Kratom Culture Magazine | Issue #6 | Spring 2020

Kratom Culture Planting the seeds of revolution

AMERICAN KRATOM ASSOCIATION'S

MAC HADDOW CHIEF LOBBYIST TALKS KRATOM CONSUMER PROTECTION ACT

SPRING 2020Â

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Welcome TO THE BOTANICAL RESISTANCE

"Kratom brought us together. Kratom showed us another way of life. It showed us that we don't need synthetic chemicals when there's a plant for anything you can think of.

Kratom created a community, as well as a culture."

Chris Miller

KRATOM CULTURE MAGAZINE

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CONT ENTS 05

FROM THE FRONTLINES Kratom advocate Kim Libby-Evans testifies about the power of kratom.

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HOME ALONE | SUPPORT GROUPS TO THE RESCUE Whether you're an AA/NA member or just someone recovering from trauma, we all need support in times like these. Insider tips on surviving lockdown during sobriety.

17

RELAX WITH REISHI

31

EXCLUSIVE INTERVIEW: AMERICAN KRATOM ASSOCIATION'S MAC HADDOW

This adaptogenic, medicinal mushroom isn't called the Mushroom of Immortality for nothing. Find out how Reishi can offer immune support, plus a recipe!

The state of affairs is complicated.

We talk to the American Kratom Association's chief lobbyist to sort through the latest legislation.

Kratom Culture.

Planting the seeds of revolution.

Our staff Heather D. Hawkins Publisher & Creative Director Shari McFadden Social Media Mgr. Marisa Michaels Staff Writer Alexandra Guadagno Staff Writer

SUBSCRIPTIONS Email heather@culpeppercreatives.com 850-450-2468 Kratom Culture is published by Culpepper Creatives, Pensacola, FL 32514 kratom-culture.com

FROM THE FRONTLINES OF THE WAR ON KRATOM

KIM LIBBY-EVANS In 2002, I was employed as a credentialer in a hospital when I was diagnosed with CRPS -- also known as "the suicide disease." It quickly spread throughout my body and, by the end of 2003, it was systemic. I was in debilitating pain 100% of the time. I had two spinal cord stimulators and an intrathecal Dilaudid pain pump implanted and was also taking huge quantities of prescribed narcotic pain medications, which got me by for many years. But I was confined to my motorized wheelchair and/or bed full-time, and had to wear continuous oxygen. At the same time, my children were growing up and, I'm embarrassed to say, I missed out on huge chunks of their childhoods as a result.

FROM THE FRONTLINES OF THE WAR ON KRATOM

Over the ensuing years, I was also diagnosed with Trigeminal Neuralgia, Osteoarthritis, Fibromyalgia and Chronic PTSD. My life was a complete mess, and I was a non-participant. I suffered greatly but went on the best way I knew how.

Life passed me by.

Then the CDC started rolling out their new narcotic prescription guidelines to American physicians. Despite their original intent, and I'm sure they originally thought they were being helpful, they hurt a lot of people -- especially those with chronic pain conditions.

I was one of those people.

My physicians forcibly began stopping my pain meds, afraid to risk their medical licenses. Over a 2-year time period, I went through forced drug withdrawal three different times and ultimately ended up with nothing but crippling pain and through-the-roof anxiety.

I thought that the suffering I had experienced during the previous 15 years had been brutal, but it was nothing compared to what followed after it all stopped. I really believed that death was my only answer.

In my search for alternative methods of pain control, Kratom kept popping up. At first I was very leery of trying it. Then I came across videos of people like Andrew Turner, and I made the leap and ordered from a vetted vendor, one that exclusively tests their products for contaminants.

To say that my life changed overnight would be the understatement of the century. I was truly astounded. I found that my pain levels were decreased, my anxiety was reduced and -- perhaps best of all -- the breathing difficulties that I had encountered with the use of narcotic pain meds simply disappeared.

The oxygen I had been using on a daily basis was no longer needed. The elevated liver enzymes in my routine blood work disappeared. My life did change, vastly for the better, almost immediately.

