Los Angeles County officials intend to immediately remove kratom and its synthetic extract, sometimes called 7-OH, from shelves.
Inspectors will be sent to retailers next week to begin red labeling illegal products containing these compounds, the Los Angeles County Department of Public Health said Friday morning. Stores that do not comply may be fined or subject to other sanctions.
Kratom – herbal extract from leaves Mitragyna is beautifultree native to Southeast Asia. It is sold in stores and online in a variety of forms, including powders, tablets, and liquid extracts. Brands that sell kratom often claim that it helps manage pain, anxiety, and mood disorders.
Matthew Lowe, executive director of the Global Kratom Coalition, said natural kratom has been used in the United States for more than 50 years to relieve anxiety and treat chronic pain.
In the past few years, a more potent synthetic version of kratom, refined into the psychoactive compound 7-hydroxymitragynine, or 7-OH, has hit shelves across the United States.
7-OH products are often marketed as “plant alkaloids,” drawing criticism from some, including Lowe, who argue that the labeling is misleading, leading consumers to think it is the same as natural kratom.
The county health department warns that when mixed with alcohol, medications or illicit drugs, 7-OH products can “cause severe respiratory depression and death. It is important to note that these products are unregulated and may contain unknown concentrations of 7-OH, increasing the risk of unintentional overdose.”
Were six reported deaths related to kratom in Los Angeles County in just the past few months.
“Given that this is a new and emerging substance, this has also occurred since the medical examiner began tracking data on 7-OH,” the Los Angeles County Department of Public Health told The Times in an email. Because the county only began tracking 7-OH deaths in April of this year, it's unclear how many more overdoses may have occurred previously.
After this article was published, the county medical examiner published a report on the death in The Times. Each of the deceased had kratom and 7-OH in their systems, according to reports, but it was not immediately clear what role they played in the deaths compared to other substances, including alcohol, prescription sedatives and muscle relaxants, and illegal drugs such as cocaine, which were also found in six of the bodies. The Times first requested a coroner's report on kratom-related deaths on Oct. 24.
“Kratom and 7-OH products are marketed as natural remedies, but they are illegal and unsafe,” Dr. Muntu Davis, county health officer, said in a press release. “They are sold at gas stations, tobacco stores, online and in other retail stores. People should avoid using these products and store owners/operators should remove them immediately to prevent harm.”
Right now, consumers are unclear about kratom, 7-OH or any other metabolites, says Yael Ossovsky, deputy director of the Center for Consumer Choice, a nonprofit consumer advocacy group. “At any gas station or tobacconist, there are powders, liquid extracts and tablets that are offered in different doses and different brands,” Ossovsky said. “This clearly leads to consumer confusion and uninformed choices, incorrect dosing and likely unpleasant experiences that could be avoided with sensible regulation.”
The market for kratom and 7-OH has grown largely because people want targeted pain relief and remedies for their ailments, “but don't necessarily want the full effect of more potent opioids that have a more complete effect on the body,” he said.
“Kratom has been used successfully for generations in other countries as an alternative to opioids,” Ossovsky said. But foods with high concentrations of 7-OH are a different matter.
According to the US Food and Drug Administration, kratom And 7-OH not legally sold in the United States as a drug, dietary supplement, or approved dietary supplement.
California is enacting a federal food and dietary supplement law, the California Department of Public Health told The Times in an email.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as impurities in drugs, dietary supplements and foods,” the agency spokesperson said.
The spokesperson added that the agency has been investigating kratom for the past two years and “continues to take appropriate action to protect the public from adulterated products containing kratom or 7-OH.”
“CDPH embargoes or destroys statewide food and dietary supplements adulterated with kratom or 7-OH as soon as they are identified through investigations; however, we do not comment on the specifics of ongoing investigations,” the spokesperson said.
Manufacturers of 7-OH have publicly defended their products in the face of lawsuits and FDA crackdowns, arguing that they are a safer alternative to illicit opioids such as fentanyl and that save lives rather than take them.
Vince Sanders, founder and CEO of CBD American Shaman, who helped develop the first 7-OH product, said the attack on 7-OH is being led by companies selling natural kratom, whose market share has been eclipsed by what he said is a “vastly superior product.”
The Kansas City businessman said a ban anywhere in the country would hurt people who have used 7-OH to treat substance abuse disorders or chronic pain and now rely on the product as an alternative to expensive prescription drugs.
“People who have changed their lives with it are extremely concerned,” Sanders said. “They're scared to death. I mean, there are people who … are planning on pulling money out of their 401K, or loading up their credit cards, or whatever it is they need to do to buy years and years of supplies.”
He acknowledged that both kratom and 7-OH are often taken in higher doses than he recommends, but said manufacturers and retailers should not be held responsible for these decisions. He compared it to alcohol: “You buy a 750-milliliter bottle, and if you go home and drink the whole bottle, and you do it every night, is it your fault or Jim Beams' fault?”
Communities across the state have taken it upon themselves to act in the absence of state and federal regulation. Orange County, as well as the cities of Newport Beach, San Diego and Oceanside, have banned the sale, distribution or possession of kratom. Riverside County is seeking to curb the sale and marketing of kratom and 7-OH products to people under 21 years of age.
Los Angeles County does not have its own regulations regarding these products.
“I think local action signals intent. [federal authorities]you need to do something about it,” Lowe said.
But a complete ban could raise another set of concerns, including whether the ban would be enforced locally at all and the potential for a black market for the products, he said.
“You leave people without any options, so they either find alternative options or just cross city or county lines and go after it themselves,” Lowe said. Indeed, kratom and 7-OH are widely available in online markets.
