragyna speciosa, a psychoactive tree from Southeast Asia with opioid activity.

PMID 20650576 - "Legal highs" on the net-Evaluation of UK-based Websites, products and product information.

I can't guarantee these are all 100% the best sources but they're all MEDLINE-indexes secondary sources and a much better place to start than case studies and mouse studies. Zad68 21:13, 1 July 2013 (UTC)

You just said that your problem was with how I was using them an not that I was using them and then I ask you how you would use them and you tell me not at all. No Wikipedia policy prohibits using them and there is no valid reason why they should be excluded. No policy and no common sense reason other than you think they are not reliable for no reason other than the type of studies they are. Wikipedia policy disagrees. ThorPorre (talk) 21:10, 1 July 2013 (UTC)

Sure, WP:MEDRS says:

• "Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse"
• "Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources"
• "The use and presentation of primary sources should also respect Wikipedia's policies on undue weight; that is, primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field" - "determining the weight to give to such a study requires reliable secondary sources"

What secondary literature are you citing to support the inclusion of the primary sources? Kratom is well-studied enough that there are six good-quality secondary sources that we can use - recent reviews articles and systematic reviews. Without a secondary source to support the primary sources, their mention is WP:UNDUE. Zad68 21:22, 1 July 2013 (UTC)

How do you define "secondary" and "primary" source? The sources you listed are also primary sources. ThorPorre (talk) 21:40, 1 July 2013 (UTC)

Thor, that is a really fantastic question. Basically, a primary source describes an experiment and its results. A mouse study where the experimenters gave kratom to some mice and not others, and then did the forced swim test, and reported the results, is a primary study. A secondary source selects and reviews the available primary sources, synthesizes the information, and then provides observations and conclusions based on all the primary data available. Review articles and systematic reviews are two "bread-and-butter" secondary sources we generally rely on the most for our biomedical content, like efficacy and safety of drugs. Wikipedia is a tertiary source, we aggregate and summarize secondary sources to write Wikipedia articles. Zad68 21:47, 1 July 2013 (UTC)

In that case let us look at the 6 studies you posted as prime examples of acceptable studies.

PMID 22271566 - Here today, gone tomorrow…and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines.

• • • This study only mentions Kratom in one sentence in the abstract. Do you happen to have the full source on hand so we can reference it? What can we use this reference on specifically? It says Kratom is used for "the treatment of chronic pain and amelioration of opioid-withdrawal symptoms" but that is all I can access.***

PMID 22133323 - Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy?

• • • This source mentions that Kratom is used for withdrawl but lacks much data and clinical trials.***

PMID 20683389 - Chemistry, pharmacology, and metabolism of emerging drugs of abuse.

• • • This source has a small abstract and it mentions Kratom in passing. Where can we see the full study to establish what it says and verify it?***

PMID 23725528 - An Evidence-Based Systematic Review of Kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration.

• • • This study is a review of the literature but what literature? What is its conclusions? What can we learn from this study? It no doubt has many good primary sources as well good info but it is a 1 sentence abstract.***

PMID 21050173 - Mitragyna speciosa, a psychoactive tree from Southeast Asia with opioid activity.

• • • This source tells us that it is illegal in four countries, has had 40 compounds isolated from it and that mitragynine has been synthesized. That is all it tells us. There are no "conclusions" or anything else that we can learn from unless we pay $60 for the reference.

PMID 20650576 - "Legal highs" on the net-Evaluation of UK-based Websites, products and product information.

• • • This is a Primary Source. It is its own study and it concerns legal highs and the marketing of Kratom. It can be used to explain how many Kratom sellers sell kratom in a very irresponsible way but again, it is a Primary source where the authors did their own study and not a compilation of other studies.

What is the point I am making here? Firstly, there is potential to misuse primary sources only because they can be up for interpretation but if used correctly primary sources can be invaluable. WP:MEDRS does NOT prohibit primary sources at all, so the removal of them only because they are primary sources is not constructive and reverting the addition of them is a violation of WP:te. I, of course, do fail to "get the point" but this is only because you are not giving a valid reason why the primary sources can not be included. You argue that it violates WP:MEDRS but that has been established as being untrue. Read the acetaminophen article and count the number of PRIMARY sources. In fact, MOST of the articles are defined as "primary sources" in that they are studies and not overviews of studies or meta-analysis or reviews.

I do not support over-emphasizing single studies but I support mentioning them. You seem to 100% oppose even mentioning primary sources despite the fact that EVERY medical article on Wikipedia has at least a few primary sources and MOST of them have dozens of them.

Another question: Why is it forbidden to use primary sources with clear conclusions and acceptable to use secondary sources that simply reference primary sources and state the same conclusions? The main issue here seems to be interpretation of the studies, but if a study says "this experiment shows evidence that Kratom may be effective in treating depression" then why can we not simply quote the authors? For instance, saying "Ziegler et al. have suggested that Kratom may be useful in treating depression"...etc.

WP:MEDRS says: ""Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources"

I agree with this.

"The use and presentation of primary sources should also respect Wikipedia's policies on undue weight; that is, primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field" - "determining the weight to give to such a study requires reliable secondary sources"

I agree with this also.

So what is the problem with using primary sources if they abide by MEDRS? As long as they can be presented in a proper way, What argument do you have to continue reverting them?

What I plan to do (If no resolution can be hashed out here) is a Request for Comment on this article from related wikipedia projects. Since apparently it is forbidden for me to get outside comments to chime in on this article, I will not be bullied.

Despite serious violations of WP:AGF and also "biting newbies" and accusing them of being sock-puppets, blocking new users from editing the article because their edits are not agreed with, accusing me of edit warring despite the fact that I am the only one who is using only the talk page for dispute resolution, accusing me of being disruptive despite the ongoing strong-arming control over the article and despite the clear misinterpretation of the Tanguay source and the obvious misquoting of it (as referenced elsewhere)...despite all of this I am more than willing to work constructively to help improve this article. Sure, I can be blocked from editing this article but there are a lot of people who see the POV in this article and my leaving won't solve the problem of many people (who are not registered wikipedia users) seeing a problem with it. ThorPorre (talk) 00:13, 2 July 2013 (UTC)

Thor, one thing you need to be aware of is that AGF is not a suicide pact. Good faith is assumed until it becomes clear that the participation is not actually in good faith and in line with Wikipedia's purpose and policies. Then the responsibility shifts to protecting article content.

It's good that we're looking at the secondary sources - we should be looking at secondary sources. I am working on getting access to the full source text of all the sources listed, not just the abstracts - should have them in a few days. We really can't say exactly how useful each will be until then. Getting and using the secondary sources should really eliminate the need to even argue about whether to use individual primary sources. PubMed did return PMID 20650576 when my filter was set to "Systematic Reviews only" so it appeared to be a systematic review, but looking at the abstract it might be primary, I'm not sure (it might not be tagged properly in PubMed), I'll have to look at it when I get the full source.

Acetaminophen does indeed cite at least one primary source. First, be aware that other articles might also have problems, and that does not give license to make those same mistakes in this article. Second, I haven't looked at that article's sources in particular but sometimes editors use the background section of a primary source as a secondary source. For example, a primary study on acetaminophen might have an overview of the drug, which can be considered secondary. However this use is discouraged because often these background sections do not give a complete or balanced overview, but just enough of one to support the primary research being done.

The problem with "I do not support over-emphasizing single studies but I support mentioning them" is that you cannot mention a primary study and give it proper emphasis without a secondary source to put the primary source in context. Without a secondary source you cannot demonstrate that the use of the primary source is in compliance with WP:DUEWEIGHT.

The one thing I am in total agreement with you on is that we need to get more outside opinions here, and starting an RFC and notifying the appropriate projects, just like you mentioned, sounds fine. Let's work on developing a neutral RFC statement and get it started. Zad68 02:29, 2 July 2013 (UTC)

I'm also in full agreement with this COA.--Metalhead94 ^{T C} 03:43, 2 July 2013 (UTC)

AGF has not been utilized at all from the start. Since being here I only made 1 revert before getting warned for edit warring, new editors have instantly been attributed to being my sock puppets, I have been threatened with being blocked, my intentions have been questioned....All while I'm the one using the talk page and not strong arming the article. Notice the article isn't the way I want it but I'm using the talk page to resolve it and not reverting like everyone else has been doing. ThorPorre (talk) 12:02, 2 July 2013 (UTC)

Implying that everyone else is "strong arming" the article and not using the talk page (when this clearly is not the case) is not helpful, especially coming from someone appears to have violated our rules such as WP:MEAT. Yobol (talk) 13:10, 2 July 2013 (UTC)

Death by "Kratom Alone"

In the case study that User:Alexbrn is suggesting presents a death by kratom alone, there are four other depressants in the toxicology report. By definition, it was not "alone". However, the case study does suggest that kratom was the primary cause of death.