I still have intense pain and anxiety issues, and I am certainly not cured and likely never will be, but I am able to cope so much better. I am no longer suicidal. I no longer use my wheelchair or walker. I no longer use oxygen. And I have successfully stayed the course with Kratom ever since then and without it, I will be permanently back in bed and no longer able to participate in my own life and the lives of my children.

#IAmKratom -Kim Libby-Evans Woodsfield, Ohio

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HOME ALONE

Saving Your Sobriety in a Time of Social Distancing

By Alexandra Guadagno While your favorite Alcoholics Anonymous or Narcotics Anonymous meetings may be closed because of social distancing, there is a world of resources available during the COVID-19 pandemic to help you stay sober.We’ve been social distancing for nearly two months now, thanks to the COVID-19 pandemic.

For many individuals in recovery from opiates and other drugs, fear, anxiety, loneliness and mandatory stay-at-home orders can feel like a recipe for a relapse. Without the ability to attend in-person Alcoholics Anonymous or Narcotics Anonymous meetings for support in their recovery, people are relapsing at alarming rates.

Even some sober living homes, where tenants are required to go to regular meetings, have not been holding meetings or making their residents attend during shelter-in-place orders. Without being provided an alternative to regular meetings, entire sober living houses have reportedly relapsed.

Regularly attending meetings provides connection and accountability to others. How does someone — whether struggling or strong in their recovery — stay on track during all the loneliness and social upheaval of COVID-19 and quarantine?“A common truism in recovery culture is that ‘addiction is a disease of isolation,’ so it stands to reason that social distancing — in every possible way — is counter to most efforts to engage in a recovery community,” according to Peter Grinspoon, MD in a Harvard Health Blog.

home alone

surviving sobriety in lockdown Dr. Grinspoon is a primary care doctor who has recovered from — and who treats — opiate addiction. “It is important to remember that experts distinguish between physical distancing and social distancing, and actually emphasize that we keep physical distance, but make extra efforts to maintain social bonds during this time of enormous stress and dislocation.”

Idle hands can be the devil’s playground when it comes to getting and staying sober during shelter-in-place orders. When our usual structures and support systems aren’t accessible, we may feel like there are no repercussions to our actions because “no one is watching,” and it’s very easy to slip up.

Couple that with the fact that this is taking place during a time of worldwide panic and fear, and many people are feeling massively depressed with no one to reach out to — or so they may think.The fact is there are plenty of resources available to support your recovery right now, and many people are staying the course while staying at home.

AA and NA are still available for those who need it, though it may take a little more effort and personal accountability for some to keep up with these meetings.“AA and NA have become a Zoom culture,” says Henry*, who has been sober and working the program for 2 years. Henry regularly attends virtual meetings since selfquarantine began in order to preserve his sobriety during quarantine. He says he enjoys the online meetings because it allows him to go anywhere in the world.

home alone

surviving sobriety in lockdown

On the downside, a lot of people are using this as an excuse to not go to meetings and haven’t given it a chance. ”Initially there were a lot of problems with the Zoom meetings that likely turned off a lot of people after their first or second attempt at trying the online meetings.

When this all started, punk kids were hacking the Zoom meetings and Zoombombing swastikas, racial slurs, porn and other offensive material by screen sharing.”

This caused a lot of people to feel unsafe and stop attending the Zoom meetings. Henry says many people would attend a meeting or two by Zoom and then he wouldn’t see them come back again.Plenty of individuals are relying on sober friends for support right now, in place of or in addition to Zoom meetings.

“I just have two good friends that are in recovery and on Kratom,” says Chelsea*. “We Zoom together anytime one of us feels a little weak. We also send each other tea if one of us runs short or if we just want to share a new blend. Lean on those close to you. If NA or AA is your thing, Zoom a meeting,” she says.

STAYING SOBER WITHOUT 12 STEP SUPPORT GROUPS Others choose to stay sober without using a 12-step program and have found ways to connect and support each other using technology since long before shelterin-place began.

“AA and NA didn’t work for me personally. I use Facebook groups as my support group,” says Plant Medicine Advocate Jacob Ringstad, who has created Facebook groups to reach those individuals that AA and NA cannot.It doesn’t matter how you are coping, as long as you ARE coping and maintaining the sobriety you worked so hard to achieve.

home alone

surviving sobriety in lockdown

Check out the meetings, if that speaks to you, or organize group check-ins with your AA/NA friends. Make dates to FaceTime with your sober friends and ask how they are doing. Support each other and don’t be afraid to ask for help if you need it.

