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Like the cannabis sativa plant, kratom has been used for centuries as a natural medicinal and recreational substance. It is often promoted as a treatment for headaches, insomnia, anxiety, depression, and opioid withdrawal — and can produce euphoria similar to marijuana.
Kratom products, sold as capsules, powders, and liquid extracts, are popping up in such retail spaces as convenience stores and online storefronts. Many users mix powders in food and drinks, and brew tea with kratom leaves.
Though kratom may appear to be a natural — and cheaper — alternative to medical marijuana, it has raised safety concerns. The U.S. Food and Drug Administration (FDA) advises against its use for medical or dietary purposes, saying its potential for abuse “has yet to be fully understood.” The agency has not approved kratom or its active ingredient, mitragynine.
Florida limits kratom sales to adults 21 and older and enforces labeling and purity standards. Sarasota County banned it in 2014, and Manatee County may follow.
Dr. Deirdre James, a board-certified internist and endocrinologist at the University of Tennessee Health Science Center, warns that kratom’s accessibility gives consumers a false sense of safety. “People will falsely think that kratom is safe because it's mostly over the counter or something you can order online,” she says. “However, it can cause severe liver damage... It can cause psychosis, especially in the developing brain.”
Bob Durkin, an attorney, registered pharmacist, and former acting director of the FDA’s Office of Dietary Supplement Programs, advises consumers to be cautious: “Look for kratom that are packaged correctly, that have a complete label... and most importantly, consumers should only buy a product that has directions or conditions of use.”
The FDA has acted against companies selling concentrated 7-OH (7-hydroxymitragynine), which “produces respiratory depression, physical dependence, and withdrawal symptoms.”
In August, Florida Attorney General James Uthmeier banned the sale or possession of isolated or concentrated 7-OH statewide.
Dr. James urges anyone considering kratom to consult a physician: “I’m not necessarily sure that the benefits outweigh the risks, but information would be the strongest tool.”
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