As a side note, that case study greatly irritates me. First, it seems that they should have weighed the possibility of it being a suicide more seriously. They also absolutely should have considered the fact that, although the other four drugs were within therapeutic limits, they undoubtedly interacted. On top of that, he took two benzodiazepines within "therapeutic limits", which activate the same receptors and therefore likely had a supratherapeutic effect. On top of that, benzodiazepines are known to cause dangerous respiratory depression when combined with opioid agonists, even in relatively low doses. I seriously doubt that he would have died had he only consumed the kratom. That, however, is irrelevant to this discussion. Exercisephys (talk) 15:19, 22 October 2013 (UTC)

The sources supporting the statement: "Several case reports document deaths involving kratom. Other drugs were used in all cases, and in one, kratom was speculated to possibly be the primary cause of death" are primary, and not really appropriate per WP:MEDRS. The quoted sentence really belongs in the "Uses and safety" section, not the lead section. It would be appropriate to summarize potential adverse effects in the lead that are ALSO mentioned in "Uses and safety", but at the lead presently includes several statements about adverse effects (e.g. death) that aren't mentioned at all in "Uses and safety".

This article is fundamentally about a plant. Maybe kratom should be a disambiguation page to mitragynine and Mitragyna speciosa? Or "kratom" could be split into a separate article on "kratom" products? "Kratom" products may be leaves of the plant, mitragynine enhanced extracts, or even extracts adulterated with O-Desmethyltramadol. Recent primary reports in the medical literature of "kratom" toxicity, and sensationalistic popular media accounts aren't necessarily relevant to an article about a plant species. Plantdrew (talk) 06:50, 23 October 2013 (UTC)

I'm just doing spot-correcting (correcting it as I see it), so I wasn't aware of that inconsistency. As for your second point, that's unrelated to the topic here, and I was never a part of the discussion on renaming or splitting this page. If you want to discuss it, I would suggest starting a new section on this talk page. Best of luck. Exercisephys (talk) 00:23, 24 October 2013 (UTC)

DEA "Drugs and Chemicals of Concern" List

This article mentions that kratom is on the DEA's "Drugs and Chemicals of Concern" list. However, the link is dead and the last Wayback Machine archive is from February 15, 2013. This is the only source of this list I can find. There's a fact sheet that mentions "Drugs of Concern", but kratom isn't mentioned.

Should we remove our discussion of this list? Exercisephys (talk) 15:35, 22 October 2013 (UTC)

According to this article, "The US Drug Enforcement Administration (DEA) has placed Kratom on its Drugs and Chemicals of Concern list, which suggests that the agency may eventually try to ban it in the US once more reliable data on its addictive properties and/or health hazards become available". Alexbrn ^{talk|contribs|COI} 15:41, 22 October 2013 (UTC)

This may sound trite, but is there any evidence that the list still exists? It seemed odd at first, not appearing to serve the purpose of spotlighting up-and-coming substances like that journal article suggested. Namely, it contained a number of well-known already-scheduled substances like LSD and methamphetamine. Exercisephys (talk) 16:08, 22 October 2013 (UTC)

Don't know from searching around, if the DEA maintain a list with this title they're certainly doing a good job of hiding it! Alexbrn ^{talk|contribs|COI} 16:10, 22 October 2013 (UTC)

Here is the list indicating drugs of concern: http://www.dea.gov/druginfo/factsheets.shtml. Kratom used to be on this list, but it's been taken off. Article should reflect that it is not on the list. Up to the community whether it wants to say whether it was on the list or not, but it's not now.Journalist1983 (talk) 11:14, 23 June 2015 (UTC)

That looks like a different document, it's still included in the more comprehensive PDF here. Please stop edit warring text that isn't supported by the source (it nowhere mentions that Kartom has been "removed"). Alexbrn (talk) 12:40, 23 June 2015 (UTC)

It doesn't say anywhere that it's been removed. It just has. Go look at the current list of fact sheets Current DEA list of Fact Sheets. One can easily confirm this is the current list of fact sheets by going to the current DEA website.Journalist1983 (talk) 14:50, 27 June 2015 (UTC)

And yet it's still on other fact sheets published on their site. What you've linked to is an index page for some fact sheets. No source says it "was removed" - that would be WP:OR even if true. Alexbrn (talk) 14:59, 27 June 2015 (UTC)

To ensure NPOV, we can't take sides in what is DEA confusion. Would you be willing to agree to language that addresses the confusion? Journalist1983 (talk) 16:15, 27 June 2015 (UTC)

Only if it's based on RS. As I see it, Wikipedia is correct: the DEA did issue the document. It is still published on the open web by them. If it turns out this is in error, then without RS commenting on that, the best solution would be to remove all mention of what the DEA did. Currently, I lean towards leaving things as they are. Alexbrn (talk) 16:47, 27 June 2015 (UTC)

Leaving things as they are is very misleading. I think we need to state the facts. The facts are not in dispute. Let me know if I am wrong. The facts are that Kratom is not currently listed on the DEA's website as a drug of concern (they have a list and it's not on there). The fact is also that sometime before August 2013, according to a blog citation I provided to you, DEA issued a fact sheet that Kratom is on such a list. If you do not agree with these facts, pls advise. Thank you. Journalist1983 (talk) 13:07, 28 June 2015 (UTC)

Kratom is currently still listed on the DEA's web site in two PDF documents[9]. It is not listed on an HTML index page, which does not appear to index all their fact sheets. I have never seen the DEA's "Drugs and chemicals of concern" document/list and don't think anything so-titled has ever been public on the web. So: we know they say it's on this list, we know that statement is still published by them on the public web, and we have zero reliable evidence it was "removed". Surely, we need something more for movement here? At any rate we have no RS for saying they "removed" it. The source we have here supports the text that cites it. Alexbrn (talk) 14:30, 29 June 2015 (UTC)

Legality

The section about legality mentions only that some states are considering legislation. As of now, TN, VT, IN and WI have banned kratom with more bans being considered. — Preceding unsigned comment added by Somnilover (talk • contribs) 02:34, 12 December 2015 (UTC)

Source? Alexbrn (talk) 02:53, 12 December 2015 (UTC)

Hypothyroidism

Kratom may cause hypothyroidism :. If that is true, overuse may lead to sexual problems like most opiates. 2001:558:6033:15:5C3A:EDBA:5DC0:12EB (talk) 14:22, 10 April 2016 (UTC)

References

Human pharmacological profile

I just put an edit discussing this study: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0115648 in the section "Safety". I know this study is not conclusive as it is not an in vivo study. I made sure to mention that in the section. Please don't delete it, or give me a good reason for deletion. — Preceding unsigned comment added by Bluesman39 (talk • contribs) 02:08, 28 August 2016 (UTC)

http://pubs.acs.org/doi/abs/10.1021/jacs.6b00360?source=cen

Should this new source be used to update the article, in specifically the phrases noting the lack of research and understanding of its pharmacological effects in humans? This is the first study done on human receptors in vitro as opposed to rodent tissues.

""At the human opioid receptors (hMOR, hKOR, and hDOR), mitragynine acted as a partial agonist at hMOR ... at hKOR, mitragynine was a competitive antagonist ... Similarly, mitragynine acted as an antagonist at hDOR, but with very low potency"

Shimunogora (talk) 13:45, 10 June 2016 (UTC)

This work is in the category of WP:PRIMARY as early-stage research on human cells/receptors in vitro and doesn't add significant applicable information to the article beyond what is already stated under Opioid withdrawal per WP:NOTJOURNAL. --Zefr (talk) 14:03, 10 June 2016 (UTC)

Supplement lawyers, professional associations favor DEA decision

FYI, published 1 Sept 2016 here. --Zefr (talk) 22:52, 6 September 2016 (UTC)

Semi-protected edit request on 5 September 2016

Please change The United States Drug Enforcement Administration states, "There is no legitimate medical use for kratom". to Mitragynia speciosa is recognized increasingly as a remedy for opioid withdrawal by individuals who self-treat chronic pain here.

Please remove "Kratom has become popular as a recreational drug" This is an opinion and no factual information has been stated that it is popular as a recreational drug. From my research over 60% of people use Kratom for chronic pain relief. I will not add that to this article, because I am not able to provide information to back that up.

