An advertisement for Kratom at a shop in Phoenix. Photo by Jerod MacDonald-Evoy | Arizona Mirror
The brown tablets in their light blue packaging look nice, but they disguise a secret you’d never know without thousands of dollars worth of testing equipment.
“Advanced kratom alkaloids,” the packaging reads across the top. Depending on where you’re shopping, the three pills could cost $10 or $40.
The tablets claim to consist, in part, of the leaf of a plant called kratom that is native to Southeast Asia, where it has been used for about 150 years. It has an opioid-like effect that laborers in the region use to ease pain and work longer hours. In small doses, kratom has a stimulant effect, but when taken in higher doses, it acts as a sedative.
But kratom advocates are sounding the alarm on these tablets because of the secret they hold.
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The active ingredient in kratom is the alkaloid 7-hydroxymitragynine, often called 7-OH, which is found naturally on the leaves of the plant and is responsible for its opioid-like qualities. But tablets like these, which are synthesized in a lab and not made from the actual plant, often have higher concentrations of 7-OH than one can get from the plant alone.
“It’s closer to morphine than it is to kratom,” Matthew Lowe, executive director of the Global Kratom Coalition, a group that advocates for responsible use of kratom and regulations to keep it legal.
The group conducted a “secret shopper” of Arizona shops and found the pills easily available and being sold as kratom. They also discovered other products like nasal sprays and 7-OH “ice cream cones,” which the group says flies in the face of existing state laws regulating kratom.
But enforcement and testing of these products seems to exist in a gray area, one in which federal authorities are waiting for each other to act and states have implemented a patchwork of regulations that advocates say aren’t being enforced.
In Arizona, the agency ostensibly responsible for enforcing kratom regulations is the Arizona Department of Health Services. But ADHS said it collects no data on kratom sales and doesn’t proactively do any enforcement, in large part because of uncertainty between state and federal laws.
“ADHS is actively analyzing the federal and state laws related to kratom due to potential conflict between regulatory approaches,” an agency spokesperson told the Arizona Mirror in a statement. “We are working with a broad set of stakeholders on compliance of the sale of kratom food products. We can investigate complaints made in regards to the illegal sale of these products. At this time, ADHS does not have data on the sale of kratom products.”
That inaction gives bad actors the ability to act with impunity, putting consumers at risk, Lowe said. To urge enforcement, the Global Kratom Coalition sent a letter to Attorney General Kris Mayes urging her to investigate.
“We are turning to the AGs to take action and we are turning to the media to report on this issue,” Lowe said. “They are proliferating widely across the United States.”
The AG’s Office said it is “reviewing the letter internally” and had no further comment.
Local law enforcement say they know there are illicit “kratom” products being sold, but there is no organized effort to police the products or the shops selling them.
“I can confirm our Drug Enforcement Bureau detectives have come across this drug during their investigations but not in high volume,” a Phoenix Police Department spokesperson said in a statement. “In Phoenix, it appears many smoke shops are selling the drug illegally. The department is always monitoring crime trends but currently Fentanyl remains the biggest concern.”
The Maricopa County Sheriff’s Office told the Mirror that they are not currently investigating anything related to kratom at this time.
“Kratom, because of the lack of oversight and regulation may or may not contain other harmful additives or ‘cuts’ and is therefore considered a drug of concern by DEA and FDA,” MCSO spokesman Sgt. Joaquin Enriquez told the Mirror. “Still, no one locally is investigating this as far as we know.”
What exactly is kratom?
Mitragyna speciosa is native to Southeast Asia and is related to the coffee plant. Its leaves have long been ground into a powder, which can then be taken in pill form, smoked or turned into tea.
The drug interacts with many of the same receptors in the brain that opioids do. Because of that, many advocates say kratom can be used as an alternative to opioids — and can be a tool to fight opioid addiction.
It has been on the DEA’s radar since 2011, when the agency listed it as a “drug of concern.”
In 2016, the DEA published in the federal registrar that it intended to classify it as a Schedule I drug, placing it alongside heroin, LSD and cocaine. When a drug is classified under Schedule I, it is deemed to have “no medical use.”
But an outcry from advocates, who raised a variety of claims on the positive impacts of the drug, led to the DEA withdrawing its intent to classify kratom as a Schedule I drug.