“You gotta adapt,” concludes Henry.

“There are a lot of old timers who have been going to meetings since the 80s, and they’ve had to change along with the program.”

What it comes down to, according to Henry, is dedication: If you want recovery, it’s still there for you.”Please check out some of these resources available to you during the Coronavirus crisis, and remember not to beat yourself up if you feel triggered or have slipped up in your recovery. Heed the advice of those who have managed to stay sober and reach out for a helpful connection if you’re struggling. Crush cravings with “positive addictions,” or hobbies like exercising, meditating, crafting, enjoying music, cooking, gardening, etc. This is a difficult time for all of us; an unprecedented era in which we should all be taking it “one day at a time.” *not the interviewees’ real names

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REISHI

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Nature's Xanax What makes the Reishi mushroom so unique?

According to Healthline: What makes the Reishi mushroom unique is its calming properties — all of which are thanks to the compound triterpene.

These mood-boosting compounds may alleviate anxiety, ease depression, and encourage better sleep, as seen in mice.

But triterpenes’ positive effect on the nervous system doesn’t stop there. Reishi can promote healing and sharpen focus, too.

Learn more about Reishi & other medicinal mushrooms on the Florida Rooted blog

ADAPTOGENS | MEDICINAL MUSHROOMS This is how adaptogens work, according to Healthline:

When we face a stressor, whether physical or mental, our bodies go through what’s called general adaptation syndrome (GAS). GAS is a three-stage response: alarm, resistance, and exhaustion.

Adaptogens help us stay in the resistance phase longer, via a stimulating effect that holds off the exhaustion. Instead of crashing in the midst of a stressful moment, task, or event, we attain equilibrium and can soldier on.

“Like a mini vaccine, some adaptogens appear to inoculate us to stress and help us cope,” Korn says.

When we can adapt to stress, we perform better and feel better despite what’s stressing us out.

And with that, we can also improve our health and well-being. When you’re stressed, your adrenal gland releases the stress hormone cortisol, which then energizes you to tackle an emergency. But too much too often is usually bad for our bodies.

“Cortisol is often the culprit for weight gain, especially around the belly area,” says Tara Nayak, a naturopathic physician in Philadelphia who recommends adaptogens to her clients. “When you reduce stress with adaptogens, you reduce stress hormones and hence their effect on weight gain.”

Adaptogens have the potential to help indirectly with other health issues, like pain, digestive concerns, insomnia, and more. “Stress sets off a cascade of physical responses that affect immune function, our hormones, our cognitive function system, and our internal clock, called our circadian rhythm,” Korn says. “If these stressors persist, this leads to chronic illness.

STARGAZER Lily Oriental lilies are renowned for their delightful perfume and flamboyantmid- to late-summer blooms. The crimson cultivar ‘Stargazer’ is a popular hybrid with large, showy flowers that make it a showstopper when in bloom.

Flowers in the Oriental lily group "tend to hang down, but this cross of unknown parentage was noteworthy because of its upward facing flowers, hence the name referencing looking at the heavens.

Like most true lilies, these herbaceous perennials die back to the ground in winter and send up a new stems from the bulb each spring.

Excerpted & adapted from the University of Wisconsin Master Gardener website

GARDENING

Spring Planting

If the weather turns nasty in the fall before you can get your lilies in the ground, you can wait until spring to plant them. Until you are able to plant, keep your bulbs in dry straw or sawdust in a dark, cold location such as an unheated garage. When your soil is workable in early spring, you can plant your lilies.

Workable soil means that when you squeeze a handful of dirt, it crumbles. If your soil forms a solid ball or drizzles mud when squeezed, it is too wet to be worked.

Spring is also the right time to plant "Stargazer" lilies in containers.

Preparing to Plant

Like other Oriental lilies, "Stargazer" lilies prefer to be in a partially shaded area of the garden. The plants tolerate morning and evening sun, but should receive dappled shade during the afternoon. Before planting, loosen the soil to a depth of 12 inches. These bulbs do best in soil with a pH of 6.5; working compost or other organic matter into the soil before planting will help lower the pH slightly, loosen the soil and add nutrients to help your lilies thrive.