Please remove "According to the DEA press release, "Kratom is abused for its ability to produce opioid-like effects and is often marketed as a legal alternative to controlled substances. Law enforcement nationwide has seized more kratom in the first half of 2016 than any previous year and easily accounts for millions of dosages intended for the recreational market, according to DEA findings. In addition, kratom has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision. These three factors constitute a Schedule I controlled substance according to the Controlled Substances Act passed by Congress in 1970."[9] DEA reported 15 kratom-related deaths between 2014 and 2016.[9]"

The above references the DEA press release that has no medical documentation. Their press release contained false information about Kratom and the general public needs to know the facts. Please dont let wikipedia continue to provide false information to the public.

Find more: here here and here.

Please correct this page so we can provide the public with factual information. What the DEA is stating is false information. I am more than happy to edit the document myself if/when i have access.

Eebo2005 (talk) 17:33, 5 September 2016 (UTC)

Of your two published studies one is a case study of a single person (which means very little) and the other is a review article which is only useful if there meaningful articles to review and I'm not seeing any evidence that there are.©Geni (talk) 18:06, 5 September 2016 (UTC)

Not done: The page's protection level has changed since this request was placed. You should now be able to edit the page yourself. If you still seem to be unable to, please reopen the request with further details. Topher385 (talk) 14:44, 8 September 2016 (UTC)

Basic editing

User:Stoneglasgow Please read WP:MEDRS and do not add sources about health to WP that do not comply with MEDRS. Please read WP:LEAD and do not add content only to the lead. If you don't understand after you read, please ask. Jytdog (talk) 02:22, 13 September 2016 (UTC)

User:Stoneglasgow please reply here. Thanks. Jytdog (talk) 21:19, 13 September 2016 (UTC)

User:Jytdog Most recent edits cited existing, accepted source material. Please advise. Stoneglasgow (talk) 21:59, 13 September 2016 (UTC)

First, thanks for starting to talk! Whew. OK.... You don't seem to have read WP:MEDRS; as I have noted the sources are not OK per MEDRS. If you tried to read MEDRS and don't understand it, please ask a specific question. Thanks! Jytdog (talk) 22:02, 13 September 2016 (UTC)

Recent edits use information from same sources cited before update; the same sources cited post-reversion. Please advise. Stoneglasgow (talk) 22:41, 15 September 2016 (UTC) — Preceding unsigned comment added by Stoneglasgow (talk • contribs) 22:40, 15 September 2016 (UTC)

too terse. what is the question? 00:05, 16 September 2016 (UTC)

Edit request on 9/26/2016 to add NIDA source alongside DEA source

I agree that the DEA source stating "15 deaths have been associated with kratom use" is reliable per WP:RS. However, the Kratom page on the NIDA's DrugFacts website states "Kratom by itself is not associated with fatal overdose, but commercial forms of the drug are sometimes laced with other compounds that have caused deaths.". Since two reliable sources are in conflict, I propose changing:

In the United States between 2014 and 2016, 15 deaths have been associated with kratom use

to

According to the DEA, 15 deaths have been associated with kratom use from 2014-2016. However, kratom itself is not associated with fatal overdose.

This would describe the dispute, while not engaging in it, by presenting multiple reliable sources (the DEA and NIDA.) This seems preferable to quoting the DEA source alone in WPOV without any in-line attribution. User:Jytdog, do you have any objections?

References

Amabelles (talk) 09:18, 26 September 2016 (UTC)

Hmm I'd suggest directly mention NIDA and dropping the however. "According to the DEA, 15 deaths have been associated with kratom use from 2014-2016. The US National Institute on Drug Abuse states that there have been no cases of deaths due to kratom overdosed but deaths have been caused by the use of kratom contaminated with other substances".©Geni (talk) 07:34, 30 September 2016 (UTC)

sorry for the delay. i have been wanting to check the reviews and haven't yet; there is some detail in them that isn't in either the DEA or the NIDA pages... Jytdog (talk) 07:39, 30 September 2016 (UTC)

And are you going to read them today or do we go with the webpages for now?©Geni (talk) 08:41, 30 September 2016 (UTC)

I will try to get to that later today. Jytdog (talk) 12:34, 30 September 2016 (UTC)

I think NIDA is considered MEDRS. I think it would be okay to add it. If a better source turns up in the reviews we can always change that section. Sizeofint (talk) 14:34, 30 September 2016 (UTC)

sizofint this has been a consistent issue for drive-bys - I want to nail this down and the reviews go into detail on this. will do it today. Jytdog (talk) 18:59, 30 September 2016 (UTC)

OK, i did it here Jytdog (talk) 20:54, 30 September 2016 (UTC)

general changes to kratom page

As a substance use researcher, I find this page very one-sided. I know that there is limited scientific information on kratom, but the government-provided information on the substance is a bit misleading. Please consider the peer-reviewed, published research I have cited below, which provides a more balanced view of the existing evidence regarding kratom. I have also attached a link to news about the ongoing controversy regarding kratom.

Marc T. Swogger Ph.D., Elaine Hart M.S., Fire Erowid B.A., Earth Erowid, B.A., Nicole Trabold Ph.D., Kaila Yee B.A., Kimberly A. Parkhurst B.A., Brittany M. Priddy B.S. & Zach Walsh Ph.D. (2015): Experiences of Kratom Users: A Qualitative Analysis, Journal of Psychoactive Drugs, DOI: 10.1080/02791072.2015.1096434

https://www.washingtonpost.com/news/wonk/wp/2016/09/15/the-dea-wants-to-ban-another-plant-researchers-say-the-plan-is-insane/

Mako7717 (talk) 12:16, 30 September 2016 (UTC)

We source content that is WP:Biomedical information according to our guideline, WP:MEDRS. That means literature reviews published in good journals or statements by major medical/scientific bodies. Neither source you present meets those criteria. Jytdog (talk) 12:33, 30 September 2016 (UTC)

I agree that the "Journal of Psychoactive Drugs" is not a major medical journal, but it does appear to be sincerely peer reviewed and not a vanity journal. On the topic of psychoactive drugs, which include kratom, it seems quite relevant. Can you explain why this journal falls below the barrier of "good journal"? Kevin143 (talk) 02:44, 1 October 2016 (UTC)

wrong question. the glaring problem is that the article is not a literature review. Jytdog (talk) 02:46, 1 October 2016 (UTC)

Deaths Involving Kratom

Less than a dozen deaths have involved kratom, although only when used in conjunction with strong sedatives such as opiate or benzodiazepine drugs. I wrote this and my edit was reverted to "Several case reports document deaths involving kratom, either alone or in combination with other drugs." Alexbrn states that he reverted my edit because "Other drugs found were not felt to be significantly related to death." He is referring to the "A Drug Fatality Involving kratom" citation. Individually, yes the drugs were within "therapeutic thresholds" in that report. But there is no way that you can conclusively state that there was no compounding effect with kratom, which only has death reports when it was likewise combined with other strong sedative drugs. Combining a kratom as a sedative in conjunction with "therapeutic levels" of other strong sedative will undoubtedly increase the overall sedative effect, am I wrong? I don't believe we can simply disregard that strong sedatives, antihistamine, and cough medicine were all present. I would be completely inaccurate to say the the death involved kratom "alone."

Furthermore, I don't like the idea of presenting that source as support for the idea that kratom alone may lead to death because the medical examiner himself stated that it is only "possibl[y]" the case, and because the report specifically addresses the "speculative nature of the conclusion." Speculative conclusions are far from argumentative support, especially support strong enough to state here on Wikipedia that kratom alone led to his death.

In conclusion, I desire to revert back to my edit of "Less than a dozen deaths have involved kratom, although only when used in conjunction with strong sedatives such as opiate or benzodiazepine drugs." Before doing so, I would like to open this issue up for discussion.

COice6 (talk) 02:12, 22 October 2013 (UTC)

I think it's quite straightforward: one of our sources is making the explicit point that other drugs needn't necessarily be involved. We shouldn't take our readers in the opposite direction to what the source is saying. Alexbrn ^{talk|contribs|COI} 06:55, 22 October 2013 (UTC)

The problem is that saying that the death was possibly due to kratom, is completely different from saying that the death involved kratom alone. The examiner speculates that it may have been kratom as opposed to the other things in his system, but that doesn't mean that kratom was the only thing in his system. The kratom wikipage currently reflects the idea that the case asserts the person died from having only kratom in his system. This incorrect. Furthermore idea of kratom even having a primary role is based speculation. Overall, this is not good support for such a strong claim (--the claim that kratom alone could kill someone). It should be removed or restated in a manner congruent with the wording that I provided earlier.

