Should link between dementia and artificial sweeteners be taken with a pinch of salt?

How peoples capacity for forgetfulness and lies may have impacted on research tying stroke and dementia to diet drinks

They were supposed to be the healthy alternative to their sugar-rich siblings. But now lovers of diet colas and other low-calorie drinks have been hit by news that will radically undermine those credentials: a counterintuitive analyse suggesting a link to stroke and dementia.

The study in the publication Stroke may cause a rethink among the persons worried about obesity, diabetes or a possible early heart attack from sugar-rich beverages who have been considering making a change. It comes to the alarming conclusion that people polishing off one can a day of artificially sweetened drink are nearly three times as likely to have a stroke or develop dementia.

Its a shocking conclusion. But the first reason to intermission is that the study determined no such hazard in people who drank standard sugary lemonades and colas.

There is little previous evidence with regard to dementia, which is why the researchers were looking at it, but the link between sugar and stroke is very well known. Too much sugar raises the risk of obesity, diabetes, heart attacks and stroke. Its altogether a bad thing, which is why the World Health Organisation is telling us all to cut down. So “whats going on” in this study?

The evidence it analyses is pulled from the well-respected Framingham Heart Study a cohort of more than 5,000 people in Massachusetts, US, whose diets and lifestyles have been monitored for nearly 50 years, with the main objective of used to identify more about heart disease. Along the route, researchers have looked at other health outcomes.

What they are up against is people capability for forgetfulness and lies. This is the case with every analyze into the food we eat except for those rare ones, almost impossible to do today, which have in effect incarcerated their subjects and controlled every sip and mouthful they took.Researchers understand this and to continue efforts to take account of it, but it is difficult.

There are several possible other reasons why an increased stroke hazard was associated with diet drinkings and not sugary drinks. One is what is called reversal causality. People who come to realise that they are ill and have a high risk of a stroke then switch their behaviour by choosing diet drinks long after sugary beverages have helped cause the problem.

When it came to dementia, the link with diet drinks that researchers ensure disappeared once they took specific aspects of the health of the people in the study into account. When the researchers accounted for other determining factor for Alzheimers, such as risk genes, diabetes, heart disease, cholesterol levels and weight, this significant association was lost, suggesting that these drinks are not the whole story, said Dr Rosa Sancho, head of research at Alzheimers Research UK.

The researchers point to it themselves: We are unable to determine whether artificially sweetened soft drink intake increased the risk of incident dementia through diabetes mellitus or whether people with diabetes mellitus were simply more likely to devour diet liquors, they write. But they call for more research and others will support them in that.

Artificial sweeteners have been viewed with mistrust by a lot of consumers for many years and not entirely deservedly. They are not natural, in the way that sugar is natural, being grown from beet or cane. Some of the hostility comes from those who worry about ingesting man-made chemicals. But while some artificial flavourings have been shown to carry health risks, examines have failed to find similar problems with artificial sweeteners.

Aspartame has been extremely controversial since its approval for utilize by several European countries in the 1980 s, says NHS Choices. In 1996, a study connected it to an increase in brain tumours. However, the study had very few scientific basis and later analyzes showed that aspartame was in fact safe to devour, says the NHS.

Large analyses have also been carried out to look at whether the sweetener increased cancer dangers, and gave it a clean bill of health. The European Food Safety Authority said in 2013 it was safe even for pregnant women and children, except for anyone with a rare genetic condition called phenylketonuria.

Dumping aspartame from its low calorie bestseller did not give PepsiCo the halo impact it hoped. In 2015, it announced it was taking the sweetener some people love to dislike out of Diet Pepsi and replacing it with sucralose. A year later, when it became clear Coca Cola would not follow suit and that fans favor their drink the style it used to be, it did a U-turn and set aspartame back in.

There have been huge efforts to develop artificial sweeteners that will taste as good as sugar and be acceptable to the doubters. Stevia, a plant extract, is marketed as a natural sweetener to the increasingly sceptical health-conscious.

Now it is not just drinks. Public Health England is putting pressure on food companies to cut 20% of sugar from their products by 2020. That will probably mean smaller chocolate bars, where artificial sweeteners merely wont deliver the same savour. But they will be part of the answer in other foods.