Excerpted from SF GATE

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EXCLUSIVE INTERVIEW American Kratom Association's Chief Lobbyist Mac Haddow Fights to Protect Your Rights

By Alexandra Guadagno

Mac Haddow chats it up with Dr. Jack Henningfield

With the world on lockdown and COVID-19 dominating the news for what seems like eons, it can seem like important non-COVID legislation has taken a backburner in some states. Kratom consumers may be worrying where the pending bills stand and how the advocacy groups we count on are currently fighting for our right to access life saving kratom. This may be particularly important to you if you live in one of the six states with a kratom ban: Alabama, along with Wisconsin, Indiana, Vermont, Rhode Island, and Arkansas have all imposed bans on kratom, which is why federal consumer protection for kratom consumers is essential.

But sip assured, even while you may be sequestered at home, the American Kratom Association (AKA) is “working carefully but aggressively in Alabama with a lobbyist on the ground educating key legislative leaders about the truth about kratom, and we think we’re making good headway,” according to Mac Haddow, Senior Fellow on Public Policy for the American Kratom Association. Still, the AKA and your fellow kratom consumers need your help in advocating for kratom. In this article, we’ll look at need-to-know updates going on in the Kratosphere, state-by-state, and share advice straight from the AKA on how your Kratom addiction recovery testimony can help the movement in a tangible way.

Haddow spoke with Kratom Culture on the 2020 and 2021 forecast for Kratom legislation and other exciting developments for proponents of the Kratom Consumer Protection Act (KCPA), or the Kratom regulation bill, as it is also known. The AKA advocates for the KCPA, a set of regulations that would mean the consumers are protected when using Kratom and ensure that harmful contaminants or adulterants are not mixed with the plant, making sure only pure, safe blends of Kratom are available. This type of an amendment would eliminate much of the confusion surrounding the plant and reduce the stigma around using kratom safely-and, in essence, would be a huge boon for kratom consumers who just want to get some relief and drink their tea without having to look over their shoulders for the moment their cups become illegal.

In a bittersweet passing of the baton, former AKA Chairman Dave Herman had to step down for personal reasons while former Congressman Matt Salmon (R-AZ) -- who led the fight in the U.S. The House of Representatives to fight the Food and Drug Administration’s (FDA’s) proposed scheduling of kratom in 2016 -has been named the new Chairman of the American Kratom Association.

They announced that Matt Salmon has assumed the title of Chairman on April 17, 2020. Congressman Salmon is, as Haddow describes, “a diamond for us” with his network and position as Chairman of the House subcommittee on Asia & the Pacific,

which will provide a huge asset, as that is where most of the world’s supply of kratom is grown and imported to the United States. He previously served as Chairman of the House Subcommittee on the Western Hemisphere.

In a move that was somewhat controversial in the kratom community, the AKA addressed a recent open letter to President Trump. “What got our attention was a very important policy issue that the President highlighted in the midst of a pandemic like COVID-19, it was his belief that the FDA ought to be cooperating with waivers on regulatory barriers that exist to potential therapeutic options, particularly when the patients face death,” says Haddow. “He was highlighting, at the time we drafted the letter hydroxychloroquine and the potential benefits it had.

[President Trump’s] point to the FDA was that you should issue an emergency use authorization for it for doctors to prescribe it where it’s appropriate. Of course, that was something that the FDA staff vigorously opposed, and yet the President used his bully pulpit and his appropriate authority to convince the FDA commissioner that there was a better possibility,” says Haddow.

“Our argument was to the President that we have a parallel pandemic or crisis that’s going on in the United States, and we are losing 60,000 people a year,” says Haddow. “We ought to be doing something at the FDA to stop them from opposing what has now become a proven alternative to manage pain by those people that are struggling with addiction issues, and to help them get off of it. We were asking the President to put the same pressure on the FDA as he did for hydroxychloroquine for kratom to get the new FDA commissioner to evaluate it, look at it and see if there’s a way we can develop a reasonable regulatory pathway to protect consumers from adulterated kratom products, but allow consumer access to kratom as a dietary supplement to use as they see fit to manage their health and wellbeing.”

