COLUMBUS -- Kratom, a plant-based supplement that consumers say alleviates chronic pain and opioid addiction, could soon be banned in Ohio.
The Ohio Board of Pharmacy voted Monday to classify kratom a Schedule I controlled substance alongside heroin, LSD and other dangerous illegal drugs. The board concluded kratom has a high potential for abuse, has no accepted medical use, isn’t safe to use in medical treatment and poses a public health risk.
The board’s vote starts a months-long process of approving new rules and regulations for kratom, and public comment will be accepted at various points in the process.
The board has already received more than 1,500 comments about the proposed change, mostly in opposition and many through a form letter drafted by the American Kratom Association, an advocacy group that formed to keep kratom legal.
The board's decision comes on the heels of a controversial advisory statement that CBD oil, another "natural supplement" sold across Ohio, is illegal in the Buckeye State.
What is kratom?
Kratom is derived from the leaves of a Southeast Asian tree similar to a coffee tree and is usually consumed as a powder or tea. The main active compounds of the plant are Mitragynine and 7-hydroxymitragynine – that’s what the pharmacy board intends to classify as Schedule I drugs.
Kratom is sold as a natural supplement, and therefore not subject to U.S. Food and Drug Administration guidelines, at natural health stores, gas stations and over the internet. Advocates say kratom, on its own, poses a low risk of overdose and can be used to treat pain and as a replacement for opioids.
Why ban it?
The pharmacy board has been discussing banning kratom for a couple years, board spokeswoman Ali Simon said. Simon said the Drug Enforcement Administration’s decision last year not to ban it federally and several recent developments prompted the board to take action now.
In 2016 and 2017, six people died in Ohio from kratom, according to Ohio Department of Health data. And the latest state drug trend report found that people were buying kratom from heroin dealers in the Akron-Canton region.
In April 2018, a Salmonella outbreak tainted dozens of kratom products and infected 199 people in 41 states, including Ohio.
Simon said the agency was especially concerned about mixing kratom with opioids, since both drugs activate opioid receptors and kratom has been marketed as an opioid substitute.
"People might be thinking they’re getting weaned off, but there’s not a lot of science behind what they’re putting in their bodies," Simon said.
Ohio law gives the board the authority to schedule controlled substances differently than the federal government. In 2016, Ohio's medical marijuana law reclassified cannabis for medical use as a Schedule II substance, even though it remains on Schedule I federally. Simon said the board also scheduled bath salts ahead of the DEA.
Six other states and the District of Columbia have banned kratom: Alabama, Arkansas, Indiana, Vermont, Rhode Island and Wisconsin.
What do advocates say?
American Kratom Association Chairman Dave Harmon said all of the board’s reasons to ban kratom are incorrect.
"I believe they’re reacting to propaganda from the FDA that’s being debunked on a regular basis," Harmon said.
Harmon said science shows kratom does not suppress the respiratory system and therefore the risk of overdose is extremely low. Harmon said the concern about kratom stems from incidents involving kratom that was laced with other drugs, and policy makers should crack down on altered kratom products.
The DEA backed off plans to ban kratom in 2016 after it was flooded with public comments supporting the drug.
"The FDA is demonizing kratom on a state by state level to get what they didn’t get on the federal level," Harmon said.
The board is accepting the first round of comments until Oct. 18 by email to Contact@pharmacy.ohio.gov.