Kratom Concerns: As kratom use surges, some states enact bans.

AuthorVestal, Christine
PositionDRUG POLICY - Reprint

On a sunny November afternoon in the quiet college community of Carrboro, N.C., a steady stream of customers walks through the doors of a local cafe called Oasis for a cup of an increasingly popular herbal beverage. The menu offers coffee, black tea, beer, wine and pastries, but nearly everyone opts for a $5 mug of kratom (pronounced KRAY-dum).

A powder ground from the leaves of an indigenous Southeast Asian tree related to the coffee plant, kratom (Mitragyna speciosa) offers pain relief and mood enhancement, similar to prescription painkillers.

Advocates say the substance, which does not depress the respiratory system and therefore presents little to no overdose risk, could help reduce the nation's reliance on highly addictive and often deadly prescription painkillers. Some addiction experts also argue the plant could be used as an alternative to methadone, buprenorphine and Vivitrol in medication-assisted therapy for opioid addiction.

Used for centuries to fight fatigue, pain and anxiety in Indonesia, Malaysia, Myanmar, Papua New Guinea and Thailand, kratom was rarely taken in the United States until recently.

Now, with growing concerns about the dangers of prescription painkillers, an estimated 3 million to 5 million people are using kratom and reporting positive results, based on information from retailers. But worries that the unregulated plant product could be abused for its mild euphoric qualities and that users could become addicted are spurring federal officials to issue public health warnings--and a handful of states and cities to impose bans.

Alabama, Arkansas, Indiana, Tennessee, Vermont, Wisconsin and the District of Columbia have banned kratom, along with at least three cities--Denver, San Diego and Sarasota, Florida. Illinois and Louisiana ban sales to minors. And legislation was considered in 2016 in at least six other states--Florida, Kentucky, New Hampshire, New Jersey, New York and North Carolina.

Animal studies have shown that kratom use may lead to addiction. But user surveys indicate that although the herb can be habit-forming, withdrawal symptoms are no worse than those encountered when quitting coffee, sugar or certain herbal supplements. Withdrawal symptoms, which typically last three to four days, include muscle aches, cravings, a runny nose, restlessness and mood swings.

The Drug Enforcement Administration last year said it intended to classify the herbal supplement as an illegal Schedule 1 drug, along with...

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