The U.S. Food and Drug Administration recently recommended classifying hydroxymitragynine, a chemical found and concentrated from the leaves of the kratom plant, as a Schedule I drug in a July 29 press release.
This would label the drug as a controlled substance, limiting how it can be sold. As a result, products containing both the concentrated form and natural product of the leaves have fallen under increased scrutiny from the public.
The scrutiny has even reached the Texas Legislature, with House Bill 291 implementing stronger restrictions on its sale and criminal offenses. With action being taken against this ingredient, what exactly is kratom, and how are thousands across the United States potentially being affected through addictions and overdoses?
Kratom is described by the Drug Enforcement Administration as “a tropical tree native to Southeast Asia,” stating that “consumption of its leaves produces both stimulant effects (in low doses) and sedative effects (in high doses), and can lead to psychotic symptoms, and psychological and physiological dependence.” 7-OH, or 7-hydroxymitragynine, is sold directly in concentrated forms, and is currently being suggested to be scheduled as a controlled substance by the FDA. However, it is also formed naturally from the consumption of kratom, as described in a 2019 article from the National Library of Medicine. In which, it is stated that “Mitragynine is converted in vitro in both mouse and human liver preparations to the much more potent mu-opioid receptor agonist 7-hydroxymitragynine.” This ingredient can be found over the counter and mixed into other products, coming in a wide variety of forms. As a result, it has become increasingly easy for people across Dallas to get their hands on it as opposed to the concentrated form normally produced after metabolism.
Dr. Jeffery Fritz, an interventional pain management physician, believes these products can be dangerous to the public. He said products that contain kratom “bind to the opioid receptors in the brain,” arguing that constant use can cause “tolerance, physical dependence and, if stopped immediately without waning off of them like most drugs that are addictive, you get withdrawal symptoms.” These symptoms range in severity, with Fritz adding that withdrawal can include “nausea, vomiting, anxiety, possibly even cardiovascular changes.” When asked if unrestricted sale of multiple bottles was a cause for concern, Fritz said. “Anything that has the ability to be addictive and overused should be looked at by the FDA.”
Despite previous efforts to regulate the sale of Kratom in Texas, such as the Texas Kratom Consumer Protection Act, the ease of access for this product still exists with plenty of risks. Singh, a local gas station attendant who refused to give his last name, at a gas station near Richland Campus, said that people would come in to buy “20, 10 bottles every visit.” While efforts such as the Texas Kratom Consumer Protection Act seek to make Kratom products safer for the public through age restriction and labeling requirements, lack of restrictions on multiple sales and sales to those under the age legally allowed to purchase kratom still fall through cracks. When asked to speak about Kratom and its presence around and on Richland Campus, Dallas College Police was not available for comment.
With the ease of access, there are cases of kratom products falling into the hands of vulnerable populations. One such case is with Keaton Brooks, a Dallas teenager whose death in February was linked to the interaction of clonazepam, an anxiety medication, and mitragynine, a component of kratom. Alaina Brooks, Keaton’s mother, seeks to “try to get state and federal government to regulate these products.” She sees the drug as helpful but poorly regulated. “Minors are easily walking into vape shops and gas stations and purchasing it,” she said.
Her son was able to buy kratom products on his own at 16, which he was using to treat his anxiety. ARK Behavioral Health warns consumers to avoid this combination, as “Mixing kratom and benzos can increase your chances of negative side effects from both substances. It may also put you at risk of a kratom overdose.” Mrs. Brooks argued that these kinds of interactions not being warned about on the product can create dangerous scenarios such as her son’s death. “The people who use kratom are the same people who might take the klonopin (clonazepam),” she said. When asked about current regulation of kratom, Mrs. Brooks saw the product as poorly understood by retailers and consumers, stating that “People just don’t think and don’t understand that this is deadly. This can be deadly. This can be addictive.”
Morgan Meyer, a Republican member of the Texas House of representatives, filed House Bill 291 on Aug. 7. This bill, if passed, would require all products containing any form of kratom to be tested within the state, as well as increasing penalties for unregulated sales and sales to minors. This bill would also raise the sale age from 18 to 21, with its addition to the Texas Controlled Substances Act increasing restrictions and placing more scrutiny on products containing kratom by the Texas Department of State Health Services. When asked about their thoughts on the bill, the media team at Botanic Tonics said that they are “working with legal experts to ensure our labeling, marketing, and distribution meet or exceed all requirements.”
Feel Free, a product of Botanic Tonics, is a kratom product sold in gas stations throughout Dallas with 25 locations in a three-mile radius around the Richland Campus.
CBD Kratom also has stores for kratom products throughout Dallas. When asked about whether their products would be submitted to the FDA, the Botanic Tonics media team referenced a clinical trial including their product in The Cureus Journal of Medical Science, citing “no evidence of significant risk to consumers.” However, it is important to identify that while the study itself discusses general safety when used moderately over short periods, it is also discussed that “concerns about adverse effects, particularly with long-term or high-dosage use, have been noted.”
The media team also provided a link to a study conducted by Chad J. Reissig, a supervisory pharmacologist and member of the FDA’s Center for Drug Evaluation and Research.
While this clinical trial is conducted by a member of the FDA, it lists in the conclusions page that “Further studies are needed to determine kratoms’ comprehensive safety and tolerability profile.” At press time, CBD Kratom has not responded to requests for comments.
