'Kratom Is the Cure for the Opioid Epidemic.' Q&A With Filmmaker Chris Bell

"I think kratom is the cure for the opioid epidemic," says Chris Bell, the acclaimed documentary filmmaker behind 2008's Bigger, Stronger, Faster and 2015's Prescription Thugs.

A plant native to Southeast Asia, kratom can relieve pain and provide a caffeine-like boost. Its most exciting application, however, is weaning addicts off heroin and prescription painkillers. Though the scientific literature is thin, users have been safely ingesting the plant for centuries. Despite kratom's promise, the Drug Enforcement Administration (DEA) claims that it poses an "imminent hazard to public safety" and tried to prohibit most clinical research on it.

In August 2016, the DEA sought to ban the plant without public input by listing it as Schedule I drug alongside the likes of heroin, though it backed off after the community rose up in protest, apparently taking the agency by surprise.

Chris Bell spent months interviewing kratom's advocates and detractors for his new film, A Leaf of Faith. He talked to teenagers who have overcome depression, vets who have found relief from debilitating PTSD, and nine-to-fivers who take refuge from their everyday stresses with a cup of kratom tea.

A Leaf of Faith, like most of Bell's films, is also a personal story. His two brothers were avid power lifters and bodybuilders, and he filmed Bigger, Stronger, Faster as his older sibling, Mad Dog, was descending into his darkest period of abuse. Bell, who had always resisted drugs, turned the camera on himself in Prescription Thugs to reveal his own struggles with addiction.

"Now there's something on the market that's safe, that can stop things from happening like my brother dying, and these asshole politicians want to [ban it]," Bell told Reason's Justin Monticello.

In a wide-ranging interview, he also discussed his views on performance-enhancing drugs, marijuana, Prince's death, the Food and Drug Administration, abstinence-only approaches to managing addiction, and why he thinks Lance Armstrong got screwed.

Produced by Justin Monticello. Cameras by Paul Detrick and Alex Manning. Music by StrangeZero, Ethan Meixsell, Topher Mohr and Alex Elena, and Kevin MacLeod.

Feather Waltz by Kevin MacLeod is licensed under a Creative Commons Attribution license (https://creativecommons.org/licenses/by/4.0/)
Source: http://incompetech.com/music/royalty-free/index.html?isrc=USUAN1100658
Artist: http://incompetech.com/

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This is a rush transcript—check all quotes against the audio for accuracy.

Justin Monticello: Chris Bell is the acclaimed documentary filmmaker behind 2008's "Bigger, Stronger, Faster," a fascinating look at the intersection of America's winner-take-all culture and performance-enhancing drugs. Its followup, 2015's "Prescription Thugs," delves into the growing use of pharmaceuticals.

Bell's new film, slated for release this summer, is "A Leaf of Faith." It examines kratom, a plant with a devoted community of users who attest to its powerful therapeutic benefits. Yet, the US Drug Enforcement Agency, or DEA, has labeled kratom a dangerous drug, and recently tried to ban it.

Let's start with kratom, because that's the subject of your work right now. So, can you just give us the basics, what is it, how do people use it, what are its effects?

Chris Bell: Sure, yeah. kratom is just a plant, it comes from southeast Asia, in the same family as a coffee plant. It's probably about as addictive as coffee, so before we even get to that point, I'll just tell you what it's been shown to do anecdotally. Now, not in any real studies, cause there's not a whole lot of studies.

Kill pain, fight depression, fight PTSD, anxiety, and in turn it actually just makes you feel good. It gives you a state of euphoria. And a lot of people are afraid of that because they say, "Well, it gets you high."

And I'm like, "Well, no, cause I don't think coffee gets you high." So I think it's on the same realm.

Justin Monticello: And how do people take it?

Chris Bell: Basically it's just the unadulterated plant, and they ground up the plant and people take it as a tea or a capsule.

Justin Monticello: So what kind of people have you met, or what is the typical kratom user, what do people use it for?

Chris Bell: I was pretty shocked by the typical kratom user, because I thought it was gonna be, honestly just a bunch of dirtbags. I thought it was gonna be just a bunch of hippie, "Yeah man, we use kratom, we're cool."

