Why Kratom and Cannabis "Don't" Mix

Learn the Risks of Using This Drug with Your Medical Marijuana

Episode Transcript

Speaker 1 (00:01):
From the WA and M Studio on the campus of
Florida A and M University.

Speaker 2 (00:04):
This is Mary Forum Radio, a weekly conversation on the
education and research of the medical marijuana being conducted to
at FAMU.

Speaker 3 (00:13):
HI. I'm Heidi Outway, your host for this conversations on
Cannabis Virtual form, brought to you by the Medical Marijuana
Education and Research Initiative at Florida and M University. In
this conversation, we're talking about credom and a synthetic version
of the herbal supplement that is now banned in Florida.

(00:33):
So let's talk and learn about this subject with our guests.
Bob Durkin is an attorney and registered pharmacist who is
recognized as a leading authority on FDA regulation. He is
also the former acting Director and Deputy Director of the
FDA's Office of Dietary Supplement Programs, where he shaped policy,

(00:55):
led compliance and enforcement initiatives, and participated in key working
groups on marijuana, CBD, and investigation on new drugs. Our
other guest is doctor Deirdre James and Associate Professor of
Medicine at the University of Tennessee Health Science Center in Memphis.
She graduated from Harry Medical College in Nashville before completing

(01:18):
her internal medicine and in indocrine training. She is currently
double board certified in Internal Medicine and Endocrinology, Metabolism and Diabetes.
Doctor James also educates trainees across several healthcare professions and
as active in clinical research. I want to thank you
both for participating in this forum. To everyone watching, please

(01:42):
share the link to this forum on your social media
channels so others can learn about this topic. We also
want you to tell us what you think about this
forum by completing the survey that will be posted on
Mary's social media pages. Your name will be entered into
a drawing in November twenty twenty five when a one
hundred dollars gift card provided by one of Mary's partners.

(02:04):
Now let's start this conversation on cannabis. So, Bob, I'm
gonna come to you so you can plant the flag
and tell our listeners and viewers.

Speaker 1 (02:12):
What is cretom?

Speaker 4 (02:14):
Thank you very much, very much. Very Creatum is a
name that's come to encompass a lot of different things.
Technically speaking, Creatim is the common name for free at
the city is tree found in Southeast Asia. Called Mitrogenis speciosa.
It's part of the Rubenet's family, the same family as coffee.
Creative has been used for millennia in Southeast Asia for

(02:36):
general wellness, for general pick me ups, and energy. It's
become popular here in the United States over the last
twenty or twenty five years. But I think you sort
of hit on in your introduction that kreatum has become
just a vernacular for a lot of different things. It's
become vernacular for the ground leaf. It's become common vernacular
for an extraction from that leaf. And unfortunately, as of late,

(02:59):
it's begun to include seven hydroxy matrageny, which is an alkaloid,
a chemical similar to the chemicals or some of the
components found in creative leaf, but it's not actually found
in creatim. So some hydroxymetragedy in or seven oh H
is a distinct article, a distinct a different thing than
creatim And that's what is scheduled right now in the

(03:22):
state of Florida.

Speaker 3 (03:23):
Yeah, wow, doctor James, would you like to add anything
to that? And then also I want to hear your
perspective on how cretom impacts the.

Speaker 2 (03:32):
Body, So excuse me, so when we think about creatim
and how it impacts the body. At lower doses, it
will increase alertness, and so you see people who will
actually mix it with coffee, so they'll actually mix it
with caffeine and things of that sort to increase alertness
and feelings of vitality. We're talking about one to five grams. However,

(03:55):
when you get to the higher doses, that tends to
have more potential sedative potential as well, more like the
opiates that are classically found, you know, the actual prescription opiates,
because it does attach to that new receptor, and so

(04:18):
people will falsely think that crative is safe because it's
mostly over the counter or something that you can order online. However,
it can cause severe liver damage, especially if you have
something that is already predisposing you to liver damage. It
can cause psychosis, especially in the developing brain. So we

(04:40):
see more young people taking this because it's a legal substance,
and these adolescents who still have not yet completely formed
all of their brain mass and completely formed all the
logical thinking. Once again, you can have a learning difficulties
and all of those things. So it really can just

(05:02):
make things much worse Furthermore, because it is an unregulated
market for the most part, you have people who will
mix kradi or once again, as mister Dirkin acknowledge, once again,
that is a general term. So they'll mix whatever substance

(05:23):
that they're calling credom with other medications. They'll mix it
with something called tramadol and they'll call it krypton. Tramadol
is an opiate like substance as well, attaching to those
view receptors as well as they will mix it with
other substances and so it will cause even more sedative effects.