The DEA then decided to wait on the Food and Drug Administration to complete a medical and scientific review of the main components of kratom, mitragynine and 7-hydroxymitragynine. The FDA has not recognized any form of kratom and is currently continuing to investigate it.
“While there’s no date to provide at this time, we expect to publish the final study results of the FDA’s single ascending dose (SAD) study in the near future,” FDA press officer Lauren-Jei McCarthy told the Mirror.
“Kratom is not controlled under the Controlled Substances Act but DEA considers Kratom a drug of concern,” DEA spokeswoman Jodie Underwood said in an email to the Mirror. “We cannot comment further.”
The Arizona Kratom Consumer Protection Act
In 2019, Gov. Doug Ducey signed the Arizona Kratom Consumer Protection Act into law.
The measure implemented a number of regulations, including prohibiting the sale to minors and setting guidelines on how kratom is sold and labeled. The law describes kratom as a “dietary supplement,” a designation the FDA has said it rejects but one that advocates embrace.
The act prohibits any kratom product, or derivative, from having a 7-OH level higher than 2%.
But products appearing on store shelves in Arizona and across the country in areas with similar regulations are seeing products with higher 7-OH concentrations than 2%. Products purchased by the Global Kratom Coalition that were labeled as kratom are actually synthetic creations that consist of higher levels of 7-OH, making them more potent than leaf kratom.
Users on sites like Reddit have spoken about how products that are made of this synthetic higher concentration are “more addictive” than pure kratom and other drugs they’ve encountered.
“RUN away while you can,” one user wrote on a post asking if anyone had heard of the products, adding that it is “vastly more addictive” with “heroin level withdrawals.”
Data across the country and in Arizona is showing that kratom is appearing in accidental overdose deaths, as well. In Florida, hundreds of deaths have been attributed to the drug, and journalists at the Tampa Bay Times found that many synthetic kratom products were misleading consumers and included high levels of 7-OH and other opioid-like alkaloids.
Center for Disease Control Data reviewed by the Mirror found that there were 30 deaths attributed to kratom in 2022, 51 in 2021 and 44 in 2020.
One of the companies making these products found in Arizona, 7-OHMZ, did not respond to requests for comment for this story.
Synthetic vs Real
Lowe and other kratom advocates say that these products give kratom a bad reputation, and are proliferating because no one is enforcing the regulations aimed at stopping them.
“We do not believe that they are kratom, and they are being sold as kratom, which is not a good look,” Lowe said. His group says they’ve seen reports of people using synthetic kratom experiencing something called “the nods,” which is commonly associated with a possible fatal overdose of heroin when a person begins to “nod off.”
“We are worried kratom will be dragged down by a substance that is not kratom,” Lowe said, adding that the level of 7-OH found on the leaves of kratom is often much lower than in the synthetic creations. “We are starting to see it from a consumer perspective and how people run into issues and we are certainly starting to see the regulations are not working.”
To combat the synthetic products, Lowe said regulators need to go after the manufacturers, who market the product as kratom and as something that is fully legal. Some even make products that look like ice cream cones, which Lowe says violates the Arizona rules barring marketing products to children.
“Consumers need to be aware of what is going on and really take caution,” Lowe said. “We are pushing now to create in (Kratom Consumer Protection Acts) that this product can be habit forming…it is super important for a consumer to understand that.”
Research has shown that kratom can be addictive and other studies have shown that lax regulations have led to contaminated products. Some kratom manufacturers are now facing legal challenges over deaths related to their products. One thing many of the studies also agree on is that there is not enough data on kratom and its use, something made difficult by the legal gray area it currently resides in.
There have been other attempts at legislation aimed at the issue. In 2021, Sen. Sonny Borrelli, R-Lake Havasu City, ran a measure that would have given sellers of kratom immunity if it was eventually classified as a Schedule 1 drug. The bill never became law.
Those who advocate for its responsible use said they will continue to sound the alarm over what they see as dangerous products that should not be labeled as kratom or sold in certain states at all.
“You got the bones of a really good piece of legislation, but the reality is it is not being enforced,” Lowe said. “No action has been taken yet, but we are going to continue to beat that drum…I think they just don’t know what is going on.”
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