Sweeteners such as sucralose, which is 650 periods sweeter than sugar, have long been in breakfast cereals and salad dressings, while saccharin is in store-bought cakes, despite a scare over bladder cancer which caused the Canadian government to ban it as an additive in 1977. It lifted the ban in 2014. The safety debate will go on, but artificial sweeteners are likely to play a bigger part in our diet as the squeeze on sugar ramps up.

There are those, however, who suppose artificial sweeteners will never be the answer to obesity and the diseases that follow in its wake. The problem, in their view, is our sweet tooth and the answer is to reduce our liking for sweetness. So they want to see the gradual reduction of the amount of sugar in our drinkings and our food and snacks without it.

It worked with salt, says Cash, the campaign for action on salt and health, which did much to bring down the salt levels in our food without our noticing it. The same should be possible for sugar. But not if artificial replaces are used to keep our food and drinks tasting just as sweet as they did before.

Read more: www.theguardian.com

Fool’s gold: what fish petroleum is doing to our health and countries around the world

Omega-3 is one of our favourite supplements but a huge new survey has received it has little or no benefit. How did it become a $30 bn business?

The omega-3 industry is in a twisting. Again. Last week, Cochrane, an organisation that compiles and assesses medical research for the public, released a meta-analysis- a study of studies- to determine whether or not omega-3 pills, one of the world’s most popular dietary supplements, reduced the risk of coronary heart disease. After comparing 79 trials involving 112,059 people, the researchers could find” little or no change to danger of cardiovascular events, coronary heart demises, coronary heart disease events, stroke or heart irregularities “.

I can’t say that I was especially surprised. Over the past 15 years, more than 20 surveys have shown a similar absence of effect. But what does surprise me is how we continue to look at the world of fish and seafood through the amber lens of a fish petroleum capsule. Omega-3s do something in our bodies- and probably something important. But without the larger context of the marine organisms that contain them, omega-3s get lost in the noise of human metabolism and modern marketing.

The confusion develops in part from the historical luggage of fish oil and the $30 bn( PS23bn) industry associated with omega-3 extraction. Once upon a time, fish oil solved a major human health problem. But it had nothing to do with coronary heart disease. During the Industrial Revolution, a disease became increasingly prevalent throughout northern Europe: rickets. Malnourished children in sunlight-poor urban slums often aimed up bowlegged by adolescence. Researchers eventually pieced the puzzle together and concluded that the disease is a result of a deficiency in vitamin D, which the body naturally generates in the presence of sunlight. And, as it turned out, vitamin D is stored in high sums within the liver of codfish.

A Norwegian pharmacist named Peter Moller confiscated upon this finding( and many other anecdotal stories about the curative properties of cod-liver oil ). Using a patented chemical process, he arrived at a product that, he announced to the world,” didn’t taste fishy “. Moller and his advertising squad then launched a campaign to institutionalise the regular employ of cod-liver petroleum, regardless of whether you were at risk of rickets or not. The campaign was a success: a spoonful a day became common practice. Moller built his company into an international presence and died in 1869 with 70 cod-liver petroleum steam mills to his name, churning out 5,000 barrels of the stuff a year. By the time omega-3s started to be a focus of medical research, there was already a rosy impression around fish oil.

In the early 1970 s, the chemist Hans Olaf Bang read in a Danish periodical that there were extremely low incidences of cardiovascular disease in Inuit communities of Greenland. He and his assistant, Jorn Dyerberg, travelled to Uummannaq on the north-west coast of Greenland to investigate. At the time of the expedition, Bang didn’t quite know what he wanted to test for. They probed and palpated 130 local people, measured height and weight, and came home with a lot of blood.

” We had these 130 precious samples of blood ,” Dyerberg told me in his laboratory in Copenhagen recently. They estimated that in 20 years, the traditional Inuit diet would have changed to the western diet, and Dyerberg recollects Bang saying: “‘ There will never be anyone who can do this again, so let’s do whatever we can !’ And we decided to do fatty acid analysis .”

The result of their analysis was a hypothesis that is an exemplary” association examine “. In an association analyse, multiple factors are logged and a hypothesis of correlation is drawn from the findings. In the case of the Bang and Dyerberg Inuit study, they found that: 1) Inuit people in Greenland had a diet high in omega-3 fatty acids and blood lipid levels of omega-3s much higher than their western contemporaries. 2) Inuit people also had, according to public health records, markedly lower rates of coronary heart disease. They hypothesised that therefore 3) omega-3s might reduce the risk of coronary heart disease.