(05:46):
So it is just something that once again people will
think they'll get a false comfort level because it is
over the counter and think it's safe, and it can
be detrimental even deadly.

Speaker 3 (06:00):
Yeah, so doctor Bob, she talked a lot about this.
You know you can get it over the counter. Can
you talk about.

Speaker 4 (06:05):
Or I appreciate so well the way doctor framed the
situation just now. So creatim by itself, Creatum is not
a classical opioid. Creative is comprised of hundreds, if not thousands,
of different types of components alkaloids, flavenoids, polyphenic compounds, different
types of compounds, and creatum is a natural substance, is

(06:28):
not an opioid. Some of the alkaloids that could be
isolated from creatom do have affinity for the move opioid receptor,
but they're not fully even partial agonists. They hit the
receptor differently. The pharmacology of creatum and its alkaloids are
it's really sophisticated. It hits at least four different types
of receptors kypnogic, adrenergic, opioid. A lot of things go

(06:49):
am with creative. It's really complex. Doctor did mention some
liver damage and she mentioned that creatum can be mixed
with things, and it turns out that the liver damage
associated with creatim was actually associated with the metabolite of tramadol.
Creative early on was contaminated with methyl tramadol, a metabolite

(07:10):
of tramadol. It was over in Sweden. It was back
in about twenty twelve, and it killed about twelve people,
and the Food and Drug Administration's early response to that
was to say all creatim is bad. Upon further investigation,
it worked out that it was actually the tramadol metabolite
that the Creatim was contaminated with is what caused delivered

(07:33):
damage in people. Doctor mentions that creative's unregulated, but it
really is regulated. It's regulated by the Food and Drug Administration.
It's regulated by the state of Florida. As we know,
a lot of creative on the market is sold as
a dietary supplement. Dietary supplements are a certain type of food,
and there's a whole section of the Food, Drug and
Cosmetic Act is certain regulations in twenty one CFR that

(07:57):
do regulate cratim. So creatim is regular related and I
think consumers should know that. And when consumers go to
buy creative, they should look for certain They should look
for creative that's packaged correctly, that has a complete label,
that is labeled as a dietary supplement, a supplement fax
panel on the back that provides all the components and
constituents of what's in that product. Most importantly, they should

(08:20):
buy a product that has directions or conditions of use
about how to use it. Aware of the product. Know
that some of the products are just plain leaf. Some
of the product extra and unfortunately, some of the things
that call themselves creatim, like seven hydroxymetragedy, are not creatom
and are not safe.

Speaker 3 (08:38):
Talk about that, but.

Speaker 4 (08:43):
It is. It is, ma'am so. Creatim is a botanical
and as I mentioned, it's it's made up of a
lot of different little components. Some of the components about
fifty are called alkaloids, major alkaloid, and creative is matragedy.
What people are doing is they're pulling matragedy out of cretom.
They're using typical pool chemicals to oxidize the matrageny.

Speaker 3 (09:07):
You said pool chemicals.

Speaker 4 (09:08):
I did, Yes, They're using simple pool chemicals to oxidize
to change the matrageny into something that's called seven hydroxy matrageny.
Seven hydroxymetrageny is not naturally found in the leaf, so
they're pulling a natural part of the leaf out chemically
altering it in the seven hydroxy matrogeny. Seven hydroxymetrageny is

(09:32):
arguably opioid ag not even a partial, a full agonist
that has twenty two times the affinity for the opioid receptor,
the morphine. As we mentioned earlier, there's been reports in
California of where seven hydroxymetrageny is associated with the depth
of at least four people. It's causing reperiatory depression, and unfortunately,

(09:56):
some people have been safe because there's beenloxon available. So
when people overdose on seven hydroxymetragedy, the loxom will reverse it.
When people take creative and they have side effects, and
the loxome will not reverse the side effects because creatim
is not an opioid, where seven hydroxymetragedy is probably a
full agonist agonist of the opioid receptor.

