Investigators find kratom with two deceased University of Mississippi students

Eleven states have banned the herb; FDA has not regulated it

Investigators this week found packaged kratom in the possession of two deceased University of Mississippi students, prompting new warnings about the herbal supplement from US officials, according to BBC News reporters Brandon Drenon and Madeline Halpert. The deaths were not attributed to kratom, but Mississippi authorities and other agencies are cautioning against its consumption.

The episode has renewed scrutiny of kratom, a tree native to Southeast Asia whose leaves have been used for centuries for their stimulant properties and, in concentrated forms sold in the US, produce opioid-like effects. The herb entered the US market as a dietary supplement around 2016, said Dr Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University. “That’s really where the problems began,” Speights told the BBC.

In the US, kratom is sold in pills, powders and liquids at convenience stores, gas stations and vape shops. Because the substance is classified as a dietary supplement, it is not subject to FDA regulation. “There’s no way to know exactly what you’re getting,” Speights said. “You could go and create something in your basement, market it as a supplement, and nobody’s really going to check and see what’s in it.”

Kratom is often marketed as a safe, natural herbal supplement that helps with pain management, anxiety and depression, according to the BBC. At lower doses, the herb produces what Speights described as “a caffeine-kind of buzz.” Because of its opioid-like effects, it has also been used with the goal of curbing addictions to actual opioids like fentanyl. Those properties stem from the way the plant’s compounds — including 7-Hydroxymitragynine — activate hormones including dopamine, producing effects Speights compared to narcotics. “At higher doses, it can create more euphoria and give you more of a general high,” he said. Hallucinations are possible, and the same dosage range carries greater risk for adverse side effects.

The biggest danger, experts told the BBC, is that kratom is not federally regulated, leaving users no way to verify what products contain or in what dose. Specific risks at higher doses include central nervous system (CNS) depression, a condition Speights called “where the deaths come in” and which can result in cardiovascular collapse and loss of breathing. Withdrawal symptoms and addiction are additional risks, according to Jana Wu, director of clinical integration at the addiction treatment centre Mountainside. “It affects marriages, relationships,” Wu said. “I’ve seen people lose jobs, spend thousands of dollars a month on it.” Because users can develop a high tolerance, they may take increasing amounts over time. “I’ve worked with people that were taking like up to 20 pills a day,” Wu said.

Asked whether there is a safe dose, Speights answered: “My answer is going to be no because — I’m going to go back to this — we don’t know what’s in it.”

Some users credit the supplement with restoring quality of life. Jeffrey Deaver, a 58-year-old retired timber cutter in Washington state, told the BBC he has taken kratom for four years to manage severe chronic hip and knee pain. He discovered the herbal product when he couldn’t find relief from doctors and while waiting for surgeries. Scared at first, he “started small” before increasing his dose until his pain subsided. “It was like a miracle,” Deaver said. “I could sleep. I could function. I just don’t know what I’d do without it.”

Kratom is banned in 11 states — Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Massachusetts, North Dakota, Tennessee, Vermont and Wisconsin. Massachusetts became the eleventh state to outlaw the supplement, issuing a temporary emergency order in August. Ten years earlier, the US Drug Enforcement Administration had moved to classify kratom as a Schedule 1 substance, calling it “an imminent hazard to public safety.” The effort failed a few months later after the Department of Justice said it received “numerous comments from members of the public challenging” the attempt, leaving regulation to the states.

Arizona recently sued a company selling kratom beverage products. Anti-kratom advocates are pushing states to do more, arguing that “gas-station drugs are poisoning our communities.” Pro-kratom groups, including the American Kratom Association, are instead pushing for bans against synthetic products “posing as natural kratom.”

Internationally, kratom is banned in the UK; European laws vary by country. In Malaysia, where the tree is native, consumption and sale are banned under the Poisons Act of 1952.