A Bedford family is sounding the alarm on a substance that their son overdosed on.
It's called kratom. Anyone over 18 can buy it legally in Texas.
Doctors have some concerns about the drug and lawmakers are working on new legislation to better regulate it.
“I wish I had known,” said Linda, who did not want to share her last name due to privacy concerns for her family.
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She said she had never even heard of kratom until addiction rocked her family. Her son, Josh, started buying kratom drinks from corner stores to help with depression last year.
“He was drinking 8, 9 or 10 of them a day,” said Linda.
Kratom is marketed as an herbal supplement that gives an opioid or stimulant-like high. However, it escalated for Josh.
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“He was vaping it, he was taking it in pill form,” said Linda. “And it has done about 50% damage to his lungs.”
Last week, Josh’s family said he overdosed. Combined with his diabetes, doctors said it nearly killed him.
“We did everything we thought we could do. He seemed to be on the road to recovery. We thought he was past the point of needing this in his life, but we were wrong,” said Linda.
At 33 years old, he has spent the past week fighting for his life in ICU. Linda said he has stabilized but the road to recovery will be a long one for him.
“Thankfully, he is coming out of the woods but he’s still having hallucinations,” said Linda.
That’s why the family is pushing for more regulation, education, and awareness of the effects kratom can have on the body.
“If we’re going to sell them, if we’re going to sell it like a vitamin or an herbal supplement, then let’s regulate it and decide how much of that is good for the average person," said Linda. “This isn’t prohibition, I want regulation. I want it to be safe. I don’t want some mother having to do what I have dealt with this past week -- worrying that I’m going to lose my son and be burying him next week instead of sitting down at Easter dinner on Sunday.”
Kratom is derived from a tropical plant in southeast Asia. Culturally, it was used medicinally for hundreds of years and potentially longer to treat fatigue, pain and other ailments.
According to the Drug Enforcement Administration, the leaves are crushed and then smoked, brewed with tea, or placed into gel capsules.
"It’s been around since the 1800s, but it started to popularize around the Vietnam War era,” said Dr. Andrew Yockey, an assistant professor of biostatistics and epidemiology at UNT Health Science Center in Fort Worth. “It’s got 40 different alkaloids. It has a very complex perspective and chemical nature. We still don’t really know what is in it.”
Dr. Yockey has done research on kratom and similar substances that are unregulated but growing in popularity due to marketing tactics. He helped published a research article last year for the Journal of Psychoactive Drugs on kratom and its retail availability in Fort Worth.
“I think what draws people to kratom is this unregulated nature, that I can go out and go buy Kratom. Much like I can buy tobacco,” he said.
Kratom was approved for sale as an herbal supplement by the Food and Drug Administration and is supposed to be marketed as such. It has not been approved for medical use.
However, Dr. Yockey said he has concerns about it being widely available because kratom has not been extensively researched.
“It could be doing a lot of harm," he said. "Overall, what worries me is this easy access and have this unregulated nature.”
He said he’s seeing similarities in marketing between kratom and delta-8 THC, another controversial psychoactive substance that is manufactured from hemp-derived cannabidiol (CBD). According to the DEA, delta-8 THC products have not been evaluated or approved by the FDA for safe use in any context. However, they may be marketed in ways that put public health at risk.
"In our research, we found people were attracted to delta-8 because of the different marketing techniques and we’re starting to see that with kratom,” said Dr. Yockey.
Kratom has gained popularity, especially in recent years during the opioid crisis, as a substance to help with opioid withdrawals.
“The research is mixed, but it’s showing a positive effect on opioid withdrawal,” said Dr. Yockey. “While kratom is somewhat beneficial, it’s also harmful. So we just need more research into this.”
There is concern that the addictive nature of kratom and lack of research makes it potentially dangerous.
“FDA is concerned 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,” reads a statement on the FDA website. “There are no FDA-approved uses for kratom, and the agency has received concerning reports about the safety of kratom. FDA is actively evaluating all available scientific information on this issue and continues to warn consumers not to use any products labeled as containing the botanical substance kratom or its psychoactive compounds, mitragynine and 7-hydroxy mitragynine.”
Taking too much kratom, as is a possibility in Josh’s case, can have negative effects, said Dr. Yockey.
“If you use kratom consistently or long-term, it can lead to seizures, heart palpitations, all these different somatic effects,” he said. “It just depends on who is consuming it and where they are consuming it.”
He added there has also been an uptick in calls to the Poison Control Center for kratom, with cases of a link to salmonella and even the substance being found in certain exercise and diet pills.
REGULATING KRATOM
Kratom is unregulated in Texas. That means manufacturers can put anything they want in their products to enhance it – even if it’s unsafe.
“It’s like you can put anything in it,” said Dr. Yockey. “I’m worried these substances may be tainted with something else. Or you might get kratom off the street and it could be laced with something.”
Because kratom is not a regulated or a controlled substance in the State of Texas, law enforcement does not conduct investigations regarding kratom, according to a statement from Dallas Police.
That's why two bills are moving through Austin during the current legislative session to crack down on kratom.
House Bill 861 and Senate Bill 497 aim to regulate the sale of kratom products in the state. They would ensure vendors follow safe manufacturer standards and label their products properly.
About 30 U.S. states are looking into putting more regulations on kratom. So far, six states have total bans on kratom products.
Linda is urging parents to speak with their teens about kratom, due to its gaining popularity.
"Be aware. Do your own due diligence Tell them not to assume that the person who is selling it to them is telling them the truth. My son thought that what he was being told was the truth, that it wasn’t addictive and that it wasn’t habit forming," she said.
She’s pushing for more research before someone else gets hurt, or worse.
“I know [my son] is an adult. This is completely on him. He knew better. At the same time, there’s that 17-year-old, 18-year-old who probably should know better but doesn’t," she said. "That’s the one I want this to help. That’s the one that I want to see this get regulated so that they don’t end up like my son."
WHAT IS KRATOM?
According to the National Institute of Health's National Institute on Drug Abuse and the U.S. Food and Drug Administration, kratom generally refers to an herbal substance derived from a tropical tree that grows naturally in Thailand, Malaysia, Indonesia and Papua New Guinea that can produce opioid- and stimulant-like effects.
Kratom and derivative products are legal and accessible in many areas throughout the United States and abroad, though there may be local or state prohibitions against them. The NIH said people have reported using it to manage drug withdrawal symptoms and cravings and to manage pain, fatigue and mental health. The leaves of the tree have a long history of use in Southeast Asia where it is commonly known as thang, kakuam, thom, ketum, and biak.
There are no uses for kratom approved by the FDA and the administration has warned Americans to avoid using kratom products because of the potential for adverse effects. The FDA said kratom affects the same brain receptors as morphine and appears to come with the same risks of addiction, abuse and dependence.
According to the NIH, kratom may also be laced with or contain harmful contaminants which can "produce effects not associated with kratom or kratom compounds alone" and the contaminants could include heavy metals and harmful bacteria.
Some people who have used kratom have reported mild side effects such as nausea, constipation, dizziness and drowsiness while others have reported more severe adverse effects such as confusion, tremors, seizures, heart and lung problems and liver problems. Interactions with other drugs could influence the side effects. The NIH said that while more research is needed, it appears that fatal overdose from kratom use alone is extremely rare. Because kratom research is new, there is little evidence to determine the long-term effect of its use.
The NIH said, "Very little research is available on kratom use before, during and after pregnancy, but there have been reports of opioid-like neonatal abstinence syndrome" (problems after birth experienced by infants whose mothers used opioid drugs while pregnant).
