AUSTIN (KXAN) – This session, the Texas legislature will look at two bills related to regulating kratom products – an herbal substance that can produce opioid-and-stimulant-like effects– which are easily accessible for anybody over 18 in the state. While Texas looks at ways to make the substance safer for consumers, others states are contemplating whether it should be banned. 

What is kratom?

Kratom products are derived from the leaves of a tropical tree grown in the South Pacific. It has two psychoactive alkaloids – mitragynine and 7-hydroxymytragynine. To feel the effects, the leaves are chewed; dried and smoked; or powdered and put into capsules to be taken orally – how it is commonly sold in Texas.

Kratom has been used in southeast Asia for hundreds to thousands of years. It is used to combat fatigue, in cultural ceremonies and to treat medical conditions, such as opioid use disorder. 

Mac Haddow, senior fellow on public policy for the American Kratom Association, said kratom first came to the U.S. around the time of the Vietnam War. Since then, it has grown in popularity and is used here to manage opioid withdrawal, pain, fatigue and mental health problems. In 2021, around 1.7 million people reported using kratom within the previous 12 months, according to the 2021 National Survey on Drug Use and Health.

Despite its growing relevance, research on the substance is still in its nascent phases, said Katherine Cunningham, director of the Center for Addiction Research at The University of Texas Medical Branch. Kratom products are widely available in Texas and are labeled as dietary or herbal supplements.

New legislation

House Bill 861 and Senate Bill 497 both aim to regulate the sale of kratom products in the state. Texas is not alone. Nearly 30 U.S. states have bills deciding the future of the substance. Six states have total bans on kratom products.

In Texas, kratom is largely unregulated. That means manufacturers can put dangerous additives in products or enhance natural compounds to unsafe levels with little consequence, Haddow said.

“It’s the wild west in this marketplace. So you have bad actors that are [selling] products that are spiked. And they’re not trying to kill people, but they put [things, like] fentanyl, in it because the natural kratom product doesn’t give you a euphoric high,” Haddow said. “People want to sell more products. If they can juice it up a little bit, they do it.”

These two bills don’t ban the use of the substance but ensure that vendors must adhere to safe manufacturer standards and label their products properly, or face a penalty. 

“We want to protect consumer access to safe kratom products, so we advocate for that around the United States,” Haddow said. 

What do we know about kratom? 

Cunningham said there is still much we do not know about kratom.  

“With humans, we don’t really know how to use it properly from a medical perspective,” she said. “There haven’t been as many solid human clinical trials as we’d like. But case reports and human subjects research do indicate that there are beneficial health effects. But there are also side effects of kratom.”

About 20% of kratom users disclose adverse side effects from using the product. Most of the reported side effects are mild – such as headaches, nausea or insomnia – but seizures and deaths have been reported, albeit very few. 

“And we don’t really know about interactions with ongoing use of prescription medications. So if someone is taking an opiate with kratom, [we don’t know if] that is going to result in even more health challenges,” she said. 

Cunningham acknowledged that the country is in the midst of a horrific opioid epidemic. She said she has worked with patients who used kratom to curb their opioid addictions, but again, she pointed to a need for more research before unequivocal claims can be made about its medical benefits. 

“Access to medications that are ethically efficacious and treating those disorders are really, really important,” she said. “We need more solid data that actually supports the use of these in health disorders, but also the dangers and the risks of it. I think the public needs to recognize that [kratom is] not without danger there. There are safety issues.”