Speaker 3 (10:20):
Well, doctor James, would you like to add to that,
And I just want to share I read an article
this morning before we started recording and they're calling this
seven H gas station heroin with an increased use by
young people. So doctor James, let me get your perspective
on that.

Speaker 2 (10:37):
So I would like to clarify my statement when I
say unregulated.

Speaker 1 (10:41):
So when I think about.

Speaker 2 (10:43):
Medications drugs, and I think about FBA regulation, if you're
going to pick up your medication, ninety eight percent of
that medication, even if you get the generic, is that
pure medication, and it's going to be within the amount
that it's supposed to be. So if I'm supposed to

(11:03):
be on tenmilligrams of this medicine, ninety nine percent of
every single pill will have that amount of medication in it.
And so that's the level of regulation that I'm referring to.
When I think about Kreatom. We do not have that regulation,

(11:23):
and that those stipulations that come with it depending on
Just like mister Derrickan mentioned, if depending on what source
you get this from, is that the whole planet is
that just leaves. We don't necessarily you don't really know
what you're buying basically, and so I think for people
who are more Internet savvy and have looked more into it,

(11:47):
then they will be able to get something that is
more pure and something that is less dangerous. But when
we think about overall risk and benefits, then it is
I do not believe. And that's what we think. You know,
when we think about physicians, right, we think about the
hipocratic Oh, we think about doing no harm, and we think.

Speaker 1 (12:08):
About risk and benefits.

Speaker 2 (12:09):
And so when we think about risk and benefits, then
the risk of taking Creatom far outweigh the benefits. There
are other medications and other lifestyle changes that can be
made that may have some similar effects.

Speaker 1 (12:24):
Now, I think the ones.

Speaker 2 (12:26):
That are the data that I have seen that is
the most convincing is the data that may discuss being
able to wean off opiates.

Speaker 1 (12:38):
So people will use creatom.

Speaker 2 (12:40):
To try to wean off of whatever opiates or working,
you know, whatever prescription medications that they're on. It will
kind of lessen the withdrawal side effects, which can cause
some sleeknessness, some agitation, things like that. However, when you
with kreatom itself, and especially with the seventeen old age,

(13:01):
it has addictive potential itself, and so you can get
some so you can basically trade one medication for another.

Speaker 1 (13:08):
That's firstly.

Speaker 2 (13:09):
Secondly, when it comes to these medications, once again, if
you are thinking you're buying cratium, but then by seventeen
old age and then you take it at the same dosage,
now you're at higher risk of overdose and things like that.

Speaker 1 (13:23):
And so I think that's where people really get into trouble.

Speaker 2 (13:26):
And once again we have people who are like you
mentioned on the article that you saw this morning. These
are adolescents who may not be asked savvy, and not
only that, they may not necessarily.

Speaker 1 (13:38):
Know the difference.

Speaker 2 (13:39):
Also, if your friend gives it to you, and of
course you know with these young adults, the friend is
the law. So if your friend has told you something
or give you something, then you're gonna take it like it's,
you know, a safe thing to do because my friend
recommended this to me, at least from a young person's perspective.
And once again that gets people into trouble because they

(14:00):
may not have even bought it them.

Speaker 1 (14:01):
Fails that point.

Speaker 4 (14:04):
I'd like to point out that dietary supplements are very
regulated under the Food, Drug and Cosmetic Act. There's good
manufacturing practices that must be followed that are very similar
to those for drugs. The labels have to be very accurate.
As a matter of fact, that the labels for dietary
supplements are required to be more accurate than those for drugs.
A drug allowed to have a plus or minus ten

(14:26):
percent variance and the amount of active ingredient. A dietary
supplement at the time of expiration, by law, is required
to contain one of what's on the label, you know,
dietary supplements. The labels have to be very clear. They
have to have exactly what's in the product. So I
think if someone's buying something that they would consider gas
station heroin, they're making a poor choice and their their

(14:49):
purchasing decision. I think be mindful about what they buy
and where they buy it. Buy it from a trusted source,
a good source. They have to be. They have to
vet the label. They have to look and see if
that has the information that they require. Many manufacturers and
distributors of Kreatim products are registered with the Food and
Drug Administration and have been inspected by the Food and

(15:11):
Drug Administration, and FBA has found some problems with their
manufacturing because they always do, but they haven't shut anybody
down for their manufacturing operations. So there are reputable products
on the market. But to doctor's point, you shouldn't be
buying something that looks like gas station heroin. You should
be buying a product that looks like it was well made,
looks like it was proper, that you'd find in a

(15:33):
pharmacy or in a convenience store.