In the letter, the AKA acknowledged that POTUS was “absolutely right when you directed the FDA to remove barriers for patients to have access to a product that has been used safely for decades, hydroxychloroquine, because it offers hope to those who are at-risk for COVID infections.” Haddow recalls that some in the kratom community were not happy that the AKA issued this letter because of their personal political views about the President. “But the truth of the matter is within a 72-hour period, we gathered more than 6,600 signatures, which was a significant outpouring of support from the kratom user community in supporting us in that effort,” Haddow says. “Our entire effort was driven by policy, not by politics, and those naysayers simply were wrong in this area because they wanted to express their political views and attack us for doing exactly what they were doing when we, in fact, had a far different purpose and a legitimate public policy argument that we were making.”

Check and see if your state appears below for up-to-date news on kratom legislation straight from Mac Haddow.

The United States of

Mac Haddow Interview (cont.)

Kratom

A STATE BY STATE GUIDE TO KRATOM LEGISLATION

ALABAMA “Alabama is one of six states that reacted to the disinformation campaign by the FDA that was literally unchallenged between 2012 and 2016. And during that period of time, law enforcement officials and prosecuting attorneys, particularly in Alabama, seized on Kratom as being part of the ‘Spice’ movement. They determined, piggybacking on the FDA’s claims, that it was a dangerous substance.

We hope that in the upcoming 2021 legislative session in Alabama, as we are optimistic in other states where the bans currently are in place, that we are going to get the ban overturned and replace it with the responsible regulatory controls that will virtually eliminate adulterated kratom products, which are the source of the adverse events that the FDA reports on, but mischaracterizes as kratom associated deaths. We think the response has been great,” says Haddow.

OREGON “COVID-19 had a dramatic impact on our advocacy efforts in The States. Several states that had the KCPA moving to passage had to abort those efforts because they were shut down.”

In the state of Oregon, there was an early adjournment of the Oregon legislature where the AKA had already had the KCPA passed by the Senate and expected to receive near unanimous support in the House. However, when COVID was still just a sidebar in the news, a battle erupted between the majority Democrat members of the legislature and the Republicans over an unrelated cap and trade bill, where the Republicans refused to show up for legislative sessions and denied the legislature the ability to act, according to Haddow. “We are confident that in early 2021 that will get back on the agenda with Orgeon to get the KCPA passed.”

COLORADO “In Colorado, we have the bill ready to go. We have a Senate and House sponsor but the COVID-19 suspension of activity in the legislature put them in a real box.

They got a temporary reprieve from the State Supreme Court, which allowed them to add some additional days onto their legislative session, but they will be very limited and the ability to have regular rules prevail in terms of hearings and processing legislation will probably impede us from getting passage, but we are hopeful that we can find a way to let lightning strike and get that done. We are confident that in 2021 we’ll do very well in Colorado.”

MISSISSIPPI “In Mississippi, we stopped three ban bills,” says Haddow. “We were hopeful that we were going to be able to negotiate with the opponents in Mississippi. We had a very successful effort with the Senate Drug Policy Committee, who voted unanimously to reject the ban and replace the ban bill with the KCPA. It was only because COVID-19 interfered with the regular operations of the legislature that we were thwarted there and I think that we are, on a reasonable basis, looking to 2021 in Mississippi.”

ILLINOIS, MICHIGAN, WISCONSIN & OKLAHOMA “We’re experiencing similar problems in Illinois, Michigan and Wisconsin, but we’re doing well in Oklahoma where the legislature has just reconvened. We had an unanimous passage of the KCPA out of the House there; we expect the Senate will follow suit quickly.”

MISSOURI In Missouri, the legislature reconvened on Monday and they’re on an accelerated schedule, only treating COVID-related bills, according to Haddow. “We were successful in amending three of those bills in the category of ‘Must Pass’’ or ‘Must Be Considered’ so that hopefully one of those bills will pass and our amendment of the KCPA will be on it. It passed 139-6 in the House. We know that there is overwhelming support for it, it’s just a matter of navigating through the blocks that have been created by the COVID virus.”

