Lawmakers urge Louisiana Department of Health to study kratom: why?

The Louisiana Department of Health has been tasked with studying kratom, the over-the-gas-station-counter supplement with a cult following, to determine whether it should be classified as a “controlled dangerous substance.”

Without any debate or line of questions May 16, the Louisiana House unanimously approved a resolution from state Rep. Frank Hoffmann directing the department to study the plant and products containing kratom. The resolution directs the department to submit a report to the House Committee on Administration of Criminal Justice no later than two months before the beginning of the 2019 legislative session.

Processed from a southeast Asian plant, kratom products (as an herb or in pills or tea) are commonly used as a painkiller and sedative or stimulant — it targets opioid receptors and largely impacts neurological and cardiovascular functions. It’s been used as a natural alternative to treat chronic pain, anxiety and other issues, including withdrawal symptoms.

There are no approved uses for it under the Food and Drug Administration, so it exists largely in a legal limbo with several states banning or looking into banning it while the feds mull over its future and warn against its use as an opioid alternative. But locally, it’s only a minor issue on health officials’ radar — while they may be skeptical of the science of its medicinal use, its impact isn’t as dire as federal warnings suggest.

Previous legislative attempts to ban kratom in Louisiana have failed, though current state law forbids minors buying or using any product containing kratom. It’s banned in Alabama, Arkansas, Indiana, Rhode Island and Wisconsin.

A spokesperson for the Department of Health said the agency doesn’t have a statement following the resolution’s passage — neither its Vital Records office or epidemiologists had any reports or statistics on kratom.

But the issue has been floating around the Centers for Disease Control and Prevention (CDC) and federal agencies over the last few years. A recent CDC study found that between 2010 and 2015, U.S. poison centers received 660 kratom-related calls.

Louisiana’s Poison Control Center has received 162 kratom-related calls between 2011 and 2017, and only two so far in 2018, according to center director Mark Ryan. Forty-two percent of those calls came from health care facilities — and the calls appear to have tapered off; there only were 22 calls in 2015, 11 in 2016, and four last year. Ryan says the apparent drop doesn’t mean fewer people are using kratom; physicians are likely making fewer calls into the center as they become more familiar with it.

Ryan clarifies that people typically are calling into the centers only when adverse effects are present. Eighty-seven percent of all those calls involved only minor, if any, effects — in other words, people aren’t calling into the center to report that they feel fine.

Those calls also represent a small portion of the center’s 88,000 annual calls and the thousands of nationwide calls, not to mention the millions of people who have used kratom. DEA reports of kratom-linked deaths even point out that kratom wasn’t the only drug involved in those deaths. The DEA also has expressed an interest in classifying it as a Schedule 1 narcotic, which would endanger its medicinal potential.

Kratom proponents like the American Kratom Association (AKA) and the Botanical Education Alliance have promoted campaigns to combat misinformation about the plant and its effects. In April, the AKA’s inaugural Kratom Leadership Summit discussed kratom legislation and legalization efforts and how to “expose bad actors in the kratom space who refuse to maintain acceptable standards,” according to Mac Haddow, AKA’s Director of Government Relations.

A recent public health advisory from the FDA warns 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.”

The FDA also issued a mandatory recall in April 2018 over a risk of salmonella contamination in several kratom products; “one to three” of those cases were in Louisiana.

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