Speaker 3 (15:37):
Them in a convenience store.

Speaker 4 (15:39):
Believe it or not, Creatim has sold the convenience stores.
It's sold at seven to eleven.

Speaker 3 (15:42):
That is it legit? I mean, is it safe in
a convenience store.

Speaker 4 (15:46):
Creatum is legal. Creative is legal under the Food, Drug
and Cosmetic Act. People Creative might be an old dietarian ingredient.
Creative belief has been used for twenty thirty years. There's
stories of veterans bringing it back from Vietnam out and
use that has been grown in use in Hawaii for decades,
So it's involved. It's evolved quite from a very sophisticated

(16:10):
marketplace over the last fifteen years. Oh and some of
the folks, just for perspective reading the adverse event reports
out of California, some of those people were in their forties.
Some of those people were adults that made informed decisions.
It's not always just adolescents. So we need to be
sure that we're giving you know, really good advice and
good information to everyone to make an informed purchasing decision.

Speaker 3 (16:33):
Yeah, doctor James, do you have any research that you
or Bob could reference when it comes to creative use,
any research out there that we could share with our
viewers and listeners.

Speaker 2 (16:46):
So when it comes to supplement use as far as
creative a lot of times it's not as well documented
as say, for instance, if you actually.

Speaker 1 (16:57):
Go and pick up things from prescription.

Speaker 2 (16:59):
This kind of more of a payer trayal versus somebody
that just goals into a grocery store and.

Speaker 1 (17:05):
Things like that.

Speaker 2 (17:05):
So we don't have any hard and fast numbers, we
can't necessarily talk about prevalence and how many people unnecessarily
use it. I think also, you know, we have to
think about the side effects that we you know, commonly
associated with creatom is, usually because of long term use.

Speaker 1 (17:22):
It's not one of those things I.

Speaker 2 (17:24):
Think, I'm going to go on a drive across the
country and so I just need to take a little
bit of low dose as a stimulant just this one time.
It may not necessarily be from those very short term uses.
It may be from more long term use. But unfortunately,
because we don't have like a prescription or anything like that,

(17:46):
we don't have a lot of data. Another thing is
when it comes to supplements, even when these things are tracked,
some people may not be asked forthcoming with supplement use.
So you'll ask what the case drawn. Even work control
feels to be honest. People, you know, they may say no, no,
I'm not on any medications because they always think about

(18:07):
blood pressure medications down be these cholesterol They.

Speaker 1 (18:10):
Don't necessarily think.

Speaker 2 (18:11):
It's almost like if I say, are you on any
medications and you tell me no, but you actually drink
coffee every day, when you may think of kratim just
like a little coffee, just a little pick me up,
just like a red bubble. And so we don't really
have a lot of hard and fast data. We have
a lot of case reports and things like that, and
that's you know, one of the things that when we
think about medications, like if you know, we see the

(18:32):
GLP ones like o zipig and the zeppetide everywhere.

Speaker 1 (18:36):
They've done.

Speaker 2 (18:38):
Year studies that are years long with one hundreds of
thousands of people, and so we can know the side
ef fake profile, we can we can know the safety potential.
But since we don't have these randomized controlled trials like
we do with krayton, and they may be you know,
down the line, but we can't necessarily talk a lot
about the safety potential.