This was backed up by further laboratory analyses that did demonstrate, in vitro, that omega-3s were involved in anti-inflammatory reactions. But- and this is a big but- while correlations abound for omega-3s and heart disease, the real trouble has always been in proving causation. That is where this latest round of studies comes in.

The Cochrane study and the others that preceded it have one thing in common: they are meta-analyses of” randomised control trials”( RCTs ). That is, trials where patients are given a supplement at random and tracked over time against another set of patients given a placebo. Most statisticians consider these trials to be the very top of the evidence pyramid. But it is these studies that have at times proven troublesome for Omega World. Each day RCTs come to illuminated that display little or no effect, Omega World tends to blend its counterargument with proof from association surveys because, as a recent industry reply to the Cochrane report put it,” it’s all connected “.

When it then turns to the RCTs, the industry, as would be expected, looks for different explanations as to why positive health outcomes weren’t reported. In the explosion of RCTs preceding Cochrane, the Omega World line was that these most recent trials did not show benefits because things such as statins, stents and other forms of cardiovascular intervention masked the anti-inflammatory effect of fish petroleum pills; earlier RCTs had shown a fairly significant effect, but none of those treatments existed at the time of those trials.

The industry also, and I believe rightly, pointed out that surveys often failed to look at omega-3 blood lipid levels before and after supplementation. In other terms, it’s not really a fair trial if you don’t know where the patients started with respect to the omega-3 levels in their blood. If we only measure impact without looking at omega-3 levels in the blood at the outset, aren’t we doing the dietary equivalent of testing how far a auto can drive without checking how much petrol is in the tank at the start?

With Cochrane, the latest industry debate is that the study’s authors cut out a number of different forms of cardiac ailments, thus skewing the stats. In particular, it notes that Cochrane failed to include” sudden cardiac death” and” sudden cardiac mortality” in its listing of outcomes. Since almost half of all patients first report heart disease to their doctors by abruptly falling dead, this is not an insignificant exclusion.

But the fact that the industry’s debates shift with each new, damning meta-analysis gives you intermission. What is going on? Is there an international conspiracy to discredit omega-3s? Or does Omega World keep moving the goalposts? When I posed this question to Ellen Schutt, the executive director of the Global Organization for EPA and DHA Omega-3s, probably the world’s most prominent omega-3 advocacy organisation, she made it seem as if the problem didn’t even exist.” As a matter of fact, we track media sentiment … and have found many more positive omega-3 tales than negative, in general. Of course, the negative stories are the ones that catch people’s attention. As we both know, negative tales are much more interesting and the media is definitely guilty of sensationalist’ clickbait’ headlines such as:’ Omega-3s don’t work .'”

As sympathetic as I am to the trials of Omega World, as analyzes continue to poke holes in aspects of the omega-3 cardiovascular argument, I can’t help supposing there is something else going on. Because, while the fish petroleum supplement business is a big deal, it is also a sheen on the surface of a much deeper pond. Long before omega-3 supplements became popular, an industry developed that used the same omega-3-rich animals not for medication, but for an odd array of agricultural and industrial purposes.

Ultimately, it was this so-called ” reduction industry” that created the oily-fish extraction system that now devours millions of tonnes of marine wildlife every year. Today, one in every four kilograms of fish capture is reduced into oil and snack and used for agriculture, land animal husbandry and, most recently, fish farming, AKA aquaculture.

The reduction industry has appeared in different forms under different ownership over centuries of human history. In the 18 th century, it targeted whales, reducing northern hemisphere cetacean populations into isolated pockets of endangered species in order to attain lamp oil and lubricants. In the 19 th and early 20 th centuries, it shifted to the southern hemisphere, reducing 390,000 of the 400,000 great whales that once wandered the Southern Ocean to margarine, nitroglycerine and other ” marine ingredients “.

In the latter half of the 20 th century, it changed again and targeted small, oily fish such as anchovies, sardines and herring. In the late 1940 s and early 1950 s, the largest reduction operation in human history started off the shores of the Peru in pursuit of the Peruvian anchoveta. The Peruvian anchoveta is by far the largest single species catch by tonnage in the world, some years comprising as much as 10% of all fish caught. And although Peruvian anchoveta are as delicious as any anchovy on Earth, an industry-influenced Peruvian statute dictates that more than 95% of the catch must go to the reduction industry.

