Brendan, the 48-year-old son of Beth Quinn, was discovered dead almost two years ago after reportedly overdosing on kratom, a plant whose effects are similar to those of opioids and stimulants and has earned it the moniker “gas station heroin.”
Quinn, whose son passed away and left behind a 15-year-old daughter, attributes her son’s death to the lack of regulation surrounding kratom.
Quinn, an upstate New York resident and former newspaper editor, stated, “There was no dosage advice.” “There was nothing but a ‘it’s on you, man, not our problem if you die.'”
In liquid, pill, or powder form, kratom is commonly and lawfully available in vape shops, convenience stores, and petrol stations. According to the American Kratom Association, which promotes consumer access to the drug, the industry is worth about $1.5 billion annually.
Despite being classified as a “drug of concern” by the Drug Enforcement Administration, kratom is not governed as a restricted substance. Although kratom has not received FDA approval for any use, supplements can be distributed without the agency’s approval.
A report from the Centers for Disease Control and Prevention states that from July 2016 to December 2017, 91 overdose deaths were related to kratom. However, other estimates place the toll much higher: Over 4,100 deaths between 2020 and 2022 were linked to kratom, according to a Washington Post research. Similarly, a Tampa Bay Times investigation last year found that over 580 people in Florida alone had died from overdoses tied to kratom since 2013.
Researchers referred to kratom as an “emerging issue” in a letter that was published on Monday in the Annals of Internal Medicine journal. They recommended that doctors inquire about kratom usage from their patients in the same manner that they do about cannabis, cocaine, methamphetamines, or heroin. According to the paper, approximately 1.9 million Americans had tried kratom as of 2022, however, the authors contend that figure is underestimated.
In 2016, the DEA attempted to temporarily reschedule kratom as a schedule 1 substance, but after receiving criticism, they changed their minds. Therefore, an increasing number of states and communities have been taking independent action against kratom in place of federal regulation.
A patchwork crackdown
As of late last year, at least six states had completely outlawed kratom, including Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin, per a Congressional Research Service report. A ban was recently enacted in some communities as well. Tinley Park, Illinois, a Chicago suburb, did so in June. In May, Newport Beach, California, followed suit.
However, limitations based on age are more prevalent. Sales of kratom to minors or those younger than 21 are prohibited in more than 15 states.
A state law that prohibits the sale of kratom to anyone under 21 and places restrictions on the chemicals that can be used in kratom products—as well as the requirement that all contents be declared on labels—brought Kentucky into the list very recently. Similar legislation was enacted in Georgia in May, and when it takes effect the next year, the minimum purchase age will rise to 21 and kratom product rules will be more stringent.
State Representative Rick Townsend, a Republican who supported the bill, stated, “As I began reading up on the drug, I discovered that people in Georgia who were consuming kratom were unaware of the precise ingredients they were ingesting.”
Townsend claimed that two residents who told him they had lost their son in part because of kratom had motivated him to advocate for the policy.
Recently, legislation requiring kratom product labels was also enacted in Oklahoma. Since 2021, the state has prohibited the selling of kratom to minors.
The bill’s sponsor, Representative Daniel Pae of Oklahoma, stated that while he is amenable to “federal consistency” in kratom legislation, he “doesn’t anticipate them taking any action anytime soon” given the political climate in Congress.
Since 2016, Oliver Grundmann, a clinical professor at the University of Florida’s department of Medicinal Chemistry, has been researching kratom. More regulation is necessary, he added, but considering that the medication seems to benefit some people with opioid withdrawal, a federal prohibition would not be the best idea.
According to Grundmann, “There are appropriate uses for it, but it needs to be in a controlled environment.”
He continued by saying that because there is no federal regulation, kratom overdose deaths are not required to be reported, making it challenging to assess the whole impact.
“In every state, you basically have to look at death certificate reports or medical examiner reports,” he stated.
More regulation is something the American Kratom Association expressed its support for. The association’s senior fellow on public policy, Mac Haddow, referred to the current business environment as a “Wild Wild West.”
He advised consumers to exercise caution and “don’t use it” if the label information was missing or dubious.
Four kratom user groups
Mitragynine, a substance found in kratom, has the ability to engage the same brain receptors as opioids. Experts say that’s partly the reason it can become addictive. The drug can produce nausea, vomiting, seizures, breathing difficulties, and, in the worst situations, even death at high dosages.
The FDA has taken action against manufacturers that make false claims and has released advisories regarding the health concerns associated with kratom. However, because there isn’t much regulation in place, a lot of kratom products come without information on dose, the concentration of active components, or additional substances that are mixed in on the label.
“No consumer desires to purchase a product that is contaminated with lead, arsenic, or tin,” stated Michael White, the director of the University of Connecticut’s Department of Pharmacy Practice. “However, I can inform you that several kratom products on the market today surpass the FDA’s guidelines for all those heavy metals.”
Users of kratom were divided into four main groups White.
The first group consists of individuals with opioid use disorder who purchase kratom in an effort to wean themselves off of even more difficult substances or as a means of getting by until they can obtain more opiates. Those who claim that kratom aids in their pain management are the second group. Finally, there is a subset of users who merely take pleasure in the stimulant effects. These users may suffer from anxiety, depression, or other mood illness.
That final category includes TikTok influencer Emmy Hartman, who has posted about kratom. She claimed to have started using it as a focus tool.
In a June interview, Hartman claimed, “I was having a fantastic time drinking it while I completed my taxes.” “I felt at ease and slightly joyous. Thus, I continued to sip them.
Hartman said that when she initially tried kratom, she didn’t know a lot about its ingredients.
“I showed it to my friend over the phone, and he said, ‘Emmy, did you read what’s in that?'” And I said, “No.” He referred to it as “gas-station crack.”
Quinn is unaware of Brendan’s motivation for using kratom. She mentioned that he had battled alcohol and drug addiction in addition to persistent shoulder pain following surgery. He only had caffeine, nicotine, kratom, and a prescription anti-seizure drug in his system, according to the toxicology report that NBC News examined after his death.
Quinn remarked, “We entered the house and discovered an empty kratom box.” “It’s not necessarily safe just because it’s sold at the convenience store.”