Los Angeles County officials will immediately remove kratom and its synthetic extract (sometimes called 7-OH) from the shelves.
The Los Angeles County Department of Public Health said in a news release Friday morning that inspectors will be sent to retailers next week to begin red-tagging illegal products containing these compounds. Stores that fail to comply may be subject to fines or other penalties.
Kratom is an herbal extract derived from the Kratom leaf Capsnaila tree native to Southeast Asia. It is sold in many forms in stores and online, including powders, pills, and liquid extracts. Brands selling kratom often claim that it can address pain, anxiety, and mood disorders.
Matthew Lowe, executive director of the Global Kratom Alliance, said natural kratom has been used in the United States for more than 50 years to relieve anxiety and treat chronic pain.
Over the past few years, a more potent synthetic version of kratom, refined into its psychoactive compound 7-hydroxymitragynine (7-OH), has hit shelves across the United States
7-OH products are often referred to as “plant alkaloids,” drawing criticism from some, including Lowe, who believe the label is misleading and leads consumers to believe it is the same as natural kratom.
The county health department warns that when mixed with alcohol, drugs or illegal drugs, 7-OH products can “cause severe respiratory depression and death. Importantly, these products are unregulated and may contain unknown concentrations of 7-OH, increasing the risk of accidental overdose.”
In the past few months alone, six kratom-related deaths have been reported in Los Angeles County.
The Los Angeles County Department of Public Health told The Times via email, “Given that this is an emerging substance, this is also the case since medical examiners began tracking 7-OH data.” Because the county only started tracking 7-OH deaths in April, it’s unclear how many other overdoses have occurred before.
Alcohol was found in all six people’s systems, so the exact role of kratom and 7-OH in their deaths remains unclear. The Times first requested a report from the coroner on kratom-related deaths on Oct. 24, but the county has not yet released a report.
“Kraft and 7-OH products are sold as natural remedies, but they are illegal and unsafe,” county health officer Dr. Muntu Davis said in a news release. “They are sold at gas stations, smoke shops, online and at other retailers. People should avoid using these products and store owners/operators must remove them immediately to prevent harm.”
Yaël Ossowski, associate director of the Center for Consumer Choice, a nonprofit consumer advocacy group, said consumers currently don’t know much about kratom, 7-OH or any other metabolite. “At any gas station or smoke shop, there are different brands and different dosages of powders, liquid extracts and pills,” Osorski said. “This clearly leads to consumer confusion, uninformed choices, incorrect dosing and potentially adverse experiences that could have been avoided with sensible regulation.”
The market for kratom and 7-OH is growing largely because people want targeted pain relief and ways to treat illnesses, “but don’t necessarily want to get the full effects of more powerful opioids that have a more comprehensive impact on the body,” he said.
“Kraft has been used successfully for generations in other countries as an alternative to opioids,” Osofsky said. But highly concentrated 7-OH products are a different story altogether.
According to the U.S. Food and Drug Administration, kratom and 7-OH are not legally sold in the United States as drugs, dietary supplements, or approved food additives.
California passed federal laws regarding foods and dietary supplements, the California Department of Public Health told The Times via email.
“Until Kratom and its key pharmacologically active ingredients, mitragynine and 7-OH, are approved for use, they will remain classified as adulterants in medicines, dietary supplements and foods,” a department spokesman said.
The spokesperson added that the department has been conducting kratom-related investigative work for the past two years and “continues to take appropriate actions to protect the public from adulterated products containing kratom or 7-OH.”
“When food and dietary supplements adulterated with kratom or 7-OH are discovered during the course of an investigation, CDPH embargoes or destroys them in the state; however, we do not comment on the specific details of ongoing investigations,” the spokesperson said.
In the face of lawsuits and an FDA crackdown, 7-OH manufacturers have publicly defended their product, saying it is a safer alternative to illegal opioids like fentanyl and that it saves lives, not takes them.
Vince Sanders, founder and CEO of CBD American Shaman, which helped develop early 7-OH products, said the attack on 7-OH was led by companies selling natural kratom, which had lost market share to what he called “an extremely premium product.”
The Kansas City businessman said a ban anywhere in the country would hurt people who use 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 had their lives changed using it are very concerned,” Sanders said. “They’re scared to death. I mean, some people…are planning to take money out of their 401Ks, or top up their credit cards, or whatever they have to do to buy a multi-year supply.”
He acknowledges that kratom and 7-OH are often taken at higher doses than he recommends, but he believes manufacturers and retailers should not be held responsible for these decisions. He compared it to alcohol: “You buy a 750ml bottle and if you go home and drink the whole bottle and do it every night, is that your fault or is it Jim Beames’ fault?”
In the absence of state and federal regulation, communities across the state have taken action on their own. Orange County, Newport Beach, San Diego and Oceanside all prohibit the sale, distribution or possession of kratom. Riverside County is seeking to block the sale and marketing of kratom and 7-OH products to people under the age of 21.
Los Angeles County does not have its own product regulations.
“I think the local action is sending a signal. It’s sending a signal to the state and [federal authorities]you need to do something about it,” Lowe said.
But he said an outright ban could raise a host of other issues, including whether local enforcement would be enforced and the possibility of a black market in the product.
“You leave people with no options, so they either look for alternatives or they drive across the city line or county line and get it themselves,” Lowe said. In fact, kratom and 7-OH are widely available in online markets.