Each decade brings a different used only for all those anchovies. In the 1940 s, they were used for fertiliser. In the 50 s and 60 s, chicken feed. In the 70 s, pet food and pig feed. In the 80 s and 90 s, aquafeed for salmon and other carnivorous fish. And now, the most upper-class product of the reduction industry: dietary supplements.

And it is not just Peruvian anchoveta that are reduced into fish dinner and oil. All told, the reduction industry removes from the ocean 20 m-2 5m tonnes annually- the equivalent of the combined weight of the population of the United States. The omega-3 industry argues that some vendors are turning to much more sustainable alternatives, such as algae-based omega-3s and fish petroleum reclaimed from recycled byproducts.

Nevertheless, the reduction industry processions on into new territory. Most recently, it has begun targeting Antarctic krill, the keystone prey species of the entire Antarctic ecosystem. Two years ago, when I asked the then chief executive of the largest krill extractor in the world why it had launched a $200 m fishing operation in the Southern Ocean to take food out of the mouths of whales, he noted that krill oil is a “phospholipid” and building it much more “bioavailable” means that consumers can take a much smaller pill. Why was this important? Customers who chose krill oil over fish petroleum would be much less likely to suffer the horrors of a fishy burp.

Amid all the conflicting reports, there is one bit of data that glistens out: fish and seafood can bring considerable health and environmental benefits. Fish, in addition to providing us with omega-3s, delivers protein with far fewer calories than meat: 100 g of salmon contains 139 calories and 23 g of protein. By comparing, 100 g of beef contains 210 calories and 20 g of protein.

Harvesting wild fish from well-managed stocks requires a fraction of the carbon as farming terrestrial livestock. Similarly, fish agriculture puts a lesser burden on the Earth in terms of carbon and freshwater use than pretty much any form of terrestrial animal husbandry. We could attain the farming of fish even more carbon- and resource-efficient if we used alternative ingredients for fish food based on algae and food waste. And if you consider growing” filter feeders” such as mussels, clams and oysters, the benefits are even more extreme. These bivalves don’t have to be fed anything, and make water cleaner even as they grow fatter. They provide protein 30 times more efficiently than cattle.

Is the epidemiological proof for fish-eating better than simply taking a fish oil pill? Again, we are stuck with the problem of correlation versus causation. It is very difficult to feed person a fish in such a manner that they don’t know they are eating a fish. Hence an RCT of seafood-eating hasn’t really ever been done. Most of the studies around seafood are association analyses. And, while one such analyze associated feeing fish twice a week with a possible reduction in mortality of 55, 000 lives a year, we don’t know what a fish-eater does with the rest of their life beyond feeing fish.

But what we do know is this: the omega-3 industry and the reduction industry that bred it removes fish from the water in a way that doesn’t put protein on our plates- it merely puts pills in our cupboards. Is this the way we want to continue to do business with the planet?

Paul Greenberg is the author of The Omega Principle: Seafood and the Quest for a Long Life and a Healthier Planet ( Penguin Press ).

* The subheading of this article was revised on 25 July 2018 to clarify that it was for heart health or strokes that the study observed omega-3 had little or no benefit.

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This Giant Invasive Flower Can Give You Third-Degree Burns

The giant hogweed is hard to miss. The monster plant towers up to 15 feet tall, with a crown of white blooms the size of an umbrella. They burst into bloom between the last week of June and the first week of July–just in time to be the perfect dramatic backdrop to red-white-and-blue-themed parties.

But whatever you do, don’t touch it. The giant hogweed’s toxic sap could give you third-degree burns if you don’t get out of the sunshine and wash it off immediately. Like an anti-sunblock, chemicals in its juices interrupt your skin’s ability to filter out harmful UV lights. Get it in your eyes and you could go blind.

In places where hogweed has been around for decades, residents know its risks well. But while the majestic bloom of the hogweed adds a courtly presence to any landscape, it is an invasive species–producing up to 120,000 winged seeds at a time. In the mid-1 900 s it expanded across New York state, carried on the riverways it likes to grow near. It hopped into nearby Pennsylvania, Ontario, and then on into Michigan. About 15 years ago it invaded Ohio. Today it’s seen sporadically in more than a dozen states–and it’s still spreading, putting more people in harm’s way.