It's not like that at all. The community is so straight-laced, normal everyday people with 9-5 jobs. And they're using it to fight pain, a lot of them are using it to fight depression. I just interviewed a friend of mine, Dr. Murray Holcomb, he lives in Austin, Texas, and his son Grant was an addict. And if not for kratom, he suffers such bad depression that he said he'd go right back to pills. And so he takes kratom every day, he's got a job, he's a good kid, and it's like, those people are the ones I don't want to see suffer. And his father said to me, "Kratom's not the thing that your kid's going to seek out, kratom's just the thing your kid's going to seek out when he's already messed up on drugs to get off of the drugs."

Justin Monticello: And are there any negative side effects of kratom, or have people become addicted?

Chris Bell: Sure, there's negative side effects to everything. There's people that have gone to rehab for kratom. Some people can't handle certain things. Like overeating for example. We have a huge obesity epidemic in this country, but we want to point the finger at things that don't really matter that much.

Let's take the real issue into consideration here. We're prescribing OxyContin to fucking 11-year-olds. Seriously. That's the issue. We're making it easier and easier for kids to get prescribed Adderall, and Ritalin, and psych meds, and our kids are walking around like fucking zombies. And now there's something on the market that's safe, that can stop things from happening like my brother dying, and these asshole politicians want to be, "Hey, you know, well, let's shut this down."

It's not that black and white, and it's not that easy. And if people want to make a change in this country, we need to rise up and we need to speak. Because when we spoke about marijuana killing all this pain, they've been able to fight the powers that be and make that a reality.

And I truly believe what my friend Joe Rogen says: the more people that have access to things like marijuana and things like kratom, the better of a society we'll have, because everybody's walking around stressed out how they're gonna pay their next bill, how they're gonna support their family, we're just so stressed. And that's why everybody's fighting over Donald Trump. And that's why everybody's arguing and yelling.

Justin Monticello: And so kratom could be the very first cure for Donald Trump.

Chris Bell: Yeah, yeah. Cure for Donald Trump.

I think kratom is a cure for the opiate epidemic. I really do. And I know that's a bold statement. And people say, "How do you know?" Cause I've done this shit.

I went the pill route. I've taken every single form of opiate that you can take, for pain, and this is better.

Justin Monticello: Bell and his two brothers were avid power lifters and bodybuilders. The striking story of the family's experience with steroids and other drugs is a narrative thread that runs through his documentaries.

He filmed "Bigger, Stronger, Faster," as his older brother, Mad Dog, was descending into his darkest period of abuse. And Bell, who had always resisted drugs, ultimately turned the camera on himself in "Prescription Thugs," to reveal his own dark secret.

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What was your journey like, how did you get addicted, and how did you find kratom, and how did you manage to wean yourself off those addictions?

Chris Bell: Yeah, so my journey was really interesting. I was lifting weights and winning all these national power lifting competitions. I had a genetic hip issue. And with powerlifting and the hip issue, they were just so bad. And it got so bad, so quick, that I needed a double hip replacement surgery, and I needed it pretty quickly. I needed both hips in one day.

Justin Monticello: Oof.

Chris Bell: And after that, I've just never been the same. After they did that, I was put on opiate painkillers. I went in to the doctor, and I said, "Hey, doc. I'm in a lot of pain here. I'm debilitated."

And he said, "You're not debilitated, you're using the wrong terminology."

And I'm like, "Well, I don't know what the fuck you call it, but I can't walk, and you did this to me, and you need to fix it."

And he was like, basically get out of my office, I didn't do this to you. "it's problems within you."

So I go home feeling terrible about myself, and I go home feeling like shit. So I just continued to do pills for the next two years, and wouldn't you know, he calls me up two years later and he goes, "I know why your hip hurts. I can see it on your x-ray right now and we never caught it. The socket, it was never attached into your hip."

I'm like, "Oh, now you see it." So I had to go get it redone. And a month after I got my hip replaced, my brother died, Mad Dog, who's like our hero, the whole reason why we played football and lifted weights and got into wrestling and did everything. Just died, in a sober living house trying to get clean.

