Faith Monahan ‘24
Kratom, a plant originating from Southeast Asia consumed for its psychoactive effects, has continued to receive increased legal attention over the past decade. The plant’s leaves can produce both sedative, opioid-like effects in large doses and stimulative effects in small doses. Symptoms of psychosis have also been reported while under its influence. The substance has been used to self-medicate for weight loss, substance withdrawal symptoms, and even depression, but it may also be addicting and have dangerous health effects. Although Kratom remains unregulated federally, state governments have begun to take steps towards regulating or banning it.
Kratom was first introduced in the United States following the Vietnam War, but its use has increased over the past 15 years. Kratom is typically consumed in the United States as a pill, capsule, or in tea. The effects of Kratom are produced by two difference compounds in the plant’s leaves which interact with both opioid receptors and adrenergic receptors. Although it can decrease pain and produce serotonin in the brain, negative health effects can include seizures and hallucinations. The opioid-like effects that are caused by Kratom are potentially addictive, but it has also been reported by users to have medical benefits. There have also been deaths reported from ingesting the drug. More research is needed to determine if there is any health benefit to Kratom or if it should be a federally-scheduled drug.
Six states have passed legislation that make Kratom illegal in that state: Alabama, Arkansas, Michigan, Indiana, Vermont, and Rhode Island. A few other states have legislation currently pending. Regulation of Kratom would allow restricted access to the substance rather than an outright ban, and several states have proposed bills to limit underage sales and ensure safety. Earlier this month, the CT General Assembly introduced a bill that would prohibit the sale of Kratom products to individuals under twenty-one years of age, parallel to the age-specific bans on alcohol and recreational marijuana. A similar bill was proposed in 2021, but it died in committee. Other states that have passed bills regulating Kratom into law include Nevada, Utah, Arizona, and Georgia.
At the federal level, there is no ban or regulation of the substance despite a push to do so in 2016 that was later reversed. The Drug Enforcement Administration has not placed Kratom under the Controlled Substances Act, so it does not fall under any of the five schedules that categorize controlled substances in the US.
There are also no FDA-approved uses for Kratom. The Food and Drug Administration (FDA) has also issued statements cautioning users about the unproven medical claims attributed to Kratom, the contamination of Kratom products, and the adulterated dietary supplements containing Kratom. In 2018, the FDA found that several products contained salmonella. The US Marshalls have seized large amounts of Kratom indented for distribution or suspected of contamination under the FDA’s request.
The American Kratom Association (AKA) has advocated for the legislative regulation of Kratom in the United States rather than its outright ban. The non-profit organization has developed manufacturing practices to make the substance safer for its consumers. The AKA also states that the FDA has not considered the role that other drugs play when combined with Kratom that may lead to the harmful effects reported by some users.
The National Institute on Drug Abuse (NIDA) states that rare but severe cardiovascular, psychiatric, and other health problems have been reported due to its use. An estimated 0.6% of Americans aged 12 or older reported using Kratom in the past 12 months in 2021. Deaths from ingesting Kratom have been very small compared to other substances, but they do occur. Most reported deaths involved a combination of Kratom with drugs or contaminants. Evidence and research regarding whether there are any health benefits or harmful impacts of Kratom as an alternative to other treatments are still emerging.