Packaged kratom found with two US students as safety warnings grow

Investigators found packaged kratom in the possession of two deceased University of Mississippi students, though officials did not attribute the deaths to kratom, the BBC reported.

What investigators found and the immediate response

The discovery prompted renewed warnings about kratom, an herbal product with opioid-like effects now sold widely across the United States. The BBC report said the students’ deaths were not linked to kratom by investigators, but that the find has focused attention on the supplement and its risks. BBC

What kratom is and how people use it

The BBC described kratom as a tree native to Southeast Asia, used for centuries in countries such as Thailand, Malaysia and Indonesia. In those places it has traditionally been consumed in a tea-like form. The herb entered the US market around 2016 and is now commonly sold as pills, powders or liquids.

Users and some sellers market kratom as a natural supplement for pain, anxiety and depression. The BBC said the plant has stimulant effects at low doses and opioid-like effects at higher doses, and that some people have used it to try to reduce dependence on opioids such as fentanyl. BBC

Health risks flagged by clinicians

Clinicians quoted by the BBC warned of serious risks. Dr Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, said the concentrated forms common in the US increase problems because the contents are not regulated. He said there is no reliable way to know what a kratom product contains.

The BBC reported that higher doses can produce euphoria and hallucinations, and that central nervous system depression is a chief concern because it can lead to cardiovascular collapse and respiratory failure. Jana Wu, director of clinical integration at the Mountainside addiction treatment centre, told the BBC withdrawal and addiction from kratom can damage relationships and careers.

Availability and the legal picture

The BBC said kratom is widely available in the US, including in convenience stores and petrol stations, and that the Food and Drug Administration does not regulate it as a drug. The report listed 11 states where kratom is banned: Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Massachusetts, North Dakota, Tennessee, Vermont and Wisconsin.

The BBC also reported that about ten years ago the US Drug Enforcement Administration moved to classify kratom as Schedule I, but the effort was later dropped after the Department of Justice said it had received many public comments opposing the move. Internationally, kratom is illegal in some countries, including the UK, and laws vary across Europe. BBC

Voices from users and advocates

The BBC quoted a long-term user, Jeffrey Deaver of Washington State, who said kratom eased severe chronic pain and described the relief as transformative, saying, “It was like a miracle,” and, “I just don’t know what I’d do without it.”

The report noted advocacy divisions: some groups call for broader bans against what they call dangerous retail products, while pro-kratom organisations such as the American Kratom Association push to restrict synthetic products that imitate natural kratom. BBC

Featured image: Fda.gov via Wikimedia Commons, Public domain.