What is kratom? FDA targets dangerous 7-OH products in nationwide crackdown

When kratom was combined with other substances, such as illegal drugs or antidepressants, hospitalizations increased nearly 1,300%, from 40 to 549. Researchers say the rapid increase — including a significant spike last year — is tied to wider availability of kratom and the growing strength of newer products. “You have things like mitragynine pseudoindoxyl, which is not found in the kratom leaf,” he said. Although only present in small amounts in the leaves of kratom, 7-OH is produced by the body as a byproduct of mitragynine, the primary psychoactive alkaloid in kratom. That all changed around 2015, with the introduction of a second wave of “enhanced” kratom products. Most users aren’t seeking a caffeine-like boost—they’re looking for the opioid-like effects to manage pain or avoid prescription opioids.

• But those products aren’t being targeted by the government bans, just 7-0H products.
• It’s been nearly a year since the FDA asked the DEA to have 7-OH – but not whole leaf kratom – classified as an illegal Schedule One controlled substance.
• A new, purified compound from kratom called 7-hydroxymitragynine (also known as 7 hydroxy or 7-OH) is now being sold in pill form.
• Assemblymember Matt Haney (D-San Francisco) proposed Assembly Bill 2365 that would require kratom products be registered with the public health department.

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That's why the general feeling in the kratom consumer community is that the powder is kind of self-limiting, whereas these concentrated products can get you into trouble. This is what gives kratom its opioid-like, pain-relieving and euphoric effects. The leaves from a tree native to Southeast Asia, kratom is an herbal medicine with effects similar to opioids. In May, Colorado's governor signed the Daniel Bregger Act into law, named after a young man who died from a toxic combination of a highly-concentrated product of the active psychoactive ingredient found in kratom and a common allergy drug. A compound that makes up a tiny portion of the kratom leaf has generated concern in recent years, as herbal products derived from the leaf but synthesized in labs to market more potent versions have contributed to calls to poison centers and high profile deaths.

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Kratom leaf companies have tried to distinguish themselves as wholly different from 7-OH manufacturers, who disagree with such delineations. The same allure pushed it into gyms, weight rooms and combat sports, where athletes look for ways to increase endurance and ease painful injuries. “That right there is legal pain medicine,” Clarke said. At the time of his arrest huntington blogs in April, Clarke had a THC vape pen on him and a prescription for a painkiller often used for sports injuries, according to the dashcam audio. “Because the partnership carried the league’s endorsement, some players understandably viewed that as a signal that the product had been appropriately vetted,” Jacobs said.

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It's in this weird, limbo area, and so drug regulators have tried to deal with it here and in other countries. It doesn't fall under the purity requirements for either herbal supplements or drugs. There's not a lot of financial incentive for a company to spend several hundred million or a billion dollars to try and get this approved as a drug, so that's not going to happen. Kroll also adds that a new paper just published looking at 551 deaths in Florida where mitragynine was detected post-mortem.

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Kratom, in some forms, is currently banned in six states. "That's how they're marketed. They're wellness drinks. And we're just seeing that people are developing, very quickly, addictive behaviors and very severe withdrawal very fast." Buprenorphine is often used to treat heroin addiction. "It looks very much like any other form of opioid use disorder," said Dr. Nemanich.