Speaker 4 (19:00):
To doctor's point, it is not as well documented as
with an approved drug. But there have been many studies
that have looked into creatum leaf and a lot of
the major alkaloids of cretem that show they can be
used safely. As a matter of fact, the Food and
Drug Administration about a year and a half ago did
a single ascending a dose study of kretum and in
that study they found up to twelve grams. Twelve grams

(19:21):
taking in one serving caused no adverse events. And that
was a study conducted by the Food and Drug Administration
in cooperation with the University of Florida just down the
road from you, folks, where twelve grams at one dose
was shown to have no side effects. So there is
a basis for safety. There's a long, long millennial history

(19:41):
of use in Southeast Asia creedum, so there is a
basis that it's safe. But the doctor's point, it is
very hard to track when people take a stone. That
and a lot of the adverse events associated with creatim
When the adverse event is investigated, you find out the
person was taking something else, they were on, they were
taking a drug, or they were taking a prescription create

(20:02):
them like a lot of dietary supplements, can interact with
things like antihistamines. So you do it to be very
mindful and consult with a healthcare professional. If you have
an underlying illness or injury, or if you're taking a
drug or a different supplement, you should consult the professional
before you take creative or any supplement. That's always my advice.
Before you take any supplement, consult a healthcare professional.

Speaker 3 (20:25):
So, doctor James, how would you recommend someone just kind
of reveal that information with me go to their primary
care position. Right from your experience, what would be the
best approach? And I guess what I think about just
in the work that we do to educate people about
plant doused substances, you know, like including medical Mariworanda, you

(20:48):
have to talk to your you have to tell your
primary your position. So can you share that a soops
listening and watching that you take so that they don't
feel a stigma as they say that they're taking these
kinds of drugs.

Speaker 2 (21:02):
So what I like to tell people is you can
lie to just about anybody else in your life, but
you cannot lie to your medical professional because they can
make choices that will kill you. And so with that
being said, I think once again, any type of over
the counter medication, any type of things that you buy

(21:23):
in the grocery, so anything, then you really need to
let your provider know because some of the symptoms that
you may be having, or even if you just before
routine checkup, could be attributed to whatever supplement you are
And you have to be careful about what you're taking
because just because it says a multi viam and look

(21:43):
at the back and see what what all multi items
are in there? Is it just d A E K
excuse me, but you know, so once again create them.
You know, once again, there are a lot of different
points in gym things like that, and so if you're
using it at little or doses, maybe to get that
extra buosive energy in the GM. And so once again,

(22:05):
if you're unsure about what something is or what something means,
maybe you don't know what seventeen hydroxy is. You know,
we just see these letters and everything at the back.
Take a picture with your cell phone, bring that picture
to your position to see exactly does that interact with
anything that you're on.

Speaker 1 (22:24):
You know.

Speaker 2 (22:24):
Unfortunately, also a common thing that creatim is mixed with
you mentioned cannabis, is it actually is mixed with cannabis
as well, and you know cannabis can have sedated properties
as well, and so now you're exacerbating those symptoms. What
I tell people is once again, for the risks that

(22:45):
can be attributed, I would like to investigate. So say,
for instance, if you have fatigue, well, is your viting
a d low? Are you anemic? Let's figure out why
you have this fatigue. Let's not try to fix the symptom,
but actually gets to the underlying.

Speaker 4 (23:02):
I think that's the point is well taken. Dietary supplements
are not meant to prevent, treat, mitigator cure disease or illness.
Dietary supplements are intended to support or maintain a healthy
function of the body. So I agree with doctor one
hundred percent. Even when we were at FDA, if a
product that was label as a dietary supplement claimed to prevent, treat,

(23:22):
cure of mitigated illness or disease, we considered it an
unapproved new drug. So consumers should not take anything over
the counter other than over the counter drugs. They should
not buy a supplement if they think they're unhealthy. If
they think they're unhealthy, they should see a healthcare provider
if they want to maintain their health. That's what dietary
supplements do. That's the role of a dietary supplement. Now

(23:44):
some people do I'm aware of it, have used creatom
as a harm reduction tool, as a tool to help
flight addiction or withdraw that's different than creative that's used
as a dietary supplement, and that's a personal choice that
someone's making in their lives. I don't know whether that's
it's a good choice or a bad choice. I don't
know if it's better than an alternative, but I do

(24:05):
know like doctor is right. I have heard reports that
people do use creatim as a harm reduction tool, but
that's not the only use of creatom. Creative is also
used as a supplement for general health, vitality, and energy.

Speaker 3 (24:18):
So, given the rapid growth of creatom, and then also
because we talked a little bit about hamp industries, what
public health measures or regulations do you all believe are
the most urgent at this time?