So to me, I was like, "I'm not gonna go out that way, there's just no way I'm gonna go out that way." And wouldn't you know, a year later I was doing the same shit. I went the same way. I was just depressed and I was sad, and I was hurting inside and I didn't know what to do. And there was nobody there to really help.

Justin Monticello: What you described is a common situation for a lot of people across the country, they start out with an injury or something like that, they start taking pills, something happens, and then they fall into that.

Can you give us a scale, of what is the level of opiate and opioid abuse in the US?

Chris Bell: Yeah, I was just talking with my friend that lives in Louisville, Kentucky, and he said, "If you're 20 years old and you've got a paycheck, you're doing pills."

That's what he said. He's like, "Everybody here is doing it." That's how he fell into it.

We represent five percent of the world's population, we take 75 percent of the world's prescription drugs. And I think a lot of people are like, "Oh, this happened to me, or that happened to me."

And that's the same thing with kratom. It's like, if you're in pain, you need to find something that's going to help you, you can't worry about what other people think.

Justin Monticello: And that's the reaction that you've gotten, right, is that some people say, "Well, now you're just addicted to kratom."

Chris Bell: Yeah. Now you're trading one addiction for the other. And I'm like, "No, it's not an addiction, though. I'm trading an addiction for a plant that's very safe."

Justin Monticello: So the way that it works is that it does activate the same opioid receptors as say, heroin, but in a different way?

Chris Bell: So the difference is, it doesn't bind to the receptor, it attaches to the receptor. Does that make sense?

Justin Monticello: Yeah. And so the effect of that is that somebody who's addicted to opiates would have that craving reduced, but they would not get high.

Chris Bell: Yeah, it's blocking the craving but it's not getting you that high, you know. I found it in the middle of doing "Prescription Thugs." And I tried it, and I think I was expecting to get high. And that was the problem.

On Twitter, somebody said to me, "Hey, have you ever heard of kratom?" When I was doing "Prescription Thugs," and I said, "Yeah, that shit don't work."

And then it comes back and bites me in the ass, because now on Reddit they're like, "I don't think Chris Bell should be representing the kratom community, because look what he said a year ago."

But to me, that's a testament to the fact that I didn't think it did anything because I was looking to get high. And now I've been taking it every day since. I actually went to Thailand, and after taking it for three months I was able to get off of it for two weeks, no withdrawals at all. The only thing that happened to me was I had to go back to taking Tylenol and Advil in a combination to kill the pain. I'd have to take two Advil, two Tylenol, each time. And that adds up, and that's gonna hurt your liver, it's gonna kill your kidneys, and we don't want that.

So I think having a natural alternative is a great way to go.

Justin Monticello: So just to clarify a little bit. So opiates are things that are derived directly from poppies, right, like heroin or opium?

Chris Bell: Yeah.

Justin Monticello: And then opioids are synthetic.

Chris Bell: Synthetic versions. Usually they'll have a base from the poppy plant, and then synthetically derived from there.

Justin Monticello: So things like Oxycontin.

Chris Bell: Sure. The one that's completely synthetic, from what I've heard, is fentanyl. And that's why it's the most dangerous and the most potent.

Justin Monticello: Fentanyl was also implicated in Prince's death, and some other celebrities too.

Chris Bell: Yes.

Justin Monticello: Like Michael Jackson.

Chris Bell: It's been related to a lot of deaths, and kratom hasn't had any deaths.

Justin Monticello: According to the DEA, however, 15 people died from taking kratom in the two years before the agency tried to ban it. To put that in context, there are thousands of deaths annually related to aspirin and similar over-the-counter painkillers.

And Bell disputes the DEA's claim that kratom was the cause of death in even this relatively tiny number of cases.

Chris Bell: There was like 15 deaths altogether, and nine of them were in Sweden. All this kratom was laced with fentanyl, and nine people died. Wouldn't you ban fentanyl, not ban kratom? It's just so asinine and ridiculous. And people need to get their head out of their ass.

There's a lot of reasons why people would need serious opiates like fentanyl, and those reasons are like cancer patients, people with terminal diseases. And I would never, ever want to take it away from them. But who's to say that we might not be able to give those people a better quality of life if we studied kratom?

