Leaves of the kratom plant, a member of the coffee family, are harvested and dried in Southeast Asia and later processed and sold in capsules. (Photo via Getty Images)
Photo via Getty Images
In a hard-to-tame industry of “legal highs,” kratom sits in the middle of a tense debate. To some, it’s a low-risk alternative to opioids; to others, it’s a vector for risky side effects and addiction.
Kratom, commonly sold as an herbal supplement in a powdered or tea form in the United States, is produced from leaves of a tree native to Southeast Asia and is part of the same family of flowering plants as coffee. Widely considered an opioid alternative, the psychoactive herb has no official approval for any use by the U.S. Food and Drug Administration and, despite multiple attempts since 2018, remains unregulated by the Drug Enforcement Agency. Kratom is a billion dollar industry, according to the American Kratom Association, and can be found in smoke shops, gas stations and other stores across the country, as well as online.
“Kratom is the kind of product that we don’t have a solid foundation to say that it should be scheduled [as a controlled substance], and also we don’t have a solid foundation to say that it’s safe,” says Emanuele Alves, assistant professor of forensic science and a forensic toxicologist at Virginia Commonwealth University. Along with graduate students and other researchers at VCU and Appalachian State University, she analyzed the chemical makeup of 27 kratom samples collected from seven stores in the Richmond region.
VCU forensic toxicologist Emanuele Alves analyzed the chemical composition of kratom sold in metro Richmond. (Photo courtesy VCU)
Alves’ work was published in May in the journal Forensic Chemistry. The findings included the presence of heavy metals such as nickel and lead in some samples, likely coming from the soil in which the plants were grown or from the industrial production of the powder. More pressingly, some samples had up to 20 times the tolerable upper intake of manganese, which may cause tremors and other neurological issues.
The results, paired with other reported side effects of nausea, sleep problems and questions about the addictiveness of the drug, bring its legal status into question from the scientific community. “The kratom analysis [is meant] to show the population that it’s not illegal; however, it’s not because it’s not illegal that it’s safe,” Alves says.
The product’s effects are dose dependent; in smaller quantities, users report stimulant effects similar to caffeine or amphetamines, though larger doses bring narcotic-like effects similar to opiates. There may be an upside to the product: Alves notes that recent studies have found that mitragynine, a psychoactive ingredient in kratom, could be a possible alternative to opioids with, thus far, no dangerous side effects that could be helpful in stemming the United States’ opioid crisis.
Some argue that government regulation could bring researchers closer to uncovering kratom’s full potential as an opioid alternative. The FDA and DEA have fought for federal regulations to verify product ingredients and set age restrictions on kratom sales but continue to fall short in part due to public demand and lobbying efforts.
In February, Virginia lawmakers unanimously adopted the state’s first regulations for kratom, setting an age limit of 21 for kratom purchases and requiring a warning label on packages. Initial legislation proposed by Del. Hyland “Buddy” Fowler Jr., representing Hanover, had included certification requirements and serving recommendations.
The FDA has not suggested banning the substance in the United States; instead, it recommends that consumers consider the risks while researchers further investigate the supplement.
“I’m not against kratom itself, in the future, if it’s well organized,” Alves says. “I just think that if you decide to use something, at least you should have the complete information of what you’re taking.”
