- Addiction & recovery
Is Kratom Legal?
David Schwartz, MD
December 27, 2021
Is Kratom Legal?
Kratom is a tropical evergreen tree native to Southeast Asia and certain parts of Africa. Kratom contains psychotropic compounds that have been used for generations for medicinal and ceremonial purposes. Traditionally kratom leaves are chewed raw or brewed into a tea to help reduce fatigue, aches, and pains. Kratom is now sold in various forms, including dried or crushed leaves, powder, capsules, tablets, liquids, and resin in stores that sell supplements and alternative medicines. They are also readily available via the internet and at farmers’ markets around the United States.
At present, kratom is gaining popularity as a natural alternative to opioids and treatment for opioid withdrawals, chronic pain, and digestive ailments. Kratom has garnered considerable attention in the U.S., and it’s now listed as a “medication of concern” by the U.S. Drug Enforcement Administration (DEA). Although kratom is allowed at the federal level, it’s prohibited in certain states. And as of 2021, federal regulation will stay on hold as the debate over kratom continues.
How Does Kratom Work?
Kratom’s two primary compounds: mitragynine and 7-a-hydroxy mitragynine, interact with opioid receptors in the brain and trigger stimulant effects in low doses and sedative effects in high doses.
The stimulant effects include:
- Increased energy
- Increased sociability
The sedative effects include:
- Reduced anxiety
- Lowered pain sensations
The interaction of kratom with opioid receptors in the brain is akin to how opioids such as morphine react with the brain. And as such, the FDA classifies kratom as an opioid.
Kratom generates effects within 5-15 minutes after consumption and lasts for 2-5 hours after the last dose. The effects of kratom differ based on each individual, dosage, and method of consumption. Kratoms’ primary compound, mitragynine, can vary in potency based on the location and season of growth. Since kratom grown in Southeast Asia has a higher mitragynine content, its effects are far more unpredictable.
There is little scientific evidence to prove kratom’s effectiveness in treating any medical condition and no controlled clinical trials to determine its safety. The majority of what we know about this substance comes from anecdotal accounts from consumers, doctors, and animal studies.
Does the FDA Approve Kratom?
The U.S Food and Drug Administration (FDA) has not approved kratom for treating any medical condition. Furthermore, the FDA has also issued warnings to companies that sell kratom in the United States or illegally promote kratom as a herbal supplement that claims to cure, treat, mitigate, or prevent mental health disorders and other medical conditions, as only FDA-approved medications can make such claims.
The FDA is currently evaluating all available scientific information on kratom and encouraging more research to understand its safety profile better. But in the meantime, the FDA continues to warn people not to use any products containing kratom or its psychoactive components. The FDA has also taken action to limit the sales and consumption of kratom.
While the FDA continues to assess the available information on kratom, health care professionals and consumers are encouraged to report any adverse reactions caused by kratom to the FDA’s MedWatch program.
What Is the Kratom Consumer Protection Act?
The Kratom Consumer Protection Act (KCPA) is a bill that governs the kratom industry in the United States. The bill addresses the following areas:
- Manufacture, distribution, sale, and possession of kratom
- Manufacture, distribution, and sale of contaminated or adulterated kratom
- Any age limits
- Fines and penalties
- Testing kratom
- Labeling kratom products
The purpose of the KCPA is to ensure kratom vendors only supply high-quality, unadulterated products that do not contain contaminants. If a kratom vendor does not follow the KCPA regulations, they could face large fines or even criminal charges.
Although the KCPA has a standard text, states can change certain elements to create their version of the KCPA bill. This flexibility allows each state to craft legislation tailored to their state’s specific needs regarding the kratom industry.
Some of the standardized text found in the Kratom Consumer Protection Act is as follows:
- Prohibits the sale of kratom to minors under the age of 18.
- Disclosing if any product contains kratom.
- Prohibiting the sale of kratom products that have been adulterated or contaminated with dangerous substances.
- Prohibiting any kratom products that are mixed with or packed with any substances scheduled in the respective state.
- Forbidding the sale of any kratom product that contains more than 2% of 7-hydroxy mitragynine.
- Prohibiting the sale of any kratom product that contains synthetic kratom alkaloids or a synthetic version of any other natural kratom compound.
- Labeling the kratom product and stating the ingredients and origin of kratom.
- Disclosing the amount of mitragynine and 7-hydroxy mitragynine that each kratom product contains.
Currently, four states have passed the KCPA bill, while others, such as Oregon, have taken steps towards legal but regulated status for kratom.
The Legality of Kratom In the United States
The legality of kratom in the United States remains complicated due to both federal and state laws. Kratom is technically legal for use and possession in the U.S. However, certain states have imposed a complete kratom ban.
Kratom is illegal to buy, sell, possess or use in:
- Rhode Island
Kratom is legal but regulated in states such as:
- California (kratom is legal in California except for San Diego)
- Colorado (kratom is legal in Colorado except for Denver)
- Florida ( kratom is legal in Florida except for Sarasota Country)
- Illinois (kratom is legal in Illinois for those over the age of 18, except for Jerseyville)
- Mississippi (kratom is legal in Mississippi except for Union County)
- New Hampshire (kratom is legal for those over the age of 18)
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- South Carolina
- South Dakota
- Tennessee (kratom is legal for those over the age of 21)
- West Virginia
Is Kratom Legal In Other Countries?
Kratom is currently illegal in many countries due to its potential for negative side effects and its capacity to cause dependence or addiction. However, as kratom gradually gains popularity in many countries that do not currently have a kratom ban, many may eventually restrict them.
Kratom is illegal in the following countries:
- New Zealand (Unless the individual has a prescription from a healthcare provider)
- South Korea
The law on kratom may vary from one city to another in Ireland, Italy, and the United Kingdom. And the legality remains unclear in China and many African nations. Furthermore, Thailand has recently reconsidered the status of kratom, making it only legal for medicinal use. However, the possession of larger quantities of the substance or trafficking remains a major offense in Thailand and bordering countries throughout the region.
Is Kratom Safe?
There is substantial concern about the safety of kratom as it can cause dangerous side effects, especially at high doses. According to the National Center for Biotechnology Information (NCBI), poison control centers in the U.S. received around 1800 reports involving kratom use between 2011 and 2017. About half of such reports included serious negative outcomes such as high blood pressure and seizures.
Some of the reported side effects of kratom include:
- Dry mouth
- Increased urination
- Loss of appetite
- Liver damage
The unregulated nature of kratom makes it highly likely to be contaminated with other harmful substances and making kratom even more dangerous. In 2018, the FDA issued a mandatory recall over concerns of kratom products being contaminated with salmonella. Kratom can also interact with alcohol and opioid medications and cause serious side effects or even death.
The DEA attempted to schedule kratom as a Schedule I substance due to the risks associated with kratom use. However, due to the backlash, they remain classified as a “substance of concern” for now to allow scientists to substantiate kratom’s medical claims as being the key to fight the nation’s opioid epidemic.
How Addictive Is Kratom?
Kratom can cause addiction when used regularly over a prolonged period. The regular use of kratom alters brain chemistry and causes it to depend on the substance to function normally. Kratom addiction can develop in as little as six months, making it one of the most serious concerns of using the substance.
Individuals with a dependence or addiction to kratom may experience withdrawal symptoms upon quitting the substance abruptly, including:
- Muscle aches
- Emotional changes
- Runny nose
- Jerky movements
Although people who use kratom believe in its health benefits, researchers who studied kratom believe that the side effects and risks of the substance far outweigh any potential benefit. Thus, it is crucial to avoid using kratom products until credible results about their health benefits are established.
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