Justin Monticello: So basically what happened is, the DEA over this past summer, they temporarily put it into Schedule 1, the most restrictive category, along with heroin and a bunch of other bad drugs. And they underestimated the community for kratom, because then there was this big swell …

Chris Bell: It actually never got to the point where it got banned. The blowback on this was incredible, the DEA's never seen anything like it. The DEA when they issued the ban, said "We will not hear any public comment, this is getting banned on this date and that's it."

So we started tweeting about it, and we started sharing it, and we got over 100,000 signatures. So then there was a March on Washington. So then they opened it up to public comment. So I called Joe Rogen, and I said, "You think we could go on and talk about this?"

He said, "Absolutely, I would love to."

After that episode aired, we had 23,000 comments on the website. And that was in one day.

Justin Monticello: So that comment period ended on December 1, 2016. So do you have any indication what their timeline is, what they're thinking about?

Chris Bell: No. Since December 1, nobody's heard anything. You know, when I talked to the DEA, it wasn't after December 1, it was right around there. He was like, "To tell you the truth, I don't see this going anywhere anytime soon, because of the blowback."

Justin Monticello: So they were referring to the ban?

Chris Bell: Yeah. They were saying, "I don't think it's gonna go through, and I don't think anything's gonna happen."

Justin Monticello: Really?

Chris Bell: Yeah. But he'll never speak to anybody on camera. But they should be transparent, right? But they're not, and neither is the FDA. And that's a big problem with this country. If those organizations were transparent, and we knew what was going on, we'd be able to make a lot better decisions.

Also, we might not bash them so much, because we understand that they have a very difficult job.

Justin Monticello: So marijuana is a good example, because the DEA put marijuana in Schedule 1, which basically is the only category that says that it has no accepted medical use. And the catch-22 there is that people can't do research on it, they can't do medical research because it's in Schedule 1, so there's no way to get it out of Schedule 1 right now.

That applies to also things like psilocybin mushrooms, ayahuasca's another one. But kratom is a little bit different because it hasn't been banned. So why doesn't that medical research exist for kratom, that would counteract that inclination to put it in Schedule 1?

Chris Bell: There is the NIH, and the National Institute of Drug Abuse, and I've heard that they're looking into doing some studies on kratom. I really hope that they do and my film's actually gonna push for that. That's the big ask. There has to be a vested interest, though, from a pharma company that says, "Hey, look, we can stop this opiate crisis if we study this."

I don't know why that's not happening. That's really something that maybe pharma has banded together and said, "We like the opiate model, and we want to keep it."

A renegade drug company would be smart to come in and say, "Hey, let's study this and let's put this on the market." But you gotta remember it's also an $8 billion process. So why stop the money machine that you have rolling, to start an $8 billion process to get a drug approved?

Justin Monticello: On average, it costs several billion dollars and takes a decade to get a new drug approved by the FDA. Despite Bell's objection to this process, and to the DEA's treatment of kratom, he believes the agency should do more to restrict the supply of prescription opioids.

Chris Bell: Why are they allowed to make 10 times the amount of pills we need? Why are there so many pills on the street?

Justin Monticello: But at the same token, you were saying your doctor was reluctant to prescribe you pills that you really needed.

Chris Bell: Yeah, but I actually was in legitimate pain. So I don't think my doctor was wrong for cutting me off, he was wrong for not helping me find a solution.

Justin Monticello: I guess my question is more about the DEA's actions. So, because we find that they have put in place programs that limit the number of prescriptions that can go out, track doctors, and we don't find a reduction in the illicit use of pills. We find people who have chronic pain who can't get pills anymore that they need.

So Oxycontin, they spent years reformulating the pills so that they were not as easily snortable and their sales went down like 80 percent after that.

Chris Bell: Yeah, their sales went way down after they did it and that's why they want to go global.

Justin Monticello: Right. But what we find after that is that with the decrease in Oxycontin prescriptions, there was a rise with heroin abuse, or street drug abuse. So it pushes a lot of people into the black market.

So do you think that there are effective ways to stop it at the supply side? Like, can we just ban things, or is that a rehashing of the drug war that we've had for decades that hasn't worked?

