The herbal extract kratom, commonly used for its opioid-like effects, has been in the news recently thanks to the Food and Drug Administration (FDA) proposing a ban on the substance. According to the FDA’s website, kratom “appears to have properties that expose users to the risks of addiction, abuse, and dependence.” However, many have argued that banning or criminalizing kratom, which has been utilized as a painkiller and for opioid withdrawal, would be harmful to its many users.

One organization that opposes kratom prohibition is Students for Sensible Drug Policy (SSDP), described on its website as the “largest global youth-led network dedicated to ending the War on Drugs.” Over email, I chatted with SSDP’s Communications Manager, Rory O’Brien, about the potential kratom ban and the current state of drug policy.

In your opinion, why is it important for students and young people to get involved with drug policy reform?

At Students for Sensible Drug Policy, we have a lot of chapters making changes on their campuses. Work could be from Good Samaritan policies for overdose response, including alcohol poisoning, or distributing naloxone and other harm reduction supplies. I believe that peer-to-peer education is extremely important. I know at 18, I would have been much more likely to listen to somebody my age talk about harm reduction—especially if they were a person who uses drugs. As far as larger policy reform, the voice of young people is often overlooked—but it’s extremely important. We do have an opportunity to make sure drug policies protect and support students and young people too.

How has the Biden Administration changed policies or attitudes around drug reform?

The main thing that has been in the media is mentioning the support of harm reduction and funding it. It has been promising to see harm reduction even being mentioned, and it gives the opportunity to educate more people in the US about what harm reduction is. However, a lot of it has still been merely talk. The administration’s recommendations for scheduling fentanyl-related substances goes against everything [SSDP] and other human rights groups have been telling them. The racist War on Drugs is still ongoing and ingrained into policy recommendations from the U.S. government. I hope that this administration and future administrations will take ending the War on Drugs seriously and as a necessity for drug policy reform.

What, if anything, makes debates around kratom unique? What are the main concerns around its usage?

I believe it’s unique because kratom has yet to be scheduled. There are the same concerns about all unregulated products, both legal and criminalized, about being less predictable than products that are tested—where people who use them are able to know exactly what is in them. But because it is still legal, the kratom supply has remained much more stable than illicit supplies of most other substances. That has been an argument pushing cannabis legalization as well, especially after counterfeit, unregulated vapes caused an increase in lung-related illness. Safe supply is the only way that people could know what they’re consuming and the best way to prevent overdose or other harm related to contaminated products.

Some concerns have been from the addiction treatment industrial complex about dependence and addiction, which are two different things. A study from John Hopkins showed that very few people who used kratom met the criteria for moderate to severe substance use disorders. But I do believe that people deserve support if they’ve struggled to reduce or stop their kratom use. Criminalizing and scheduling are not the solutions, however. That only will make it more dangerous, including people who transition to other illicit supplies if they lose access to kratom.

Do you see kratom as being particularly popular amongst young people?

I haven’t observed it being more popular amongst younger folks than other age groups. One thing that myself and others in chronic pain communities have observed is that people are more consistently being unable to access opioids—and even other controlled substances for conditions like ADHD and anxiety—in the first place. With the CDC recommendations and attacks on prescribed opioids for pain, people who had had prescriptions were often abruptly cut off, which is extremely dangerous and torturous. More stories and formal studies have shown it leading to deaths from suicides and overdose. But now, there is a trend of hesitancy to prescribe most controlled substances. Young people may not even have the option to be prescribed proper pain management, or controlled medications other than opioids, in the first place. This was actually a persistent issue for people of color, especially Black folks, due to medical racism prior to prescribing restrictions. Kratom remaining legal has been an option for people who have been failed by our medical system.

The FDA has proposed a controversial kratom ban. How would an organization like SSDP respond if such a ban were implemented? 

SSDP hopes to fight alongside organizations like the American Kratom Association and prevent both scheduling in the U.S. and internationally. The HHS rescinded their recommendations for scheduling and the FDA has been losing traction to schedule kratom federally. Bringing this to the WHO and the UN could be seen as a move to go around that. Ultimately, the process the UN has is not only dictated by the FDA or the U.S. government. We stand strongly opposed to any kind of scheduling or criminalization of kratom.

If it were implemented, it would have devastating consequences. Being in an overdose crisis, where people lack access to prescription opioids for pain and a safe supply, surely would lead to even more overdose deaths. A common use of kratom is for pain relief. Another is to transition off opioids or to manage withdrawal symptoms. In the U.S., medications for opioid use disorder are still not accessible. Methadone has many inhumane barriers, and on top of insurance issues, buprenorphine is less accessible in communities of color. I mentioned other controlled substances for mental health as well, like stimulants for ADHD and benzodiazepines for anxiety. People use kratom for many reasons. Different strains and doses provide different effects. It’s a really fascinating plant. There are many reasons why [a Kratom ban] would be extremely devastating.

Do the debates around kratom reflect the United States drug policy trends at large?

I would say so. “Just Say No”, abstinence-only and fear-based drug education (as well as addiction treatment) is still dominant even though it’s been shown to be ineffective and harmful. Risks of substances are exaggerated and anything with the potential for addiction is demonized—along with the people who use it. The focus remains on the drugs and not the reasons people use them. There is a theory called the Iron Law of Prohibition that shows when substances are banned or criminalized, they become more potent and more unpredictable. For example, during the alcohol prohibition, it led to dangerous products that were easier to keep hidden—like moonshine. Cannabis prohibition and the practice of urine drug testing led to synthetic cannabinoids (sometimes known as K2 or spice). Banning opium led to heroin and decreasing opioid prescribing is why we have had such an increase in fentanyl and other synthetics. 

The War on Drugs is racist and classist. Black and brown communities often face the most harm and are targeted by police. We are seeing this even in an overdose crisis that’s been very whitewashed. Areas with populations of East African immigrants, including Minneapolis where I live, had a racist response to the increase of khat which led to raids in immigrant communities. SSDP is currently pushing to end the funding of psychoactive crop eradication in Colombia. Kratom is indigenous to Southeast Asia. A global response to criminalizing kratom is also a big concern for the harmful consequences of an international ban.