What is kratom, the “gas station heroin,” that worries U.S. officials?

Jeffrey Deaver, a 58-year-old retired logger in Washington state, has been taking kratom for four years to relieve severe chronic hip and knee pain.

He discovered this herbal product when he was not finding relief from doctors and while waiting for surgery. Scared at first, he “started small,” but then took more until his pain went away.

“It was like a miracle,” Deaver said. “I could sleep. I could function.

“I just don’t know what I would do without it.”

Kratom – a plant with opioid-like effects – has gained popularity in the United States over the past decade and is commonly purchased over-the-counter and consumed in pill or liquid form.

This week, investigators found packaged kratom in the possession of two deceased University of Mississippi students. Although their deaths were not attributed to kratom, authorities are now issuing warnings about its consumption.

For years, kratom advocates have called for it to be banned, and in some countries, such as the United Kingdom, it is illegal. But kratom is not regulated by the U.S. Food and Drug Administration and is legal in some states, including Mississippi.

Here’s what we know:

What is kratom?

Kratom is a tree native to Southeast Asia, in countries like Thailand, Malaysia and Indonesia.

It has been used for centuries for its stimulating properties, ground and consumed in the same way as tea.

As its popularity spread around the world, it entered the US market as a supplement around 2016.

“That’s really where the problems started,” said Dr. Shane Speights, dean of the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University.

In the United States, kratom is primarily sold in highly concentrated forms, such as pills, powder or liquid, Speights said.

It’s also widely available – found everywhere from convenience stores to gas stations to vape shops.

Additionally, due to supplement classification, kratom products are not federally regulated.

“There’s no way to know exactly what you’re getting,” Speight said. “You could create something in your basement, market it as a supplement, and no one will really check what’s in there.”

What is kratom used for?

Kratom is often marketed as a safe, natural herbal supplement that helps manage pain, anxiety, and depression.

At low doses, its stimulating properties create a “caffeine-like buzz,” Speights explained.

Due to its opioid-like effects, it has also been used in an effort to reduce dependence on opioids like fentanyl.

These properties come from the way compounds in the plant, like 7-hydroxymitragynine, activate various hormones, including dopamine.

What are the effects and how dangerous is it?

“It’s almost like taking a narcotic,” Speights said. “At higher doses, it can create more euphoria and give you a more general high.”

Hallucinations are also possible.

Higher doses also carry a higher risk of unwanted side effects.

This includes central nervous system (CNS) depression – which is “where deaths occur,” Speights said.

CNS can lead to cardiovascular collapse and respiratory loss.

Withdrawal symptoms and addiction are also risks, said Jana Wu, director of clinical integration at Mountainside Addiction Treatment Center.

“It affects marriages and relationships,” she said. “I’ve seen people lose their jobs and spend thousands of dollars a month on them.”

Since it is easy to develop a high tolerance to this herb, users may need to take an increasing amount to achieve the same effect over time.

“I’ve worked with people who were taking up to 20 pills a day,” Wu said.

Experts told the BBC that the greatest dangers come from the fact that kratom is not federally regulated.

“Is there a safe dose?” » said Speights. “My answer will be no because – I’ll come back to this – we don’t know what’s in there.”

Is Kratom Legal?

Kratom is banned in 11 states: Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Massachusetts, North Dakota, Tennessee, Vermont and Wisconsin.

Massachusetts was the last state to make it illegal, issuing a temporary emergency order in August.

Ten years earlier, the U.S. Drug Enforcement Agency (DEA) decided to classify kratom as Schedule 1, the most dangerous level of drugs, calling it an “imminent danger to public safety.”

But that attempt failed a few months later, after the Justice Department said it received “numerous comments from members of the public disputing” the attempt.

That leaves states to act, like Arizona, which recently sued a company selling kratom drinks.

Groups opposed to kratom want states to do more, saying “gas station drugs are poisoning our communities.”

Pro-kratom groups like the American Kratom Association are pushing to ban synthetic products “masquerading as natural kratom.”

Internationally, kratom is banned in the United Kingdom. In Europe, laws vary depending on the country.

In Malaysia, where kratom originated, consumption and sale is prohibited under the Poisons Act of 1952.