ANNAPOLIS, Md. — Kratom, a substance that users told lawmakers they take as a pain and addiction treatment, would see more stringent regulation in Maryland under legislation making its way through the General Assembly. Some government agencies advise against using the substance, calling it dangerous — while opponents of the bill are advocating for safety standards instead.
Originating in southeast Asian countries, including Thailand and Indonesia, kratom is an herbal substance that comes directly from evergreen trees and has similar effects as opioids.
House bill 283 would categorize kratom as among the most dangerous controlled substances in Maryland, a list that includes heroin, LSD, ecstasy and a hallucinogen called peyote.
Proponents of the bill argue kratom’s similarity to opioids can lead to further abuse and addiction, while opponents say the substance, when regulated properly, can help people alleviate pain, and help those with opioid addictions overcome withdrawal.
The Centers for Disease Control and Prevention released a report in April naming kratom as a possible cause of death in 91 drug overdoses across 11 states between July 2016 and December 2017. Kratom, often times spiked or used with opioids, was the only substance found in seven of those 91, according to the CDC report.
The FDA in a 2019 advisory has said that kratom, which “affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.”
But advocates for the substance told state lawmakers that it is safe, effective for treating pain and not addictive unless it has been mixed with another drug or processed improperly.
“Some enterprising vendor is spiking kratom to enhance sales, because kratom doesn’t give you a high,” Senior Fellow on Public Policy for the American Kratom Association Mac Haddow told lawmakers. “Kratom doesn’t give you a high. If it gives you a high, it’s an adulterated product, and if it’s adulterated you put your life at risk.”
Opioid-related deaths have been a nationwide issue, particularly in Maryland. The first nine months of 2019 show a decline in opioid-related deaths in the state. If this trend holds, last year would be the first in a decade to see a decrease in opioid-related deaths, according to the Maryland Opioid Operational Command Center.
Kratom is banned in six states and four cities in the United States.
The American Kratom Association advocates for the Kratom Consumer Protection Act, which requires proper labeling from kratom vendors to certify product pureness. It has been passed in four states – Utah, Georgia, Arizona and Oregon – without much opposition, and is being considered in 21 other states this year. Haddow is pushing for Maryland to join them.
“There’s no guarantee people don’t get bad kratom because of the internet,” said Haddow, who said he uses kratom for his arthritis. “(The Kratom Consumer Protection Act) puts a stop to the bad actors in this industry.”
Maryland Poison Center Medical Director Josh King told Capital News Service it would be tough to regulate kratom without it going through clinical trials. King said he doesn’t recommend clinical trials due to concerns of abuse and the reported opium-like effects from kratom.
“Something that is natural isn’t always safe,” King said. “This is a good example of that.”
Delegate Ken Kerr, D-Frederick, said he wanted to introduce the bill after hearing how a Frederick County citizen’s family was torn apart from abuse of the drug.
“It has the dependency potential, the overdose potential and it’s a dangerous subject that deserves some attention,” Kerr told Capital News Service.
The Judicial Proceeding Committee held a hearing Jan. 22 for the identical Senate version of the legislation, Senate bill 147. Introduced by Sen. Ronald Young, D-Frederick, the bill drew testimony from dozens of people.
Many of the speakers are part of a Facebook support group, where they exchange safe practices for consumption and ways to spread awareness.
John Shorter, an Annapolis native and information technology employee at the Naval Academy, testified at the hearing that he started using kratom in 2016 to wean off his opioid addiction after suffering from severe anxiety and depression.
“I wouldn’t be here right now without the use of kratom,” Shorter said. He said kratom is a better alternative than waiting a week for mental health counseling.
Frederick Phelan III, a 34-year-old Middletown, Maryland, resident and student at an online career school called Penn Foster, said kratom helped him stop drinking.
“My family told me I was gonna die (from alcoholism),” Phelan, who usually takes three daily doses, told Capital News Service. “Now, I feel like I’m on the right path.”
After hearing the “educational, informative and excellent” testimonies from last week, a staff member for Young said he worked with the American Kratom Association and the Judicial Proceedings Committee to add amendments to the bill on Friday.
The amendments used language from Haddow and the American Kratom Association that would require users to be 21 and older, and added guidelines to make sure the product was unadulterated, according to Young’s office.
The full Senate is expected to take up the measure on Monday.
Illinois and Louisiana have both similar passed laws banning the sale to minors younger than 18.
Kerr told the Capital News Service he wants to move forward with his version of the bill as drafted — which would add kratom to the list of Schedule I substances — for Tuesday’s scheduled hearing, and has six co-sponsors — four Democrats and two Republicans.
Sean Nicholson, the director of development for a recovery group based in Frederick, Maryland, called the Phoenix Foundation, counseled Kerr on introducing the bill. A former opioid addict himself, Nicholson said there’s not enough information on the benefits of kratom to regulate it.
Nicholson is working with Kerr on a project that would build a recovery high school in Frederick called the Phoenix Academy, and leads structured living houses for addicts to provide sober living environments. He said it’s here where he sees the similar effects it has to opioids.
“From my perspective, using kratom as a detox for getting off opioids really has no positive results,” said Nicholson. “It’s absolutely not the missing link.”
As a manager of a residential center for addicts, Nicholson said having someone who is experiencing similar side effects like opioids can produce unwanted distractions. He said effects of kratom that he has seen include constantly nodding off and fading out of conversations, itching and scratching, and becoming more talkative and energized.
“I do have a question whether they’re truly in recovery as they continue to be dependent on an addictive substance,” Kerr told Capital News Service.
While Kerr is going forward with his bill, he said more research is necessary.
“We need to do something about it,” said Kerr. “We can’t let it continue to be an unregulated substance.”