Jane Castro is a journalist and media enthusiast. She graduated from the University of Bacolod in the Philippines. She loves skating, scuba diving, and archery on her free time.

Kratom, a plant native to southeast Asia, is a legal alternative to the opioid painkillers that have been linked to thousands of deaths in the US. But as new research and studies emerge with regard to its effects on the body, so too do the concerns over how it has become legalised.

The American Kratom Association has been pushing for the legalisation of kratom products since 2015, when its president Michael Miller began lobbying state legislatures, including Georgia, where he lives.

He told the Washington Post that his motivation was to “prevent unnecessary suffering”. The association also works closely with the FDA, which has previously said that it does not view kratom as an illicit drug. In fact, the FDA has even gone as far as to say that it has seen no evidence that kratom is dangerous or addictive – a claim that appears to be at odds with other research into the substance.

A recent study published by researchers at New York University found that kratom can cause hallucinations and seizures, while another paper from the National Institute on Drug Abuse found that it can suppress breathing. However, kratom advocates argue that these findings don’t apply to the way people use kratom, which they describe as a safe and effective treatment for chronic pain.

It is this argument that seems to have made some Americans – namely those who are battling chronic pain – more open to exploring alternatives like kratom. As such, there has been a surge of online sales of buy kratom supplements, which are now available in most countries around the world.

Kratom, a plant native to southeast Asia, is a legal alternative to the opioid painkillers that have been linked to thousands of deaths in the US

While kratom can offer the same relief as opioids, it doesn’t carry any of the negative side-effects associated with them. For example, one person taking a high dose of kratom may experience nausea, but someone else could get the opposite effect (such as feeling euphoric). It is this ability to affect individuals differently that means it provides a useful alternative to opiate-based pain medicines.

The problem is that because it’s classified as a supplement, many doctors aren’t aware of it. This has contributed to many people turning to it as a solution when they are looking for pain relief without resorting to prescription drugs, something that has caused alarm among health experts.

In 2017, the DEA added kratom to its list of controlled substances after concluding that it poses a public health threat, even though its use has never been conclusively linked to addiction or overdose deaths. At the time, the DEA estimated that 100 million Americans had used kratom in the previous year, and claimed that it was being abused by young adults and seniors.

But a recent report by the FDA suggests that this figure may be much higher than the agency originally anticipated. The agency found that there were nearly 1,200 complaints about kratom between 2010 and 2016, with more than half of them related to adverse events like nausea and vomiting. There were also several reports of people developing psychosis or seizures after using it.

This information led to calls for increased regulation of the substance. In September 2019, then-FDA Commissioner Dr Scott Gottlieb proposed banning kratom entirely, arguing that the agency needed to take action to protect the public safety before kratom became entrenched in society.

However, despite the FDA’s warnings, kratom is now legal in all 50 states. Although the legal status of kratom varies from state to state, it is generally considered to be a dietary supplement rather than a medication. As such, it is sold without a prescription, unlike pharmaceuticals that require doctor’s approval. While the FDA continues to warn against the dangers of kratom, it hasn’t taken steps to ban it outright.

With the FDA refusing to regulate kratom, the responsibility falls on the states to decide whether or not to allow it to remain legal. And while some states have moved quickly to make changes, others have decided to wait until further scientific research is conducted. This includes Tennessee, which will hold off making a decision until October 2020, when more data on kratom is expected to be made available from the FDA.

One thing that isn’t up for debate is the demand for kratom. Online retailers in the US have reported record highs for sales of the product, which has grown to rival CBD as the top selling natural supplement in the country. Sales of kratom increased by more than 600% in 2018 compared to the previous year, according to the National Pain Report.

Even though there is still a lot of uncertainty surrounding kratom, it is clear that the substance is here to stay. Whether or not it will continue to grow in popularity remains to be seen, but it seems unlikely that we will ever return to the days of opioid-based painkillers once again.