RHODE ISLAND “We see similar problems in Rhode Island,” says Haddow. “Although Rhode Island is technically in session throughout the year depending on how they reconvene, we have bills filed in both the House and the Senate there.” New Hampshire “We’re confident we’ll get passage as soon as they reconvene because it is a unanimous vote in the Senate to pass the KCPA, which was a replacement for a proposed ban. The sponsor himself agreed to replace his own proposed ban so we’re confident there.” Louisiana “In Louisiana, we have high hopes that our bill that’s been filed will pass. They started late and so they’re minimally impacted by COVID-19,” says Haddow. “Although they delayed their session we still expect to have a full session and Haddow believes that they will get a fair hearing there.”

FLORIDA “In Florida we had a setback with COVID-19. Before it hit we had just reached an agreement on the House side for the filing. We’ve had a constant stream of Kratom-ban bills year after year in Florida, led largely by Representative Kristin Jacobs down there, who has been a vociferous opponent of ours, and she had been able to persuade some influential leaders in the State Senate on the Health Committee to block our Kratom Consumer Protection Act. She’s been unsuccessful each year in getting the ban.

Unfortunately, and we extend our sympathies to her family, she passed away three weeks ago after a long battle with cancer. We expect that there will be a more reasonable approach taken going forward by the legislature. We struggled in Florida but we’re optimistic we’ll have a better shot at this in 2021, with the possibility of getting something done in 2020. We’ll just have to wait and see.”

OHIO “In Ohio as soon as COVID-19 gets out of the way, we think we’ll get rapid passage in the House,” says Haddow, “We’ve already been through the first hearing in the House Health Committee. I had a very favorable reaction from all the members of the House. There was no opposition testimony at the hearing. We’ve negotiated with the State Board of Pharmacy there and they are willing to cede to the legislature’s will on this.”

Although the outlook is positive, it hasn’t been all peaches ‘n’ cream for the AKA. “We do have some problems with the Department of Agriculture, who are being heavily influenced by the FDA’s disinformation campaign, and they are actively trying to interfere with the sale of Kratom products in Ohio, so that’s a major problem to us but we are continuing to work on that.”

PENNSYLVANIA “In Pennsylvania, we have two members who have committed to filing the KCPA. They're year-round, so we think when the legislative gets back up in operation that we are going to do well,” says Haddow.

“We have a large number of states that we think either in 2020 in the remaining days that are left in various legislative sessions that we have an excellent chance of getting at least three to four of those states to pass the KCPA. We think that early in 2021 that there will be 15 more states that will join in, and perhaps more because we are seeing when legislators see the science and the hear the appeals from kratom consumers who are documenting in their own personal testimonies that kratom has saved their lives and positively influenced their ability to function as normal citizens and workers in society, that they are moved. When we are able to do that, that’s why you see these overwhelming votes; we have offered a responsible way to offer a safe kratom consumer product to consumers, free from contaminants and adulterants. That’s the main thrust of what we do and it’s being universally hailed by most legislators as they review that material.”

If you’re living in a banned state, hope isn’t lost. Haddow says the AKA expects their federal effort with the KCPA to be filed in the next couple of weeks. “We expect to have numerous cosponsors to that and we hope that the FDA will come negotiate with us a more responsible and reasonable regulatory pattern for kratom,” he adds.

With the AKA working diligently to protect our health and consumer rights, it is still not the time to rest on our laurels if we are part of the kratom community. We need to share our experiences and get in front of the policymakers who have the power to change the legislation and stigma against kratom. Don’t discount the impact of appealing to the big, bad government bureaucracy and appealing to them as a human being whose life has been changed for the better by kratom. The big, bad, government bureaucracy is, in fact, made up of people, and your personal kratom testimonies are a surprisingly helpful tool that Haddow says has more of an impact than you may even realize.

