Ban or Regulate Kratom? State Lawmakers Weigh Approaches to Herbal Supplement

Users of an herbal supplement say the drug alleviates chronic pain, lessens depression and even helps tame opioid cravings of those striving to overcome their addictions. 

For state legislators, the increased consumption of kratom, a substance derived from the leaves of trees native to Southeast Asia, is raising the question of whether they should ban it or establish regulations to ensure any products for sale are safe.

Crushed into a powder, kratom is often ingested as tea and reacts with different receptors in the brain producing either a sedative or stimulant effect depending on the amount consumed.

The Food and Drug Administration has advised consumers against using kratom, expressing concern that the substance affects the brain’s opioid receptors and could put users at risk of addiction or abuse. 

Last June, the FDA issued warning letters to two marketers about touting “unproven claims” that kratom can help with serious medical problems and cautioned that there were high rates of salmonella contamination in products for sale. 

“Despite our warnings, companies continue to sell this dangerous product and make deceptive medical claims that are not backed by science or any reliable scientific evidence,” said Dr. Ned Sharpless, then-acting FDA commissioner.

But at the federal level, the herbal supplement isn’t outlawed. The Drug Enforcement Administration in 2016 threatened to ban kratom and classify it as an illegal drug in the same category as heroin and LSD, but backed off amid an outpouring of opposition from advocates and lawmakers.

In the states, an industry lobbying group is rallying users and urging lawmakers not to ban kratom, but instead regulate the substance . 

The problem with kratom’s use stems from when it is mixed or used in conjunction with other substances, said Peter Candland, executive director of the American Kratom Association.

“We feel that the danger out there is in adulterated kratom, not pure kratom,” Candland said. 

That’s why he said the association is lobbying lawmakers to adopt “labeling requirements that show the consumer what is in the product they are purchasing.”

The association is actively working in at least 15 states this year on proposed laws members say would protect kratom consumers, Candland said. These measures sometimes  include prohibiting sales to minors, banning the sale of kratom mixed with dangerous substances, and requiring kratom products to include labels that list their contents.

Kratom can be bought online or found in many tobacco or head shops. Six states—Alabama, Arkansas, Indiana, Rhode Island, Wisconsin and Vermont—and four cities have outlawed kratom, according to the association. The group is lobbying this year to replace some of those bans with regulatory schemes. 

Concerned about kratom’s easy accessibility and federal warnings about its use, Maryland lawmakers initially introduced legislation this year in the House and Senate that would make kratom an illegal drug. 

“Kratom is unregulated and marketed as an herbal supplement, however, it is clearly a drug, an unregulated, uncontrolled drug that you can buy at several locations a short distance from here,” Maryland Del. Kenneth Kerr, a Democrat, told the Maryland House Judiciary Committee at a hearing on the kratom bill this week. “We should treat it like a drug.” 

After an outpouring of testimony from users who extolled its virtues, however, lawmakers have instead amended the House proposal to  restrict the sale of kratom to adults who are 21 or older. An amended bill that bans sales to people under the age of 18 was passed by the Maryland Senate on Friday.

During the House Judiciary Committee hearing this week, some lawmakers expressed skepticism over the amendments, saying they did not go far enough to regulate the substance. 

“I think there needs to be something more than it’s okay if you're 21 and over, go use it,” said Del. Susan McComas, a Republican. 

The House committee has not voted yet on the amended bill. 

Elsewhere, state lawmakers opted to adopt regulatory standards for kratom. Last year, Arizona, Georgia, Nevada and Utah all passed legislation supported by the AKA, which would ban the adulteration of kratom and require businesses that sell kratom to ensure labeling accurately reflects what is in the product.

The Centers for Disease Control and Prevention has linked kratom use to some drug overdose deaths. The CDC found that out of 27,000 drug overdose deaths occurring in an 18-month period, medical examiners listed kratom as a cause of death in 91 cases. Kratom was the only substance detected in seven deaths, although the CDC said it could not rule out the presence of other substances in those cases.

Oregon is among the states this year to consider legislation regulating sales of kratom, with the state’s House Committee on Economic Development holding a hearing this week. The bill under consideration would require the state’s agriculture department to regulate kratom, and bans the sale of kratom products that are mixed with dangerous substances or to anyone under the age of 21.

Currently Oregon has no information on how many businesses sell kratom in the state or the purity of the substances sold, said Rep. Bill Post, the bill’s sponsor.

Post said he was curious about kratom, having seen signs advertising the substance around the state. But it wasn’t until he learned more about it from AKA lobbyists that the typically small-government Republican saw the need to propose regulations.

Encouraged by testimony that kratom can help people successfully beat opioid addictions, Post said he believes the state will be “in good shape” if it can keep adulterated kratom off the market and the product out of the hands of those under 21 years of age.

Asked if he’s ever tried kratom, Post said he’s thought about using it for relief from the occasional headache or backache, but ultimately declined because of concerns about purity. 

“There’s 15 stores in my town that probably sell it, but I don’t know what they are selling,” he said.