In mid-June, Virginia agriculture officials confirmed the plant had been found for the first time in the country, at sites in three separate counties. In all three instances a property owner had planted the invasive species intentionally–just as early Americans had in some of the nation’s first botanical gardens. One person bought the seeds at a farmer’s market, where they were misidentified as the herb angelica. At another, the planted specimen had spread its seeds across a nearby pond, sprouting more than 100 new plants.

For now though, country agencies believe those sites are contained and say the plant isn’t spreading in the wild. But they are investigating the flood of reports from concerned citizens. Giant hogweed is one of three plants listed as Tier 1 noxious weed in Virginia, entailing it’s considered a major threat to the surrounding agricultural environment, and its trafficking is highly regulated. So it’s get people on high alert.

“We’ve been getting calls and emails with parents afraid to let their children outside, ” says Elaine Lidholm, a spokesperson for the Virginia Department of Agriculture. And rightly so. Hogweed sap contains a class of chemicals called furocoumarins that assimilate specific wavelengths of illuminate. Those excited molecules bouncing around in scalp cells causing DNA damage and cell death, beginning with the blisters and a raised rash. The more hour you spend in the sunshine, the more energy they assimilate, injury tissues even further down, which can result in second- and third-degree burns.

Other plants and foods can induce similar symptoms of phytophotodermatitis–like limes, figs, carrots, and celery. But none of them are as potent as the hogweed.

Luckily, most of the photos the agricultural department has received turn out to be one of the commonly used lookalike plants–Queen Anne’s lace, otherwise known as wild carrot. Cow parsnip is another one that’s easily mistaken for its dangerous cousin. One route to tell them apart is to look closely at the junction where the plant’s leaves meet its stem. “If you consider coarse white hairs and a splotchy purple, reddish mark on the stem, that’s a good clue you’ve got giant hogweed, ” says Michael Flessner, a weed science specialist at Virginia Tech.

It’s always better to report a sighting if you’re unsure, though. Flessner recommends taking a photo with someone in it for scale and marking your GPS location if you think you’ve found one, so you can report it to local agriculture officials afterward. In nations where the plant has become endemic, it’s routinely exterminated and monitored to make sure it doesn’t get out of control.

Hogweed’s story is like that of most of America’s other invasive plants; an fled from a garden into the wild, where its prolific seeding bullies out endemic species. These invaders can reduce plant diversity until a scenery can no longer supporting native communities of wildlife. Hogweed also employs its size to its advantage; its dense canopy steals sunlight away from lower-growing stream-side plants, which can’t compete in the tint. But unlike America’s other top invaders–plants like purple loosestrife, Japanese honeysuckle, and kudzu–hogweed also presents a serious health hazard to humans.

However, getting rid of a giant hogweed is easier said than done. In addition to that prolific seed-shedding flowerhead, the plant sends down a tuberous root the size of a Volkswagen that can be nearly impossible to dislodge. “If you cut down the plant before it’s had a chance to flower, it’s smart enough to know that and it will come back the next year, ” says David Marrison, an Ohio State Extension scientist.

Every few years Marrison gets a call about a plant that keeps popping up under a covered bridge in Ashtabula County. “You have to stay on top of these things, because if left unchecked, pretty soon entire regions will be overrun by this plant, ” he says. “It will only choke out everything.” He’s got a note on his desk right now to go check it out.


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Why is the US banning kratom, the virtually harmless herb? | Marc Lewis

It acts on opioid receptors, hence the panic. But since some heroin users take it to ease withdrawal, its prohibition could have some very harmful effects indeed

Just this morning I got an email from a head shop Id dropped into on my last trip-up to San Francisco. I didnt recall leaving my email address, but I surely remembered the shop, festooned with fascinating herbs in colorful packets, unfamiliar plants, water pipes like octopi, merging esthetics with efficiency. Sunshine streaming through the windows and the scent of incense, barely noticeable but enchanting as always.

I was visiting the haunts of my hippy days, the famous intersection of Haight and Ashbury, and of course everything looked so much cleaner, more commercial, and, well, more legal, than it had back then. But what to buy? I dont commonly take medications anymore, legal or not, but I distinguished the name kratom on several vividly coloured pouches on display behind the counter.