“When we evaluate the effectiveness of the campaign to keep kratom legal, there are two important components to it: one is an organized effort, such as we try to do at the American Kratom Association,” says Haddow. “But secondly, it is the powerful, personal testimonials of kratom consumers who stand before public policy officials and tell their stories. Because I can tell you from personal experience of listening to thousands of those testimonies at hundreds of hearings around the country, that that moves these public policy officials. We owe an enormous debt of gratitude to those courageous kratom users who will stand up and tell their stories-- sometimes at risk for their own personal safety: In the state of Wisconsin we packed a room at the Senate Health Committee with kratom consumers who described their experiences with kratom knowing that they were acknowledging that they were violating the Wisconsin State Law in doing so. And yet, they were willing to tell that story,” says Haddow. He says he knows the testimonies were appreciated by the members of the Senate Health Committee because they unanimously opened a bill file to replace the ban on kratom in Wisconsin with the Kratom Consumer Protection Act. “We are a united group with a strong voice and it is derivative of these people who have had an experience with kratom and are willing to stand up and tell their stories,” concludes Haddow. “We’re grateful for that and for them.”

Your Labs Look Fine: What the FDA Doesn't Tell You About Implants

by Alexandra Guadgano

Imagine having the flu: you’re achy, you’re irritable, you’re fatigued, and you pretty much feel incapacitated. Little things like getting up out of bed and lifting your arms to wash your hair in the shower seem like insurmountable tasks. Walking up the stairs feels like climbing your personal Mount Everest. But the great thing about the flu is... it always passes. You’re up and at ‘em after a few days of rest and things pretty much return to normal quickly after you’ve recovered. Now imagine again how you felt when you had the flu; imagine feeling that way every day of your life and still having to function like a normal human being. This is the reality of Breast Implant Illness (BII), which is a condition experienced by many women who have breast implants.

Breast Implant Illness describes a variety of systemic symptoms including (but not limited to) fatigue, chest pain, hair loss, headaches, chills, light sensitivity, chronic pain, rash, body odor, anxiety, brain fog, sleep disturbance, depression and many more. BII is something that women must self-identify, as there is no test for the condition. Little things most people take for granted, like showering or grocery shopping, can exhaust a woman with BII for an entire day or longer.

Women who have either silicone or saline implants carry the same risk of developing BII, as all breast implants have a shell made out of silicone. The shell surface may be either smooth or textured, with some textured implants carrying yet another risk: BIA-ALCL, a rare form of blood cancer. Because of the small risk of developing BIA-ALCL associated with textured implants, some breast implant manufacturers like Allergan have voluntarily recalled certain models of their textured implants.

Breast implants were marketed for many years before the FDA even had the legal authority to approve of these medical devices, and many women were not told by their plastic surgeons that their implants would need to be replaced at some point. While plastic surgeons now agree 10-15 years is the “shelf-life” before breast implants need to be removed or replaced, many women were sold a much different story: they were told by their plastic surgeons that they would not need to be removed or replaced unless “something went wrong.” In many cases, something did.

Stephanie Durand is a woman who decided to get implants. Approximately two to three years after her breast augmentation, she started to experience symptoms such as brain fog and other neuropsychological issues.

“In the past, all physicians either thought my symptoms were some psychological issue or neuro Lyme disease,” Stephanie recalls. She researched doctors and spent ten years meeting with top physicians throughout the US in all areas of expertise, including neurologists, neuropsychiatrists and autoimmune specialists to try to figure out what was going on with her health. “I was going through many different aggressive and lower-key treatments, some that nearly killed me!” says Durand. “Not one physician asked me if I had implants or even thought to do that type of in-depth screening, and the surgeon who implanted never told me of these types of risks.”

Stephanie has already been planning on the removal of her implants because she has developed capsular contracture, another risk that comes with breast implants. This is a tightening of the scar tissue surrounding the breast implant that can be very painful for the patient. “But when my cousin reached out and told me about BII, I was bewildered! I’d never heard of it before, had no idea what it was, so I joined some Facebook groups [for women with Breast Implant Illness] and was non-stop reading story after story, crying and thinking, ‘OMG. I definitely have this!’ And that’s when my mission to find the best surgeon began.”

