Up until about two weeks ago, I had never heard of Kratom. It wasn't until the story about the two Ole Miss students that had mysteriously died in September that I even heard of the name.

On September 21, two University of Mississippi (Ole Miss) students were found dead in separate locations, one in a campus dorm room, the other off campus in an apartment. Authorities treated them as separate investigations and initially said there was no confirmed evidence the deaths were connected. Officials initially stressed there was no confirmed information that kratom (or any specific substance) was a contributing factor, and toxicology/autopsy results were pending. They urged the public to avoid kratom and unregulated substances out of caution.

So, what is kratom? Kratom is an herbal substance from the leaves of Mitragyna speciosa, a tropical evergreen tree in the coffee family native to Southeast Asia (primarily Thailand, Malaysia, Indonesia, and neighboring countries). Traditionally, people in the region have chewed the fresh leaves or brewed them into tea for centuries to combat fatigue, boost energy and productivity in hot conditions, relieve pain, treat diarrhea or cough, and sometimes as a mild opium substitute or during ceremonies. So, I had to research this further and here is the technical talk about kratom and how it works.

The main active compounds are alkaloids, especially mitragynine (the most abundant) and 7-hydroxymitragynine (present in smaller amounts but more potent). These interact primarily with opioid receptors in the brain (as partial agonists) and also affect other systems. Effects are strongly dose-dependent: Low doses (typically under 5 grams of leaf powder): Stimulant-like effects—increased alertness, energy, sociability, focus, and reduced fatigue, which is why so many younger people are using it but, higher doses are more like a sedative with opioid-like effects—pain relief, relaxation, calmness, and reduced anxiety, with a much higher risk of side effects.

In the U.S., where an estimated 1.7 million people aged 12+ used it in recent survey data, common self-reported reasons include: Managing chronic or acute pain (the most frequent reason in many surveys), Easing opioid withdrawal symptoms or cravings, or as a perceived harm-reduction alternative to stronger opioids, Boosting energy, focus, or productivity and reducing fatigue and Self-treating anxiety, depression, stress, or low mood. I thought to myself, I must have been under a rock not to hear about something like this sooner, but my kids are grown and have kids of their own now. And my oldest granddaughter just turned ten so hopefully she hasn't been exposed yet to these things.

The internet is the information superhighway, and I don't want to sound alarmist, but we need to talk more with our kids about these types of supplements. Research is still early-stage. The U.S. FDA has not approved kratom for any medical use and states there is no evidence it is safe or effective for treating any condition (including pain or opioid withdrawal).

Kratom is legal under U.S. federal law (it is not scheduled as a controlled substance), but individual states set their own rules. However, it is legally being sold in New York, Pennsylvania and New Jersey. As if kratom itself wasn't enough of a concern, although low dose uses may have benefits, there are higher dose synthetic kratom derivatives hitting the market all the time.

The kratom connection to the two university students was that investigators found packaged products described as kratom or synthetic/kratom-like derivatives (commonly labeled “Smax” or “Smax Pseudo-DHM” tablets) in those two locations. These were higher-potency products containing concentrated compounds such as 7-hydroxymitragynine (7-OH), mitragynine pseudoindoxyl, and/or MGM-15, rather than traditional leaf kratom. Such synthetic or highly concentrated versions are more potent, have drawn regulatory scrutiny and can be extremely dangerous. So, if you have teens or millennials in your family, talk to them about the dangers of these supplements. You might not have heard about kratom, but they probably have.