COice6 (talk) 00:15, 23 October 2013 (UTC)

The DEA is claiming 15 deaths are the result of kratom, but do not cite their sources. We cannot verify what they consider a death from kratom. All the research I've found indicates that deaths "associated" with kratom are the result of other drug combinations, not solely from kratom. The current phrasing is misleading. — Preceding unsigned comment added by Ingenium (talk • contribs) 03:13, 1 September 2016 (UTC)

Better get your "research" published - then we can consider it. Meanwhile, we stick to the published sources. Alexbrn (talk) 03:17, 1 September 2016 (UTC)

The sources cited on the main article all show other drugs in the person's toxicology reports. One even specifically states the cause of death was propylhexedrine, not kratom. Ingenium (talk) 03:25, 1 September 2016 (UTC)

Alexbrn: See Forbes article published Friday, September 30 by David Kroll, research pharmacologist. He writes that "Columbia associate research scientist, Andrew Kruegel, PhD, was specifically cited in the (senators Corey Booker-Gillibrand-Wyden) letter to DEA as he led an 11-scientist letter of objection to kratom scheduling that was submitted to congressional representatives on September 2. Kruegel is also first author on a paper published in the Journal of the American Chemical Society in May showing the alkaloids in kratom act on opioid receptor signal transmission entirely differently than strong opioids such as morphine, fentanyl and oxycodone, posing less risk of respiratory depression."Ronsword (talk) 19:29, 1 October 2016 (UTC) The research provided does not prove Kratom alone caused any deaths. It's speculation of the highest order. Perhaps you could provide some "research" that proves Kratom ALONE caused a death. — Preceding unsigned comment added by Moochee22 (talk • contribs) 20:49, 17 September 2016 (UTC)

"Decreased effort to breathe" listed as severe side effect is FALSE

Kratom has proven NOT to be a CNS depressant, nor does it cause difficulty breathing or as stated here, "a decreased effort to breath". This is misinformation and should be removed promptly. There are numerous studies that show that, unlike normally prescribed and abused Opiate/Opioids, Mitragyna Speciosa (Korth) does NOT cause respiratory depression, which happens to be the number one reason for death in Opiate/Opioid overdose deaths. Please review this and make the necessary corrections. People rely on Wikipedia for ACCURATE information. Also, this page states that another severe side effect is Death, and also states there have been 15 deaths caused by Kratom. This is absolutely FALSE. Kratom has never caused a single death. I'm fact, the 15 deaths related to Kratom have been because of various other substances combined with Kratom, or, from substances being sprayed on to Kratom leaf powder before packaging, and then sold as an all natural supplement. Please make the necessary changes to this page so that Wikipedia users can educate themselves with accurate, factual information. Please guard this information against special interests who wish to spread misinformation for their own private interests and purposes. Thank you Garmadill0 (talk) 17:43, 5 September 2016 (UTC)

The abstract of the first source states "The main active alkaloid substances in kratom, mitragynine and 7-hydroxymitragynine, present with a range of CNS stimulant and depressant effects mediated primarily through monoaminergic and opioid receptors." Sizeofint (talk) 18:54, 5 September 2016 (UTC)

My interpretation of the scientific literature is that kratom does cause respiratory depression, but causes less respiratory depression than morphine for equally analgesic doses. I don't think I have seen this cited in a secondary source, only primary sources involving mice, but if someone finds a secondary source comparing the respiratory depression of kratom and morphine, we can add to the article that kratom causes less severe respiratory depression than morphine. Kevin143 (talk) 19:35, 1 October 2016 (UTC)

Semi-protected edit request on 1 October 2016

There is some cherrypicking of information on kratom's adverse effects. In the same article detailing these reverse effects, making it seem far more dangerous than it is. According to the same source [3] http://onlinelibrary.wiley.com/doi/10.1002/phar.1522/full, where you can read:

"Serious toxicity is rare and usually involves relatively high doses (more than 15 g) or coingestants.[50, 51] A 64-year-old man experienced multiple witnessed seizures requiring intubation 30 minutes after ingesting a tea made with kratom and Datura stramonium.[53] Datura, commonly known as jimson weed, itself has rarely been associated with seizures. A 43-year-old man experienced a generalized tonic-clonic seizure lasting 5 minutes after he combined kratom with 100 mg of modafinil.[50] This patient self-treated his opioid withdrawal with a tea made from kratom 4 times/day without significant adverse effects until he added modafinil in an attempt to improve alertness. Seizures and coma were reported in a 32-year-old man after kratom use, although coingestants were not reported.[54] Cases of jaundice and pruritus after massive chronic exposure to kratom (14–21 g/day for 14 days)[55] and severe primary hypothyroidism, potentially through reduction in the normal response of the thyroid gland to thyroid-stimulating hormone,[56] have been reported. Fatalities typically involve coingestants."

I am confident that the current wikipedia page here is written in a biased way, making kratom out to be a much more dangerous substance than it is. Kratom deaths have ONLY occured in instances of coingestants, there are clear examples in the scholarly article that demonstrate this. and only ever in high doses. I think it's completely undemocratic and people deserve to know much more about its good effects. It's legal in many countries-- mine included-- and the only reason this article is so negative is because the DEA has just scheduled this substance in the US.

Cherry picking information and not showing the whole story is the same thing as outright lying, if you ask me, and I know Wikipedia is better than that.

2607:FEA8:E91F:F89D:D433:45CE:47F9:608E (talk) 15:08, 1 October 2016 (UTC)

 Not done. Your request isn't specific enough. Please put it in the format change X to Y. Sizeofint (talk) 16:07, 1 October 2016 (UTC)

Yes I don't understand. No substance that has bioactivity is without side effects - look at the adverse effects section for any drug article and you will find a list of side affects it can cause. there appears to some illusion out there that kratom is some kind of magical substance that has no side effects.... Jytdog (talk) 18:03, 1 October 2016 (UTC)

Per anonymous user's requests, are there places where the cited source can be used to add a softening statement like "While serious toxicity is rare"? The tone of the article seems to focus on negative aspects of kratom. I recognize that this is because the secondary sources on kratom are focused on the side effects and that good literature reviews on anecdotal herbal medicine use of kratom don't exist. Kevin143 (talk) 19:29, 1 October 2016 (UTC)

Kevin, as I noted above, if you hang around this article long enough you will find that there are lots of people who show up here who a) do not understand how WP works; b) passionately believe' that kratom is a wonderful thing (I am guessing many of them are using it in one way or another, in ways that are important to them); c) are angry that DEA is getting ready to schedule it; d) make changes to the article or make demands here on the talk page, to remove or play down the risks and play up the benefits. This is a general issue in WP; folks who are what we call "advocates" and want to use WP to right great wrongs and as a soapbox (that last wikilink is a link to policy) are generally what we call "disruptive" - they don't care about WP per se nor its policy and guidelines and just push and push and push for what they want. It gets very difficult because they often will not stop and will not base their arguments and edits on WP's mission and WP's policies and guidelines. This is one reason why making sure that everything is sourced, and sourced per MEDRS for biomedical content and RS for the rest, is so important. Jytdog (talk) 20:01, 1 October 2016 (UTC)

Attempts to use primary source to refute secondary ones

In this edit [10] this text "this may not be necessary for kratom since it does not cause respiratory depression in rats was added.

References

We specifically do not use primary sources to refute secondary ones per WP:MEDRS. Doc James (talk · contribs · email) 02:59, 1 September 2016 (UTC)

The original source does not mention naloxone being used for kratom. It specifically says "naloxone may be used as an antidote for desomorphine overdose". The original source lumps many unrelated drugs together. — Preceding unsigned comment added by Ingenium (talk • contribs) 03:07, 1 September 2016 (UTC)

The source says "naloxone should be considered if acute kratom overdose with respiratory depression is suspected" Doc James (talk · contribs · email) 03:32, 1 September 2016 (UTC)

But we have other sources saying that kratom does not cause respiratory depression. That is a very important fact that needs to be included. The current phrasing implies that kratom does cause respiratory depression. Ingenium (talk) 03:36, 1 September 2016 (UTC)

What other sources? Doc James (talk · contribs · email) 03:38, 1 September 2016 (UTC)

The one cited in this section is one example. Ingenium (talk) 03:40, 1 September 2016 (UTC)

References

That is a primary source. We need to use reviews and other high quality secondary sources per WP:MEDRS Doc James (talk · contribs · email) 03:43, 1 September 2016 (UTC)

It should still be stated that it may not apply to kratom. Ingenium (talk) 03:50, 1 September 2016 (UTC)

Not if it can't be reliably-sourced. Alexbrn (talk) 03:51, 1 September 2016 (UTC)

