A compound that makes up a tiny portion of the kratom leaf has generated concern in recent years, as herbal products derived from the leaf but synthesized in labs to market more potent versions have contributed to calls to poison centers and high profile deaths.
In May, Colorado's governor signed the Daniel Bregger Act into law, named after a young man who died from a toxic combination of a highly-concentrated product of the active psychoactive ingredient found in kratom and a common allergy drug. Among other things, the act limits the concentration in kratom products of 7-hydroxymitragynine, or 7-OH, a highly potent compound that makes up less than 0.1% of the natural kratom leaf.
This guardrail comes after a surge of these high-potency products being sold in convenience stores and smoke shops across the state.
“Because it is such a rare constituent part of the kratom leaf, it is being semi-synthetically derived in a lab before being added to kratom products,” said David Kroll, PhD, professor and director of the Master’s Degree and Certificate programs at the CU Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences. “And 7-OH is five to 50 times more potent than the normal kratom powder used in capsule or tea form, resulting in a much higher likelihood of overuse and abuse.”
What is kratom?
The leaves from a tree native to Southeast Asia, kratom is an herbal medicine with effects similar to opioids. It is most often found as a powder in the United States, in capsule or tea form and more recently, concentrated extracts.
On July 29, the U.S. Food and Drug Administration (FDA) recommended adding 7-OH to the Schedule I drug list, putting it in the category of heroin that labels it as having “no currently accepted medical use and a high potential for abuse.”
We recently sat down with Kroll, whose research focuses largely on herbal medicines, to learn more about the issues with the popular-yet-unregulated kratom, often used as an alternative to opioids for pain relief and as a self-therapy for alcohol and opioid addiction.