Speaker 2 (24:33):
And so once again, I'm coming from a provider perspective.
I think once again we have to have solid information
that is placed into the public. A lot of times,
especially our younger generation, are getting their information off of Facebook, Instagram,
a lot of TikTok wonderful, thank you right ahead.

Speaker 1 (24:55):
And now all of these sources where you have.

Speaker 2 (25:00):
So called medical professionals, they may not have went to
a day of pharmacy school or a day of a
medical school.

Speaker 1 (25:08):
They may have just searched.

Speaker 2 (25:10):
The internet or not, maybe not even a primary sports
just been looking on Wikipedia for all we know. I'm
not saying Wikipedia is a bad thing, but when I
think about making my health decisions, I don't necessarily think
about Wikipedia. But once again, uh, and they will actually
do those you know, challenges that are on Facebook or
TikTok or Instagram, and they will do these things with

(25:33):
the intent of you know, changing their actual lifestyle to
to actually for the better, so actually curing whatever ailment
that they're having. And so sometimes they'll even actually stop
taking their position prescribed medication as this alternative. And so

(25:54):
what I would suggest once again, speak to your doctor
about it. Don't stop taking whatever medication that you're taking
in exchange for this.

Speaker 1 (26:06):
And if you.

Speaker 2 (26:07):
Do make an informed decision to supplement with kratom, start
at a very low dose.

Speaker 1 (26:13):
Tie trade up.

Speaker 2 (26:14):
If you feel as though whatever reason you need to
tie trade up, do it slowly to see how it
makes you feel. Do not, you know, operate heavy machinery
or go driving or do anything like that when you're
under the influence of this medication.

Speaker 1 (26:31):
Do not.

Speaker 2 (26:33):
Get two or three hours of sleep after taking that
medication that you're okay for the next day.

Speaker 1 (26:38):
Get a full night's rest.

Speaker 2 (26:40):
And so it's a lot and you know, it's a
few things that I'm not necessarily coming up on my
mind right now. But once again, I'm not necessarily that
you are from a provider's standpoint, that the benefits of
it outweigh the risk.

Speaker 1 (26:56):
But I think.

Speaker 2 (26:57):
Information would be the strongest tool. I think regulation, just
like the ones that are occurring.

Speaker 1 (27:03):
In Florida, are another huge tool.

Speaker 2 (27:07):
And I'm see training of medical professionals site. So say,
for instance, you know, I guarantee you the the emergency
medical team who saw those overdoses of kretom probably thought
that they were under the influence of some type of
opiate and so that's why they used the not locks
on and or they thought maybe the creative had been laced. However,

(27:30):
if somebody comes to the emergency department and say I
took cretim, most physicians are going to know what to do,
and so they need to know that you can use
no locks on dependion. Once again is seventeen old age.
They need to know, you know the science and symptoms
and what to look for in these individuals. So once again,

(27:50):
information is always the.

Speaker 4 (27:52):
Key for advice. I agree with just about everything doctor said,
except for calling creatum a drug. I think it can
be a supple. And to doctor's point, a lot of
a lot of healthcare providers don't know what creatim is.
A lot of consumers, the conversations come full circle. People
have used the word creatum to mean too many things.

(28:13):
Proxymetragedy is not creatim. So physicians, healthcare providers, parents, consumers
have to really be suspect and really look at the
products they're buying and understand what they are. Training our
medical professionals to understand these things is really really important,
you know. Turning back to regulation, creatim is a consumer choice.

(28:33):
Consumers have shown they want creatim. Creatim is not going
to go away. Is arguably legal under the federal's paradigm.
Creative can be an old dietary ingredient. Creative is regulated
as a dietary ingredient dietary supplement under the Food, Drug
and Cosmetic Act. But there are states, about eighteen states
have chosen the past what they call creative Consumer Protection

(28:53):
Acts Casepa's exactly in front of the Foreiger legislature right now.
One these things do is they of add on to
federal requirements and they add on to state requirements specific
to creatim. What has to be on the label, what
can or can't be in the product. The product can
only be marketed to people eighteen or twenty one and older.