Yes - it needs to be reliably sourced or it cannot come in. Studies in rodents don't always translate to humans. Jytdog (talk) 03:53, 1 September 2016 (UTC)

The secondary source cited makes the assumption that kratom may cause respiratory depression without any evidence that it does. Ingenium (talk) 03:56, 1 September 2016 (UTC)

Peer reviewing the contents of a source that complies with MEDRS is beyond the scope of what editors are allowed to do. See WP:MEDASSESS. Jytdog (talk) 04:12, 1 September 2016 (UTC)

Does this count as a secondary source? "Although mitragynines agonize mu-opioid receptors, respiratory depression, coma, pulmonary edema and death have not, to our knowledge, been associated with human kratom ingestion" here. Ingenium (talk) 17:21, 1 September 2016 (UTC)

Yes, the Warner article counts as a secondary source and is one of the more cited secondary sources in the kratom Wikipedia article. I believe the sentence you quote could be cited and used in the article to lessen other statements in the article stating that kratom causes death and respiratory depression. Kevin143 (talk) 20:05, 1 October 2016 (UTC)

• [11]several reviews(12 to be exact)--Ozzie10aaaa (talk) 21:52, 1 September 2016 (UTC)

It appears we have some socks [12] Doc James (talk · contribs · email) 07:00, 1 September 2016 (UTC)

Have requested semi-PP. Alexbrn (talk) 07:09, 1 September 2016 (UTC)

Those aren't socks from me. Ingenium (talk) 17:21, 1 September 2016 (UTC)

Clarify

"Adverse effects are similar to opioids and include hallucinations, psychosis, seizures, agitation, tachycardia, nausea, constipation, bowel obstruction, drowsiness, respiratory depression (normal breathing is reduced, which can lead to carbon dioxide poisoning and death), reduced appetite, itching, sweating, dry mouth, and increased urination."

References

A bunch of these adverse effects are not similar to opioids. So the sentence does not really make sense. Doc James (talk · contribs · email) 02:12, 9 September 2016 (UTC)

I was following Recht which says: "Adverse effects are similar to opioids including nausea, vomiting, constipation, respiratory depression, itching, sweating, dry mouth, increased urination, anorexia, and palpitations. Neurologic effects include hallucinations, psychosis, seizures, and agitation." I guess Recht separateed out the neuro effects and I added them in; maybe that is where I went awry. I am fine with the change.

But the reason I wrote " respiratory depression (normal breathing is reduced, which can lead to carbon dioxide poisoning and death)" is that there was some edit warring nonsense over "decreased effort to breathe" in this dif today and others in the past - I was trying to explain "respiratory depression" more clearly.... Respiratory depression isn't really about "effort" is it, since it is about the autonomic breathing system.. I was tempted to say "slowing of normal breathing rhythm" or "inhibition of the sensors that tell the body when to breathe" and settled on what you see above.... what do you think? Jytdog (talk) 04:57, 9 September 2016 (UTC)

Okay adjusted to "respiratory depression (decreased breathing)". Does that clarify you think? Doc James (talk · contribs · email) 01:04, 10 September 2016 (UTC)

yes is better. hard thing to say simply, autonomic and all. Jytdog (talk) 01:05, 10 September 2016 (UTC)

An opinion piece, with first-hand testimony and some reportage; evidence (alas, primary) of the current controversy; maybe something useful here nevertheless?: https://www.theguardian.com/commentisfree/2016/sep/09/kratom-ban-harmless-herb-heroin-users — Preceding unsigned comment added by 2601:2C7:8001:7800:D54E:EF2D:7EF4:B5C6 (talk) 07:03, 10 September 2016 (UTC)

Well the Guardian's "Comment is Free" is not a useful source for anything much. It does however explain the activity on this page: obviously the topic of Kratom has managed to bind to a strand of the Big Pharma conspiracy theory which is why we're getting increasing numbers of Truth™ warriors showing up here. If we just stick to reflecting what reliable sources say we'll be fine. Alexbrn (talk) 07:21, 10 September 2016 (UTC)

The Adverse Effects section needs to be re-edited and clarified. The references at the conclusion of the adverse effects section which are allegedly similar to "opiates" (nausea, hallucination, respiratory depression, psychosis, etc.) are not consistent with the reference abstracts cited - some of which find "therapeutic potential" for Mitragyna, or some which appear to be speaking of opiate adverse effects in general, of which Mitragyna has not been established an "opiate" drug. In addition, recent studies at University of Mississippi and additional published peer-reviewed research (of which I will be happy to provide and which have now been presented to DEA do not substantiate the respiratory depression claims; in fact, one of the novel pathways of Mitragyna that has most interested scientists is its agonist effects on specific opiate receptors that respond significantly differently than they do from opiate drugs, these effects not involve respiratory depression. It's for this reason that patents by governmental agencies including USDA have been taken on this compound and scientists are fearful of its restriction as a Schedule 1 substance. In addition, the reference that Mitragyna is many-fold times greater in potency than morphine is misleading, as the amount of this constituent non-isolated, as in the generally consumed kratom leaf, is significantly much less potent than morphine.Ronsword (talk) 18:54, 1 October 2016 (UTC)

Agreed. I did a very slight change here but didn't substantially alter the content in the way you suggested. Primary literature on mitragynine and 7-hydroxymitragynine clarifies that while mitragynine and 7-OH may be stronger antinociceptive agents by weight, they are much less rewarding than morphine. My interpretation of this is that mitragynine and 7-OH cause significantly less euphoria per equal analgesic dose than morphine. However, since to my knowledge this is only described in primary studies with mice, I'm not sure how to go about adding it to the article. Can mouse model studies be discussed on a Wikipedia health page when they are clearly labeled as describing effects in mice? Kevin143 (talk) 19:41, 1 October 2016 (UTC)

User:Ronsword you obviously feel passionately about this, but please know that you have to actually read the source; we don't edit based on abstracts. If you don't have the paper, you don't have it. Sometimes if you ask people will provide you with a copy of a paper, but please don't waste everyone's time here. And please stop making assertions here that are not supported by MEDRS sources; it is just not helpful. Thanks. Jytdog (talk) 19:52, 1 October 2016 (UTC)

Please desist from resorting to ad hominem and petty squabbling. It doesn't advance your argument, nor should that be what your role is here. Please read my comment below under "DEA" on peer-reviewed research as cited in Forbes article of yesterday. Yes, there are plenty of peer-reviewed articles that refute several claims being made in this Wikipedia article and yes, I have READ the actual articles and not merely the abstracts. FYI- My earlier remarks about abstracts which apparently, have caused you some consternation, were meant to highlight that, those specific abstracts don't, in and of themselves, support a broad-sweeping indictment of Mitragyna as having adverse opiate-like side effects. I have no idea whether the editor who included those particular abstracts "read" the actual peer-reviewed article or not, but you're suggesting the general reader is to make that assumption? Assuming the actual articles DO, however, show such facts, then direct quotations from the general article should thus be made, not simply including highlights from the abstract.Ronsword (talk) 21:48, 1 October 2016 (UTC)

It is not ad hominem. Please deal with the entire source, and all of them. Thanks. Jytdog (talk) 22:05, 1 October 2016 (UTC)

More nuanced Adverse Effects information

I have looked over the most recent reviews with regard to Adverse Effects, and by far the best treatment is in Warner. I am going to revise based on Warner. Hopefully it will be OK. If folks raise objections to this, it needs to be based on what MEDRS sources actually say. Jytdog (talk) 23:20, 1 October 2016 (UTC)

See section on talk I just added showing a major error made by Warner. This makes me uncomfortable using them as a major source without meticulously checking all of their references. Kevin143 (talk) 23:25, 1 October 2016 (UTC)

What do you think of the treatment by Ward in Herbal Medicines for the Management of Opioid Addiction? It's a literature review in a real journal but doesn't seem perfect. https://www.ncbi.nlm.nih.gov/pubmed/22133323 They list some severe side effects but state that emesis is not associated with kratom and seem to claim that respiratory depression has not been observed in humans or mice with kratom which I'm not sure is true, and I'm not sure how they can make a claim by omission in a literature review. I'm trying to dive deep into the sources here and I'm noting that the authors of these literature reviews on kratom seem to take a lot of leeway and that we should follow up on their primary sources. Kevin143 (talk) 23:49, 1 October 2016 (UTC)

Kevin that is a five year old source - we have Warner and Rech from 2015, Hassan from 2013 and Rosenbaum from 2012; the coverage in PMID 22133323 from 2011 is pretty cursory... not sure what value it brings.. Jytdog (talk) 01:58, 2 October 2016 (UTC)

done here, using Rech and Warner; waiting to update lead based on whether this is accepted. Jytdog (talk) 01:53, 2 October 2016 (UTC)

