States and Cities Move to Ban Kratom as Safety Concerns Rise

Kratom, an herbal extract often sold in convenience stores and vape shops, is under increasing scrutiny by local and state governments across the U.S. More and more cities and states are banning the sale of kratom, which remains unregulated at the federal level. In recent years, six states and several cities have banned kratom outright, while an additional 15 states have put in place laws restricting its sale to minors. These moves come as authorities express growing concern over the safety and risks associated with the substance.

What is Kratom?

Kratom comes from the leaves of a tropical evergreen tree native to Southeast Asia. Known scientifically as Mitragyna speciosa, it is often marketed as a herbal supplement. Kratom is believed to have effects that vary with the dose: in smaller amounts, it acts as a mild stimulant, while in larger doses, it can produce effects similar to opioids. Because of this, some people use kratom in hopes of easing pain or as a substitute to reduce cravings for stronger opioids. Others take it recreationally, believing it helps elevate mood.

Although kratom has been around for decades in the U.S.—first introduced in the late 1990s—it was not very popular until the opioid crisis began pushing some people to seek alternatives. As more people turned to kratom to manage pain or to combat addiction to prescription opioids, its use spread. Data from Poison Control Centers reflect this rise: while there were only 13 kratom-related calls in 2011, the number grew to 682 by 2017. Most of these calls came from the years 2016 and 2017, indicating a sharp surge in popularity around that time.

Concerns Over Safety

Kratom is often sold in the form of a liquid, powder, or tablet, and some of these products are found to be contaminated with high levels of heavy metals. This lack of quality control is partly due to the fact that the sale of kratom remains unapproved by the Food and Drug Administration (FDA). Since the FDA does not regulate kratom, products can vary widely in potency and quality, and consumers have no guarantee that what they are buying is safe or even what it claims to be. In 2018, for instance, a salmonella outbreak linked to contaminated kratom sickened people across 41 states.

The FDA has issued several warnings about the potential dangers of using kratom, including the risks of addiction and overdose. Because kratom products are unregulated, the exact ingredients and strength can be unpredictable. This poses a significant risk when kratom interacts with other drugs, alcohol, or even prescription medications, which can lead to serious side effects or overdose.

Between 2020 and 2022, kratom was implicated in at least 4,100 deaths in the U.S., according to the National Institutes of Health (NIH). It’s important to note, however, that most of these fatalities involved multiple substances. The role of kratom in such cases might be difficult to isolate, but its involvement in these incidents raises red flags.

The Legal Landscape

At present, there are no federal laws regulating kratom. The FDA has, however, exercised its power to limit kratom imports under rules governing unapproved drugs and dietary supplements. Regulation has mostly fallen to individual states and municipalities, leading to nationwide patchwork of laws.

In 2023, Virginia became one of the states to impose restrictions on kratom, making it illegal to sell the product to anyone under 21 years of age and requiring all kratom products to have warning labels. Meanwhile, several states and cities have decided to prohibit kratom altogether.

Side Effects and Health Risks

Kratom use is not without its dangers. Even though it is a natural product, it can have harmful side effects, especially when taken in high doses. Some commonly reported effects include loss of appetite, nausea, vomiting, itching, and a rapid heartbeat. People may also experience tremors or insomnia. At high doses, kratom can lead to seizures and regular use has been linked to liver damage.

Because kratom acts on some of the same receptors as opioids, it can also be addictive. Babies born to mothers who use kratom during pregnancy can experience withdrawal symptoms similar to those seen in opioid addiction, and mothers are advised to avoid using kratom if they are pregnant or nursing.

What Should Users Do?

For people who are currently using kratom, talking to a healthcare provider is strongly recommended. A doctor can help address why someone is using kratom, discuss possible side effects, and provide information about safe alternatives. If someone plans to continue using it, they should still consult a healthcare provider to understand any potential interactions with other drugs or alcohol. Anyone who is pregnant, planning to become pregnant, or breastfeeding should discontinue using kratom to protect their baby from possible harmful effects.

Kratom, like all substances that can affect the body, should be handled carefully and stored out of the reach of children. Accidental ingestion by a child can lead to serious health problems. If accidental ingestion does occur, it’s important to call the Poison Control Center hotline at 1-800-222-1222 or, if severe side effects are present, dial 911 immediately.

Moving Forward

The debate around kratom is likely to continue as authorities work to balance the needs of those seeking alternatives to opioids against the concerns over public safety and health. While advocates argue that kratom can help individuals dealing with opioid dependency, the current lack of regulation and the potential for harm means that many officials are taking action to limit its availability.

Until a clearer consensus emerges at the federal level, kratom’s legal status will likely remain a patchwork of local laws. Consumers, meanwhile, should stay informed about the risks and always seek professional medical advice if they are using or considering using kratom.