Kratom( Mitragyna speciosa) is sold as the crushed-up foliage of the kratom plant, grown in jungles throughout southeast Asia. You can stimulate kratom tea or dissolve it in juice to experience its effects, and its become increasingly popular all over the Western world( though its been around for centuries ). You can buy it at head shops, hundreds of internet website, and now at kratom bars popping up in Los Angeles and other happening places. Plainly some people enjoy this legal high.

Kratom was indeed the subject of the email, and the tone of the message was urgent 😛 TAGEND

Important Info Considering the Future of Kratom

In case you havent heard, theres a very important developing regarding your access to this safe and incredibly helpful herb!

And then:

On August 30 the DEA announced their intention to place Kratom on the Schedule I list of substances starting September 30.

You can read all about this remarkable decision by the medication police. Theres a tidy article in Forbes, theres lots on YouTube, and the DEA sitesuccinctly states their rationale 😛 TAGEND

The Drug Enforcement Administration( DEA) today announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act in order to avoid an imminent hazard to public safety.

The first thing you should know is that Schedule I medications most famously heroin, and somewhat embarrassingly marijuana and LSD call for the most severe controls and penalties.( Meth and cocaine are nearby on Schedule II ). So the kratom user may end up cell-mates with meth and heroin addicts.

The second issue is why? Whats the imminent hazard to public safety?

I wasnt well informed any hazard when I asked the pierced young lady behind the counter what type of kratom I should try. I had taken kratom with a friend in the Netherlands where I live. Here its fully legal and sold in stores, as it is in most( but not all) Western countries. Kratom happen to be illegal in Thailand, apparently because it undercuts the lucrative opium industry.

I hadnt felt much the first time Id taken kratom and wanted to give it another try. So I asked the young woman what she recommended and she brought out a menu card. Midnight Blue is the most relaxing, Sunrise is sort of stimulating but melloweds you out at the same time. Starshine just helps you feel … centered. Each mixture was touted to profer a somewhat different buzz. So I bought got a couple of packs for about $20 and got a little … high?

High is a strong term for what kratom actually offers. This plant is just one of a list of age-old plants and herbal extracts that stimulate people feel a bit peppier, a bit happier, a bit more relaxed. A list that includes St Johns Wort, ginseng, wild lettuce, coffee( yes, coffee ), kava, lavender, valerian, betel nut the listing goes on and on. The word medicinal is sometimes use. But high? That would be stretching it.

You can read all about kratom on the web, but perhaps one reason the DEA considers it an imminent hazard is because part of its impact comes from inducing opioid receptors. You know, those receptors that get you smashed when you shoot heroin. Anything that stimulates opioid receptors and makes you feel pleasant must be very dangerous, so we shouldnt take any opportunities. In fact, lets ban alcohol( martinis owe much of their buzz to opioid receptors ), lets ban jogging( that notorious runners high a long, gale road to the gutter ). And while were at it, lets ban breast milk, which helps babies feel relaxed because it too induces opioid receptors.

But kratom is not an opiate. The molecule isnt even vaguely related to morphine or heroin. Its merely an herb. Its impossible to overdose on kratom. Youre likely to get a headache if you take too much. The roughly 20 deaths attributed to kratom in recent history are thought to be caused by other narcotics: the National Institute on Drug Abuse notes that commercial forms of kratom are sometimes laced with other compounds that have caused deaths. And having regard to the 88, 000 deaths a year linked to alcohol and the 28, 000 overdose demises from opiates( heroin and analgesics) in the US alone, it seems someone isnt doing their math.

Is kratom addictive? Maybe a little. But not as much as coffee and cigarettes or Q-tips, tattoos, and Pokemon Go. And if you take it daily, guess what? It loses its effect.

Ive made the DEAs announcement sound silly, even stupid. There they go again, banning whatever bothers them until voters in Colorado or somewhere start to object. But theres a terribly tragic outcome to be expected if kratom is banned. Because kratom attaches to opioid receptors, its an ideal route for heroin addicts to get off heroin with minimal withdrawal symptoms a harmless, herbal methadone replace. This folk-wisdom is splashed all over the net and freely shared among drug users. If kratom is banned in the US, many heroin junkies who want to quit will go back to heroin instead, and many, many more people will die.

Read more: www.theguardian.com