Contaminants

Source says "The presence of this contaminant in some online products is well documented"[13] From a good source and is notable. It is not like this is a pharmaceutical. One simply does not know what they will get. Doc James (talk · contribs · email) 20:50, 2 October 2016 (UTC)

Extent of research

To be clear about this, there have been no clinical trials on kratom or the two main bioactives in it that I have found. for the importance of clinical trials see clinical trial and drug development - for what i mean about "none" see here and here. When people say "little research" this is what they mean. We understand very poorly what happens to people when they take kratom. I added some content with sources to make that more clear. Jytdog (talk) 23:14, 2 October 2016 (UTC)

Major Error in Warner Paper (mitragynine is not 13 times as potent as morphine)

The Warner literature review says "Mitragynine is suggested as having approximately 13 times the potency of morphine in regards to its opioid-like effects." That statement is cited to another literature review, Rosenbaum's "Here today, gone tomorrow..." which states that "Mitragynine is approximately 13 times more potent than morphine". Rosenbaum cites that claim to Vicknasingam's "The informal use of ketum (Mitragyna speciosa) for opioid withdrawal in the northern states of peninsular Malaysia and implications for drug substitution therapy" and Matsumoto's "Antinociception, tolerance and withdrawal symptoms induced by 7-hydroxymitragynine, an alkaloid from the Thai medicinal herb".

Vicknasingam cites Matsomuto to state "Two alkaloids in ketum—mitragynine and alkaloid 7-hydroxyminitragynine—act as agonists to supraspinal mu- and delta-opioid receptors and produce effects similar to morphine. In fact, the latter exhibited about 13 times higher potency than morphine and about 46 times higher potency than mitragynine in animal studies (Matsumoto et al., 2004)." Matsomuto states "Consequently, 7-hydroxymitragynine exhibits about 13- and 46-fold higher potency than morphine and mitragynine, respectively." He also says " In this ileum test, 7-hydroxymitragynine exhibits about 13-fold higher potency than morphine as reported previously (Takayama et al.,2002). Also, "The antinociceptive effect of mitragynine on noxious mechanical and thermal stimulation has been already reported in the tail-pinch and hot-plate tests in mice (Matsumoto et al., 1996a,b; Tohda et al., 1997; Thongpradichote et al., 1998; Watanabe et al., 1999), although its antinociceptive effect was less potent than that of morphine." In the Matsomuto paper that Rosenbaum and Vicknasingam cite, mitragynine is not otherwise compared to morphine, the paper is primarily on 7-hydroxymitragynine.

This error makes me think that the Rosenbaum literature review is no good and should not be used as a reliable source on this article, at least not without checking all the references it cites. It also suggests that we should not treat the Warner article as sacrosant and should follow up on the primary sources it cites. Kevin143 (talk) 23:24, 1 October 2016 (UTC)

We can likely just remove that statement. Doc James (talk · contribs · email) 02:15, 2 October 2016 (UTC)

Nice catch, Kevin! I just wrote an email addressed to both the corresponding author of the Warner paper and of the Rosenbaum paper, asking each of them to issue a correction. Everybody is human and nothing under the sun is perfect; hopefully they will each issue a correction. I will write back here again if/when I get a reply from either. Yes per Doc James we can leave this pharmacology information out for now. Or, as I noted above, since this is pharmacology,. we can cite it to a primary source. Thanks again. Jytdog (talk) 03:06, 2 October 2016 (UTC)

OK, I'll plan on correcting to a primary source tomorrow unless someone else does it first. I think cite Matsumoto as they are the true primary source for the modern pharmacology of kratom. Kevin143 (talk) 03:12, 2 October 2016 (UTC)

Makes sense! There is another editor named User:Seppi333 who I think is interested in pharmacology of substances like this; pinged him here as he may have some useful input to sort out the literature on this, in this article and the articles on the substances. Seppi I have been thinking of you with regard to the interesting dual stimulant/opioid activities involved here. Jytdog (talk) 03:26, 2 October 2016 (UTC)

Note, received a reply from the corresponding author of the Rosenbaum paper; she is looking into it. Nice. Jytdog (talk) 04:16, 2 October 2016 (UTC)

Note, received a reply from the corresponding author of the Warner paper; he is looking into it. Nice. Jytdog (talk) 05:28, 3 October 2016 (UTC)

Hmm... it's actually not unusual for something to have a combined stimulant/opioidergic effect on the body; even amphetamine induces the release of endogenous opioids in certain parts of the brain along with catecholamines. What I find unusual is the rationale for what causes "stimulant" effects, because the receptors mentioned don't mediate any notable psychostimulant effects (perhaps cardiac or respiratory stimulant was the intended meaning here). Alpha-2 blockers don't function as psychostimulants (also, based upon nootropic#Stimulants, one might infer that blocking the α2 adrenoceptors in the brain would cause a transient deficit in executive function) and to my knowledge 5-HT2A receptors are notable in the context of psychoactive drugs only for at least partially mediating the hallucinogenic effects of certain psychedelic drugs. In the case of Kratom, based upon the pharmacodynamics mentioned in the article I'd assume the hallucinogenic effect is mediated by antagonism of NMDA receptors, similar to PCP and ketamine, as opposed to agonism of κ-opioid receptors (a la salvia divinorum/salvinorin A) or 5-HT2A receptors (a la LSD). FWIW, I generally don't have much of an interest in plant pharmacology because it's often very difficult to isolate the primary bioactive compounds that mediate a given effect of the plant; plants often have very "dirty"/non-specific pharmacology that involves a large number of major xenobiotic metabolizing enzymes (CYPs, MAOs, FMOs) and receptor targets associated with a number of different major neurotransmitter/neuropeptide systems (dopamine, norepinephrine, serotonin, kappa/mu/delta opioid, cannabinoid, glutamate [NMDA/AMPA receptors], GABA, etc.). Even so, I have tried a few novel pharmacologically active plant extracts (S.t. John's wort, salvia divinorum, and yohimbine) out of curiosity. Seppi333 (Insert 2¢) 13:55, 3 October 2016 (UTC)

OK thanks anyway Seppi. Jytdog (talk) 15:10, 3 October 2016 (UTC)

Pronunciation

Can anyone found anything citable that gives the proper way to pronounce kratom? Kevin143 (talk) 04:03, 4 October 2016 (UTC)

A new literature review

Singh, Darshan; Narayanan, Suresh; Vicknasingam, Balasingam (September 2016). "Traditional and non-traditional uses of Mitragynine (Kratom): A survey of the literature". Brain Research Bulletin. 126: 41–46. doi:10.1016/j.brainresbull.2016.05.004.

I added the cultural use of kratom in Thailand they cite under the traditional use section. Following their reference back to the primary source, it came from http://www.ijdp.org/article/S0955-3959(12)00144-2/abstract, where it appeared to be sourced from interviews with Thai villagers. This seems to be fine for a cultural claim; both the secondary source and the primary source were published in peer reviewed journals. Or should the primary source be cited instead of the secondary source for a cultural claim? Kevin143 (talk) 04:07, 4 October 2016 (UTC)

proper abbreviation for 7-hydroxymitragynine?

The article uses 7-HMG in the pharmacology section which is a non-standard abbreviation I haven't seen elsewhere. The scientists that discovered 7-hydroxymitragynine use the abbreviation 7-OH-mitragynine, which I have seen colloquially shortened to 7-OH. To use the style of the abbreviation from the article, 7-OH-MG seems a more correct abbreviation. Any thoughts on the right way to abbreviate mitragynine when using chemical shorthand? I'm going to edit the article to use the changed abbreviation, if someone knows a more correct way to abbreviate, please go ahead and make the change. Kevin143 (talk) 03:24, 1 October 2016 (UTC)

we follow sources in WP; 7-HMG is how it is abbreviated in the source provided. "seems to me" is irrelevant here. Jytdog (talk) 03:34, 1 October 2016 (UTC)

That's fair. Would you consider it reasonable to switch the abbreviation if there were at two other proper sources that consistently used a more correct abbreviation? Is it ever correct in organic chemistry to use the abbreviation "H" to refer to a hydroxy (-OH) group? There seems lots of potential confusion with the overlap with the abbreviation for hydrogen. Since Wikipedia can set the standard for abbreviations used elsewhere, I would like for us to try and find the sources that use the most correct abbreviations. Kevin143 (talk) 04:05, 1 October 2016 (UTC)