Chris Bell: I think so. I think that if there wasn't as many pills available, I think that's the issue. There's such an abundance that that's where people are able to get them. However you can cut the number of pills on the street out, I would say would be the things that they need to try to focus on.

And I might be completely wrong. We might just say, "Hey, let's just make half the amount of pills." We might make half the amount of pills and have the same problem. Might have a worse problem, because it might be harder to get for people, they might do more aggressive actions to get it.

So we don't really know, but I think the DEA knows, I think that's their job, and they should figure it out. But I think if we started looking at, how can we service addicts besides throwing them in prison? Let's find things that we can help them do, that will help keep their brain going the right way.

Justin Monticello: So now it sounds like you're advocating for less intervention, you don't want people to go to prison, which is what happens when the DEA gets involved.

Chris Bell: Yeah.

Justin Monticello: Do you think that the best thing the DEA might be able to do, or the FDA, is to loosen some of those regulations so that other people can come in, whether it's kratom, whether it's new EpiPen, and get that passed more easily, so that these types of monopolies don't exist and Big Pharma can't exert their influence.

Chris Bell: Sure. I think the path to getting a drug approved needs to be fixed. To make things so hard and difficult to take a look at, I think limits a lot of things.

Justin Monticello: One way kratom could avoid the drug approval process is if the FDA and DEA treat it like other botanicals in the market, which are classified as dietary supplements.

But Bell also thinks these substances should be more tightly regulated, to ensure standardized ingredients and dosages.

Chris Bell: The supplement industry is regulated to an extent, but the extent that it's regulated isn't really good enough. Because you don't have to show efficacy, you just have to show safety. What happened in 1994, Orrin Hatch wrote a bill called the DiSHA Act, the Dietary Supplement and Health Act, and what that said is that anything that's already on the market, we're gonna say is generally regarded as safe.

Kratom's been on the market for 2,000 years in Thailand. Over here, I know a guy that's been selling it since 1984. So it's definitely been on the market before then. And I asked the DEA, I'm like, "Well, why would you try to ban this if it's been on the market, you know the rules."

And they said, "Well, because it was on the market, but nobody ever really knew about it."

Justin Monticello: So there's a lot of argument that kratom might only be able to be legal if it's considered a supplement.

Chris Bell: Sure.

Justin Monticello: So if the concern is that the FDA is preventing kratom from being a legitimate competitor to these other analgesics that the pharmaceutical industry is selling, why do you think that tighter regulation on supplements is the answer, given that they've used that in the past to constrict the supply of new drugs?

Chris Bell: I think it's better to regulate it and have something where people trust it and people are like, "Oh okay, this isn't the boogeyman, this isn't something that's the unknown." But at the same time, if regulation's gonna mean it has to get banned for a while or something, I don't want to leave the people stranded that are taking it now.

It's more of like the kratom industry needs to regulate itself according to the FDA compliance. So I know as a plant, that kratom works. But what I don't know, is that if I buy certain brands, I don't know that it's actually kratom. They're not testing it in their facilities. And that's what we need to fix. The way that kratom's being sold and marketed in the United States, you can only buy it at smoke shops, it's not really in the health food stores.

The brand that my friend owns, he's the only one doing FDA testing, FDA compliance. So I know, because I know how much money it costs him, if you're gonna do something, we have to do it right. Because we look like a joke otherwise.

Justin Monticello: Bell was recently barred from speaking at his former rehab facility because he uses kratom. While he credits AA for helping him get clean, he believes that the abstinence-only approach championed by the organization and celebrities like Russell Brand isn't always the best way to help addicts.

Chris Bell: The issue is for me, how do I address my pain? Like, it's easy for Russell Brand to say if he's not in pain. That's another thing. Abstinence-only from what? Because he probably smokes cigarettes. Everybody in rehab smoked, everybody. I was the only one that didn't smoke.

So you know what? Fuck those people. Abstinence-only? You're probably the ones that are smoking in rehab, or they're sex addicts, they have all these other issues. And they're preaching abstinence-only because they don't want you to have any fun because they can't have fun.