Stephanie consulted with several top microsurgeons and now is scheduled to explant this May. “Explant” is a term for the procedure that will not only remove the implants but also the capsules, or scar tissue, that naturally form around them. Many times, the implant will adhere to bone and has to be scraped off the rib cage during the explant and capsulectomy procedure, according to Dr. Brian Buiniwicz, a triple board certified NJ surgeon with over 23 years of plastic surgery experience. It is important to note that explant is different from basic breast implant removal, as it involves the full removal of the scar-tissue capsules that have formed around the implant that can continue to cause illness if left in the body. Recovery from this procedure can be pretty painful, but Stephanie is excited and says nothing will stop her! She is hoping to see a complete decrease of all BII symptoms, especially her brain fog.

Gina Morreale Rizzo is another woman who had breast implants and has already gone through explant surgery. She had the implants done in 2004 and was told they were a “lifetime device” by her original plastic surgeon. About five or six years later, she woke up with a very swollen large right breast and went to see the same surgeon for an MRI. Results were negative for anything malignant, and she was told it was fluid build-up that her body would absorb, which it did. It was after that incident that Gina started having health issues and symptoms consistent with BII, but she never associated her symptoms with her implants until she found a Facebook group and started talking to other women who have or have had Breat Implant Illness.

“My hands would get VERY swollen and hurt to the point I was on steroids,” Gina recalls.

“My hair started to fall out, my joints hurt so much, I was exhausted all the time.” She didn’t believe her rheumatologist when the doctor suggested her symptoms might be because of her implants. “I completely dismissed him, I thought he was crazy,” says Gina.

But after her explant surgery in December 2019, Gina feels like herself again. “My healing?

Unbelievable!” says Gina. “Inflammation gone, pain in my neck and shoulder gone the next day [after explant]. No more knee and hip pain. My eyes are whiter, and fatigue is gone, but seems to have creeped back lately.” Such is the case for a lot of women recovering from BII after they remove what Gina calls “toxic bags” from their bodies.

Some explant surgeons say it takes a month for each year the patient had the implants to fully heal. Other naturopaths say that silicone takes one to two years to leave the body completely, but many women do start seeing immediate relief of symptoms after explant. “Oh, and my hair is growing back!” Gina says excitedly.

If we know the symptoms of BII generally clear up after the foreign objects are removed, why don’t all women who fear they may have BII make an appointment for an ASAP explant?

Even though Stephanie knows she is ill because of her implants, she will foot the bill for her explant, as most insurance companies offer little to no coverage for this procedure.

There are some exceptions, and these should always be looked into, but most times, even when the patient is removing her implants for serious medical concerns, the explant is considered a cosmetic procedure and entirely up to the patient to finance. Prices vary widely from state to state, and no -- you don’t get a refund for your original implants either! It can feel rather unfair, causing women to beat themselves up emotionally for ever getting them in the first place.

For Stephanie, however there is a silver lining. She says her company, BrainOpt, “would most definitely not have come to fruition without the decision to have implants, so for that I am accepting of my apparently necessary journey.”

The FDA says it is currently struggling to better understand BII, why some women get it and some women do not. “Researchers are investigating these symptoms to better understand their origins. These symptoms and what causes them are poorly understood.

In some cases, removal of the breast implants without replacement is reported to reverse symptoms of breast implant illness.” Meanwhile, ads for breast implants are still running and women are still implanting without full disclosure about how putting these foreign objects inside the body. Implants can and have devastated the lives of thousands and thousands of women, many of whom gather on various Facebook groups to revel in each other’s progress, ask questions, find “explant buddies” with their same surgery date, and to cheer each other on.

Stephanie says that if she could give any advice to her younger self, it would be not to get implants in the first place.

“I lost ten years of my life and don’t even like them.” If you have breast implants and are concerned you may have BII, trust your instincts and be your own advocate. Listen to your body, and keep a journal. Do not even worry about the aesthetic of your “after”-your health is more important. You aren’t any less of a woman without implants, and many of the women who have gone through both implant and explant have happily proclaimed that they like their natural breasts much better!

Many women would love to have “the perfect body” and are willing to pay good money to get it. Breast implants are still the most popular type of plastic surgery done in the United States. It was shocking to find out that when the term “breast implant illness” is searched Google, the first few items you see are ads for breast implants. Surgeons are still putting implants into women as others strive to save up for their explant when their insurance fails them, out of work and out of money from the damage their breast implants have caused to their bodies.