(29:13):
It has to have good, good directions for use. It
has to have a phone number to report adverse events.
So states like Florida that are considering CACPAS are doing
that step further to protect their consumers. The problem happens
when some states like Louisiana, for example, don't take the
time to understand creatum. They confuse it with seven hydroxy matragedy,

(29:34):
and they throw the baby out with the bath water.
I think it's important for consumers, legislatures, regulators, for everyone
really be educated before they start passing regulations or start
trying to regulate kreatum to make sure they understand what
creatim is creative meal and an extract from that botanical
and what creatum is not creative is not There's reports

(29:57):
of seven hydroxymetragedy is killing people, and I thought Florida,
who declared that seven hydroxymetragedy in the SKEPU, he did
that under his own authority, and you should flout it
for it. And then FDx the Florida Department of Agriculture
and Consumer Services came behind and now they're starting to
enforce it, and that's wonderful. The problem is we need

(30:21):
to be sure that our regulators and our folks enforcing
those regulations understand exactly what they're regulating and enforcing. The
scheduling the seven O eighth could have been done a
little better. It was a little confusing. The way X
is enforcing it could have been done better. It's a
little confused. They have full in mind, they just need
to sharpen the way they're doing it. And I encourage
them to reach out to people that understand creatum and

(30:42):
understand regulation to mean some advice or some help.

Speaker 3 (30:46):
Yeah. Do you think the listeners and viewers who are
watching this to use the FDA's website around kretom to
kind of be a starting point to get credible information.

Speaker 4 (30:58):
I don't think FDA's credumsite is disingenuous.

Speaker 3 (31:01):
Okay, tell me about where a consumer would go to
get information.

Speaker 4 (31:05):
You know, it's hard, it's hard to go and get information.
You really have to do your own research. Because people
that's helping creative, people that want to regulate creatim want
to regulate creatum. It's hard to go out there and
get an unbiased opinion. Takes a lot of research, and
I think Doctor's advice was good. If you're going to
choose to buy Creative as a dietary supplement, be informed,

(31:27):
follow the directions for use, and start small. See how
that dietary supplement's going to treat you before you start consuming.
Consuming in large amounts poisons in the dose for anything.
Too much water can kill you. We've all heard that adage,
So just make sure that moderation is the key. Anything
can be habit forming, anything can form an addiction. It's

(31:48):
not coffee's habit forming exercises habit for me. So I
think it's all about choice and about consumers educating themselves.

Speaker 3 (31:56):
Before we wrap up, doctor James, that you want to add.

Speaker 2 (31:58):
Anything to know, just if just maybe one thing for
my providers who may be listening on today.

Speaker 1 (32:09):
The reason that I call.

Speaker 2 (32:10):
You know, even dietary supplements drugs, because I feel as
though it will make your patients realize the seriousness of them.
So even you know, like you said, water, vitamin D
that you get over the counter, vitamin A, all of these
things can have deleterious effects on your health if you

(32:32):
take too much of them. When we use the word supplement,
some people feel as though they can use as much
as they want, and it is okay because it's just
a supplement. But if you use the word drug, it
kind of peaks the ears and it lets people know
I really have to be a little bit more for
them and a little bit more leary. And so once

(32:52):
again it is, you know, a semantics. But I will
continue to use the word drug just for the bit
of my patients, for nothing else.

Speaker 4 (33:02):
I don't think you could argue that. I think if
it's for the patient, it's the right thing to do.

Speaker 3 (33:07):
Well, Bob and doctor James, I want to thank you
both for being our guests on this Conversations on Cannabis
virtual forum, brought to you by the Medical Marijuana Education
and Research Initiative at Florida and M University. Thank you
to everyone watching this program. Tell us what you think
about this form by completing the survey posted in the
comment boxes on Mary's social media pages. If you complete

(33:30):
the survey, your name will be entered into a drawing
in November twenty twenty five to win a one hundred
dollars gift card provided by one of Mary's partners. We
also want to encourage you to go to the Florida
Department of Health Office of Medical Marijuana Use website to
learn more about how to obtain a legal medical marijuana
card in the state of Florida. And we also encourage

(33:51):
you to go to Florida and M University's Merry website
to learn more about this initiative, its educational programs, and
about cannabis use in Florida. Thanks everyone.

Speaker 2 (34:05):
The views and opinions of our invited guests are not
necessarily the views and opinions of Florida Agricultural and Mechanical
University or the Medical Marijuana Education and Research Initiative.