And I don't like that part of it. I don't think there's anything wrong with it, it's just wrong with it if you're gonna preach it to me. They want to call it a disease. They're the ones that call it a disease, in AA. They call it a disease. You can't treat a disease with religion. You can't. It's a mental condition, and a mental condition can be treated with therapy. That's the only way I think you can really treat it.

And that's all AA is, actually, therapy. But they want you to have a Higher Power, and all the stuff like that. And when I was in there I just couldn't grasp that concept.

Justin Monticello: I would imagine that they would say, your particular case, you have a lot of pain. Most addicts would just … let's say heroin addicts. You're giving them methadone, you're just substituting another opiate for this opiate. So do you support harm reduction strategies like that, whether it's methadone.

Chris Bell: Suboxone's the other one.

Justin Monticello: Suboxone, needle exchange programs, things like that.

Chris Bell: Yeah, sure. Anything that can help, I think the best way to help people, though, is to empower them, and allow them to have things like kratom and these other kind of things. Making it so they don't get into harmful situations. Harm reduction, as you said, I think that's a good thing. Because I think after a while, people will get out of it.

I got sick of it. I couldn't do it anymore. I think that's what most people … some people die before that. That's a thing as I tell people, it's 100 percent curable. And anybody that reaches out for help, it gets better.

Justin Monticello: A main theme of Bell's films is distinguishing between responsible drug use and misuse, particularly for sick people and athletes.

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What for you is the line between healthy use and abuse?

Chris Bell: I think abuse is when you know something's toxic but you take it anyway. However, I have to say. If your goal is to be a professional bodybuilder, then drug abuse might be part of it. I'm not saying that you're not abusing it, I'm saying drug abuse might be part of that. If you want to play in the NFL, drug abuse is probably gonna be part of it. If you want to fight in the UFC, drug abuse is gonna be part of that.

And you just have to be ready for that. Because you're not using it for a medical reason, you're using it for a certain effect.

Justin Monticello: So do you think that there are certain performance-enhancing drugs that should be outlawed from sport, or do you think it should just be fair game, that we're kidding ourselves?

Chris Bell: We talk about this all the time. I don't think it should be anything goes. If it's anything goes, there's just too much craziness out there. But I believe in baseline testing for testosterone and growth hormone, because growth hormone is gonna help with CTE. With brain injuries, so will testosterone. So it becomes more dangerous for them not to be on it.

Justin Monticello: Oh, so you mean treated by their doctor to get them to a certain healthy level?

Chris Bell: Yeah. A doctor can treat them whatever way they want, and whatever's on the doctor chart better be in their body, and that's it.

Justin Monticello: Do you think that it's cheating, basically, if somebody's doing something that is not hurting themselves?

Chris Bell: Of course. As the rules are set up, it's cheating. I just think this whole system should be different. I guess I don't feel so pure about sports. I just did a podcast with Lance Armstrong the other day. I know a lot of people hate him, and a lot of people hate a lot of people, they hate the lying. That's what we hate.

I think that people hide so much and then it's like, "Oh, I gotcha."

Justin Monticello: Right.

Chris Bell: The reason why Lance Armstrong got caught, was because he came back. But also because they wanted to get him. They wanted to get Barry Bonds, they were definitely out to get those guys.

Justin Monticello: Yeah. And you know, Lance Armstrong is a childhood hero of mine, so that is also a big thing growing up, I followed all his races. It was disappointing, but at that point, dozens of other cyclists, everybody that he competed against, went down for it at some point.

Chris Bell: I think the top 18 got outed, we're talking about doing a documentary together, all this stuff. And I was shaking his hand, and I go, "You got screwed. I think you're the best guy that ever got on a bike."

And he's like, "Thanks man, I really appreciate that."

But I really believe that. I believe if you took all the other people, it's about heart, and drive. And he's got this freaky weird, crazy genetics.

Justin Monticello: And anybody else could've taken the drugs that he did.

Chris Bell: Look at Michael Phelps. He's like 6'8'' with webbed feet, like what the fuck? He was made to swim.

Justin Monticello: But he smokes marijuana, right? That's the problem.

We'll leave it there. Thank you so much for talking with us today.

Chris Bell: Absolutely, man. Great talking to you.