Please never edit health content in WP unless it is based on an actual source that you are citing. It is not uncommon that chemicals have more than one abbreviation; there is no reason to exclude any. Just cite a source for the other one. Please use literature reviews when you added content about drugs/bioactives or health to WP; please don't use primary sources as you did here. If you don't know the difference between a research paper (a primary source) and a review (a secondary source) please ask Jytdog (talk) 04:44, 1 October 2016 (UTC)

Sorry about that, I'm just diving in deep here and trying to be be bold while being sincere and well intentioned. Rhynchophylline is already covered under https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7901 which is listed as an "external link" at the bottom of the mitragyna speciosa page. Does a reference page from the US Natural Library of Medicine count as a literature review? My read of the Wiki policy is that it probably doesn't but maybe it does? Should the references after Rhynchophylline be removed with the Wiki link to Rhynchophylline being enough? Or should the whole sentence be deleted until mention of Rhynchophylline as NMDA antagonist is found in a literature review? I understand the reasoning behind why secondary sources are the only sources allowed on Wikipedia for health content. However, this particular section is on pharmacology rather than health effects so seems less subject to Wikipedia editor misinterpretation. Does the strict interpretation of the Wikipedia health content policy still apply for a specific pharmacology reference? What I suggest for now is that I leave the sentence as is and I will replace with a secondary source within 48 hours. Kevin143 (talk) 06:14, 1 October 2016 (UTC)

OK I went through and searched the Warner literature review and it does mention kratom as containing rhynchophylline though does not name NMDA antagonism. I changed the primary sources to that Warner link. Does that work, with the primary sources for NMDA antagonism then being cited in the rhynchophylline wiki article? Or should I leave all of the references? Kevin143 (talk) 06:22, 1 October 2016 (UTC)

The sourcing is not per-article but per-content. I didn't remove your edit because actually, for pure pharmacology content - something like "Drug A binds to receptor X with Ki of X, IC50 of Y, Kd of Z" - like what you added, WP:MED and WP:PHARM made an agreement that it is OK to use a primary source; however including a claim "and this causes side effect B" is not OK to say based on that primary source as that is a health claim. This arrangement troubles me as the primary literature is not necessarily reliable for this kind of thing; even in receptor binding individual labs can come up with different results. Have a look at how the receptor binding profile of 7-hydroxymitragynine is described in our article and its sources, to what Warner says, for example.

And for content that is not WP:Biomedical information - in this article, the "Taxonomy and etymology" section and the "Regulatory" section are not biomedical information and so MEDRS doesn't apply, just WP:RS. Jytdog (talk) 16:56, 1 October 2016 (UTC)

is 7-hydroxymitragynine really long enough that we need to abbreviate it?©Geni (talk) 18:53, 2 October 2016 (UTC)

It's not long enough that we're required to, no, but if referenced repeatedly the article would be more readable with it abbreviated. https://www.crcpress.com/Kratom-and-Other-Mitragynines-The-Chemistry-and-Pharmacology-of-Opioids/Raffa/p/book/9781482225181 is a textbook that uses the abbreviation 7-OH-MG for 7-hydroxymitragynine. Kevin143 (talk) 21:07, 4 October 2016 (UTC)

http://www.tandfonline.com/doi/abs/10.1080/02791072.2016.1229876 uses 7-OH as their abbreviation Kevin143 (talk) 00:17, 5 October 2016 (UTC)

"Some versions of the product contain other opioids." from lead

I don't think this is a proper generalization from the references. The first reference discusses krypton and the second reference discusses a kratom cocktail made in Thailand.

The krypton mix was the only documented occurrence of mixing kratom and other opioids for resale. The Thai kratom cocktail isn't a version of a kratom product.I think this statement should be removed from the intro section. Krypton and 4x100 are already discussed elsewhere in the article. The Karch reference could be used to expend the 4x100 section in the body Kevin143 (talk) 00:23, 5 October 2016 (UTC)

Yes which supports that some versions contain opioids.

Had already started discussion of this up here

Drugs.com states "As with many herbal alternatives, designer drugs, or illicit products sold on the Internet, the possibility exists that Kratom may also be contaminated with illegals drugs, black market prescription medications, or even poisonous products."[14]Doc James (talk · contribs · email) 16:52, 5 October 2016 (UTC)

Miscitation in Warner

I removed "as of 2015 people who consumed this were often viewed like methamphetamine and heroin addicts." from the article in the recreational use section.

Warner's paper says "users are sometimes compared to methamphetamine and heroin addicts". This sentence is followed by a reference to https://www.ncbi.nlm.nih.gov/pubmed/16837141 . This paper, "Substance use among high school students in Southern Thailand", does not mention 4x100 at all. It does not compare 4x100 users or kratom users to methamphetamine or heroin users, though makes some statistical claims about correlations in use patterns.

Before re-adding that statement, can you show me where in the source that Warner cites that that statement is made? I know that the Warner primary source makes that claim. I am stating that Warner made an error and his citation does not support this claim therefore that statement should not be on Wikipedia. Kevin143 (talk) 07:44, 8 October 2016 (UTC)

see here Jytdog (talk) 08:51, 8 October 2016 (UTC)

DEA source

This article appears to be relying heavily on unsourced DEA claims (presenting them as fact- itself a conflict of interest) as opposed to scientific/medical sources. Johnnyp123 (talk) 02:07, 12 September 2016 (UTC)

That is not a valid critique of a source in WP. Please read WP:RS. Thanks. Jytdog (talk) 02:22, 12 September 2016 (UTC)

The DEA is a reliable source? No the DEA isn't a reliable source. Articles should be based on reliable, third-party, published sources with a reputation for fact-checking and accuracy. The notice of intent from the DEA doesn't list sources. Kratom does not cause hallucinations, the only source on this page that claims that is the un-sourced notice of intent. — Preceding unsigned comment added by Moochee22 (talk • contribs) 20:39, 17 September 2016 (UTC)

As above, that is not a valid critique of a source in WP. Please read WP:RS. Jytdog (talk) 21:17, 17 September 2016 (UTC)

Then explain that the "valid source" you keep referring to is, in fact, "the "DEA", while also allowing rebuttal of those claims by additional primary and secondary sources that wholly dispute DEA's claims - and which are now, in fact, being litigated by lawyers and lawmakers and are available. We don't get to decide that one source is valid because it's a governmental agency, but other sources don't matter.Ronsword (talk) 18:13, 1 October 2016 (UTC)

It is a reliable source per MEDRS. Please name the MEDRS sources that contradict it. Thanks. Jytdog (talk) 19:05, 1 October 2016 (UTC)

Jytdog, I didn't say DEA wasn't a "reliable" source, I said contradictory 'sources' are not being allowed or voiced. FYI, please see Forbes article on Kratom (not as a 'reliable source' but as a link to recent peer-reviewed sources), published this Friday, September 30 by David Kroll, research pharmacologist. Kroll writes that "Columbia associate research scientist, Andrew Kruegel, PhD, was specifically cited in the (senators Corey Booker-Gillibrand-Wyden) letter to DEA as he led an 11-scientist letter of objection to kratom scheduling that was submitted to congressional representatives on September 2. Kruegel is also first author on a paper published in the Journal of the American Chemical Society in May showing the alkaloids in kratom act on opioid receptor signal transmission entirely differently than strong opioids such as morphine, fentanyl and oxycodone, posing less risk of respiratory depression". The JACS reference here, incidentally, is but one reliable peer-reviewed source on the potential safety profile and therapeutics of mitragyna; there are others I'll be glad to link you with. Best Ronsword (talk) 20:47, 1 October 2016 (UTC)

The only possibly useful source for supporting biomedical information, that you talk about is the JACS source, which is PMID 27192616. A primary source, not MEDRS; it cannot be used to support content about reduced risk of respiratory depression.

btw in Wikipeda we consider a source with regard to the content it is used to support. What content sourced to the DEA are you objecting to, at this point? Jytdog (talk) 04:22, 2 October 2016 (UTC)

Jytdog, thanks for getting back on the points raised above. To your question, please note, I'm not objecting to the content sourced by DEA. I do have a question, however, as to whether the DEA citations - left to stand without any additional information now emerging on mitragyna - presents a scientifically balanced picture for the general reader on this still new and emerging topic. You are likely more familiar with Wikipedia policy than I (regarding such matters as MEDRS, etc.), so I'm wondering whether the following information should, or should not be cited or referenced in the main article: A recent letter to DEA from US Senator Corey Booker and colleagues asks that DEA's proposed ban on mitragyna as an "imminent health hazard" be seriously reconsidered. Attached to the Booker letter is a September 2 letter that concurs with his request, drafted and signed by 11 eminent scientists affiliated with established research facilities. The letter includes 2 references to peer-reviewed journals (the JACS article noted by you previously, and another from J Med Chem). The subject of "improved respiratory safety" and "greatly attenuated tolerance" (as compared with opiate drugs for example)among other benefits, are emphasized in this petition. NOTE: The letter is in PDF format but, at your request, I'd be glad to insert its contents here on Talk page for review. In any event, thanks for your time.Ronsword (talk) 05:17, 2 October 2016 (UTC)

If you are not objecting to content sourced to the DEA ref, then we have nothing to discuss about the DEA ref.

