The Panhandle Health District on Monday issued a districtwide warning for kratom, a drug that PHD officials state has addictive and overdose potential.   

"Kratom and in particular 7-OH, appears to be a growing problem in Northern Idaho and the rest of the nation,” said Panhandle Health District Medical Director Gregory Pennock, M.D., in a press release.

Pennock said the Kootenai County coroner had associated deaths with kratom use in North Idaho. He said the district wants to increase local awareness of these "potentially dangerous products."

Kratom, marketed as a stimulant, is routinely available at convenience stories in North Idaho. Two active components of kratom are the alkaloids mitragynine and 7-hydroxymitragynine (7-OH). 

According to the Drug Enforcement Agency, kratom consumption can lead to addiction. There have even been cases of psychosis resulting from kratom use, the release said.

The American Kratom Association has lobbied for states to pass the Kratom Consumer Protection Act to establish safety guidelines and manufacturing practices for kratom vendors.   

As of February, 19 states have passed the legislation.      

There are about 24 million residents who have used kratom in the United States, according to a new bill Feb. 13 called the Idaho Kratom Consumer Protection and Safety Act.

The bill intends “To preserve adult access to natural kratom while preventing the sale of unsafe, adulterated, or synthetic products.”  

State Sen. Tammy Nichols of Middleton and Rep. Mark Sauter of Sandpoint were working on similar bills and have joined forces to get more guidelines in place for regulating kratom products and synthetics. 

“It’s a good step in the right direction and we haven’t really had anybody push back and say it’s not warranted. I’ve checked in with law enforcement and our medical professionals and they all state that it seems like it should be at least better regulated,” Sauter said. 

Sauter said there were a number of concerns with the substance and how it is handled, including labeling issues and organic versus synthetic kratoms. 

“I had a constituent ask me about it in December and ask me to follow up on what we can do to regulate it from Boundary County and I made a commitment to doing so,” Sauter said. “Sadly, that constituent passed away, but it’s a matter of sticking to your commitments.”    

The sales age is restricted to age 18 and older, something Sauter thinks may be adjusted up to 21 and older in the future.   

"If we can get it in place by July 1, then we can start seeing if it makes a difference or not. I’ve also reached out to the sellers of it and some of the retail establishments, they actually support regulation," Sauter said. 

As a senior fellow in public policy for the association, Mac Haddow said the nonprofit views 7-OH as a whole new synthesized element that fundamentally changes the product's character. 

“We are not for an unregulated market,” Haddow said. “We advocate for states to pass what we call the Kratom Consumer Protection Act, which establishes strict formulation requirements, warning labels that are appropriate and age restrictions.” 

Haddow said that some people using kratom use it for energy boosts, others for mood enhancement and other users partake in kratom as an alternative to opioids and prescription pain medications to manage acute or chronic pain. 

The difference in how the substance binds to receptors between organic and synthetic variations is significant and is the reason the AKA wants more regulations, Haddow said. 

“7-OH products are the ones the FDA has targeted for being subject to controlled substances because they are so powerful and they are being chemically manipulated,” Haddow said. “They need to be regulated for the potency of extracts and synthetic products. It makes it highly potent, binds to the receptors in our bodies in a way that is significantly addictive in a way that kratom does not.” 

Panhandle Health District officials recommend seeking medical advice for side effects, addiction or withdrawal symptoms and reporting adverse reactions of kratom or 7-OH products to the FDA’s MedWatch program and to Panhandle Health District by calling 208-415-5235. 

Concentrated preparations may contain unsafe levels of the active alkaloids and may cause seizures, addiction, liver and kidney toxicity, according to Panhandle Health.  

    Mark Sauter