With regard to the letter, per the WP:NPOV policy, we give WP:WEIGHT (space and emphasis) to ideas or events based on how they are discussed in the relevant kinds of sources (we look at several not just one). This is a "Society and culture" matter (not biomedical information) so we look at plain old reliable sources. So - was the letter from Booker discussed in major media like the NYT, WSJ, LA Times, etc? If so then sure we can add it in the US regulation section. If not, then it doesn't deserve WEIGHT.

Relying on sources like this (instead of what is important to individual editors) is a key to Wikipedia working. Jytdog (talk) 05:50, 2 October 2016 (UTC)

Thanks for the prompt reply. Haven't had time to check all national media coverage of the Booker letter, but I do know at this time and with certainty, that Forbes and Huffington Post both covered the story. Not sure what weight these carry? BTW- thanks for your patience.Ronsword (talk) 06:11, 2 October 2016 (UTC)

Also, the Washington Post reporting on a separate letter objecting to DEA proposal, sent by 9 additional senators.Ronsword (talk) 06:17, 2 October 2016 (UTC)

If you could provide links as you find them, that would be great. Thanks. Jytdog (talk) 06:23, 2 October 2016 (UTC)

Okay. Here are three links to national media publications and one Florida publication regarding congressional/senatorial actions this week concerning DEA ban; I can include more as more surface:

• Kroll, David. SEP 30, 2016 @ 10:44 PM. “DEA Delays Kratom Ban, More Senators Object To Process And 'Unintended Consequences'”. Forbes.
• Wing , Nick. 09/30/2016 02:42 pm ET. “Senators Ask DEA To Delay Plans To Criminalize Another Herb. Members of both chambers of Congress now want to take a closer look at the DEA’s plans to wage war on kratom.” The Huffington Post.
• Ingraham, Christopher. September 30. “DEA defies senators’ appeal to reconsider ‘unprecedented’ kratom ban”. The Washington Post.
• Stapleton, Christine. Sept. 29, 2016. “Kratom ban starts Friday: Frankel among lawmakers trying to delay it”. Palm Beach Post.
• Nelson, Steven. "Kratom Will Remain Legal for Days, Possibly Longer". September 30, 2016. US News and World Report.

-- Ronsword (talk) 16:55, 2 October 2016 (UTC)

Formatted proposed refs (btw, in the toolbar of the editing window, you will see "Cite" over on the right; if you click the little triangle another menu bar will appear. to the left are templates, if you select the correct one, and fill in one field that has a little magnifying glass icon by it, then click that icon, the template will autofill. Nice. You have to fix some fields sometimes, but url for news or websites works pretty well, and for journals, doing the PMID field does everything perfectly except the PMC field which you need to do manually. I did that below, then removed the ref tags)

1. Kroll, David (September 20, 2016). "DEA Delays Kratom Ban, More Senators Object To Process And 'Unintended Consequences'". Forbes.
2. Wing, Nick (30 September 2016). "Senators Ask DEA To Delay Plans To Criminalize Another Herb". The Huffington Post.
3. Ingraham, Christopher (September 30, 2016). "DEA defies senators' appeal to reconsider 'unprecedented' kratom ban". Washington Post.
4. Stapleton, Christine (September 29, 2016). "Congress members ask DEA not to ban kratom: opiod research needed". Palm Beach Post.
5. Nelson, Steven (September 30, 2016). "Kratom Will Remain Legal for Days, Possibly Longer". US News.

OK so the first two are really blogs. 3-5 are OK. The best sources would be top tier media like NYT, WSJ, LA Times, etc but those three will do. I will generate something... Jytdog (talk) 22:15, 2 October 2016 (UTC)

Thanks Jytdog for the concise explanation and input. It is duly noted and helpful.Ronsword (talk) 23:14, 2 October 2016 (UTC)

sure! Jytdog (talk) 23:16, 2 October 2016 (UTC)

Okay on the edits. Just wanted to vet a suggestion/additional comment regarding this paragraph excerpt: "A group of 51 members of the US House of Representatives and a group of 9 senators each sent letters to Acting DEA Administrator Chuck Rosenberg protesting the listing.......The DEA noted the responses but said that it intended to go forward with the listing; a spokesman said: "We can't rely upon public opinion and anecdotal evidence. We have to rely upon science"[37]. Note that the US News & World Report article sourced to that paragraph also included an update at the article's end which reads: "Update, 3:30 p.m.: David Kolovson, a spokesman for Rep. Mark Pocan, D-Wis., tells U.S. News that Pocan spoke with DEA Acting Administrator Chuck Rosenberg on Friday, and that Rosenberg indicated the decision to ban kratom will be postponed while the agency opens a modified public notice and comment period. Rather than enact the ban in the immediate future, "it appears the DEA will instead open up a modified comment process before a final decision will be made," Kolovson says. "While we do not know the exact timing or details of the new comment period for kratom, Acting Administrator Rosenberg assured Congressman Pocan that we will find out more in the near future."

Wondering if this should be added to the spokesman's earlier comment which occurred prior to the update? Let me know what you think! Thanks.Ronsword (talk) 18:12, 3 October 2016 (UTC)

Interesting. As the DEA didn't confirm that, let's wait until they make an actual announcement (and see if they do) Jytdog (talk) 18:27, 3 October 2016 (UTC)

Okay. (Since the spokesman's original quote is on the record, then any second-hand "assurance" from acting chief or whomever would be considered heresay or second-hand and thus, best to wait for official word, correct?) Ronsword (talk) 19:08, 3 October 2016 (UTC)

Great. Yeah I guess "hearsay" is a decent way to describe why not to use it now. We also talk about WP:CRYSTALBALL - we avoid adding content about what may happen in the future unless it is really certain. Jytdog (talk) 19:18, 3 October 2016 (UTC)

Thanks.Ronsword (talk) 19:27, 3 October 2016 (UTC)

Proposed update: On October 6, the DEA officially announced its intention to not proceed with its scheduling of kratom at this time, and instead, is allowing a public comment period and a review of the evidence via the FDA and other public and private sources. Scheduling, permanently or temporarily, or no scheduling awaits the results of this new appraisal. I'm recommending we revise accordingly. Thank you.Ronsword (talk) 20:35, 13 October 2016 (UTC)

Semi-protected edit request on 16 October 2016

Under the header Adverse Effects, the phrase

"adverse effects related to stimulation include include anxiety and agitation, ..."

should be

"adverse effects related to stimulation include anxiety and agitation, ..."

Please correct the double word typo "include include". Thank you.

H0r14 (talk) 22:57, 16 October 2016 (UTC)

Already done with this Cannolis (talk) 00:30, 17 October 2016 (UTC)

US Congress appeals to DEA for more time to review kratom

Published 5 Oct 2016.

The article states:

• on Aug 31, DEA placed a 30-day provision for kratom on Schedule 1 which infers the substance has a high risk of abuse and so should be controlled as having no apparent medical uses
• several US senators and congressmen have written letters to DEA here and here, asking that the review period be extended because, in their view supported by a letter from 11 scientists, kratom has potential as a replacement for opioid abuse, and is under current NIH-sponsored research for treating opioid withdrawal
• Forbes is reporting that the DEA is open to a longer timetable for review, with a petition signed by 140,000 people to stop the Schedule 1 implementation

--Zefr (talk) 16:57, 5 October 2016 (UTC)

much of this is already discussed in the article. The forbes posting is a blog there and needs to be handled gingerly and probaby not used at all; see [posting on that. am waiting for an actual statement from DEA on what they are doing. (note that this is the source used in the forbes blog, and even if we took that source as reliable, the DEA statement is completely noncommittal: "“I don’t have a timetable. It could be this week, could be in the future, I just don’t know,” DEA spokesman Rusty Payne told Pain News Network." Jytdog (talk) 17:39, 7 October 2016 (UTC)

Official withdrawal of DEA notice of intent for Schedule 1 classification, as published in the US Federal Register on 13 Oct 2016. Includes invitation for public electronic or paper comments ending 1 Dec 2016. --Zefr (talk) 16:40, 18 October 2016 (UTC)