As the nation grapples with how to handle kratom at all levels of commerce and government, the state of the kratom question was encapsulated last week in a four-hour committee meeting by the Georgia House of Representatives non-civil judiciary committee.
Ultimately, lawmakers unanimously voted to table the proposed ban, instead favoring an approach of more research and a potential reworking of current regulations around the substance. But it’s not what the committee decided that is proving significant in the debate around kratom, it’s how the committee got to that decision that shows the current state of kratom in the United States.
The proposed bill was sponsored by Rep. Rick Townsend, who started the committee meeting with a presentation to lawmakers. Despite the proposed bill seeking to ban all kratom sales, Townsend instead began his portion of testimony by highlighting issues of “quality control” and inconsistent labels.
One of the few moments of direct confrontation arose when Rep. Shea Roberts questioned Townsend on research that Roberts presented from Johns Hopkins. Roberts pointed to Townsend’s issue with quality control and inconsistent consumer information, and questioned if perhaps scheduling the substance was the wrong approach.
“It seems like the primary issue you have is labeling,” Roberts said. “Wouldn’t it be better possibly to bring a bill that requires labeling instead of banning it?”
In response, Townsend claimed the research was paid for by the American Kratom Association (AKA), to which Roberts said she trusted the institute that treated a family member’s cancer to provide honest information. During the public comment period, Mac Haddow from the AKA said the organization had not funded any research from Johns Hopkins.
Georgia passed a law in 2018 requiring clear product labels and a list of ingredients, however, the state senate stripped the enforcement measures from the bill. Townsend testified that he did not believe adding enforcement measures would adequately address “thousands of deaths” caused by kratom, and claimed that Oregon had spent $500 million on enforcement and was still seeing deaths increase.
The only issue with those claims is that Townsend did not present any information to back those claims, which were later refuted by others providing testimony.
Even the experts who were allowed to speak immediately following Townsend started to show the cracks in logic behind the proposed ban. First up was Dr. Jeffrey Smith, the Chief Medical Examiner for the Georgia Bureau of Investigations. Smith did concede that any substance that is included in a death toxicology is “dangerous” in his opinion. At the same time, the numbers presented by Smith still fell far short of any claims made by opponents during the public hearing.
In data presented from 2017-2021, Smith said that kratom was present in the toxicology report of 239 death investigations, including 33 deaths where kratom was the only substance on the report. Despite kratom being the only substance present, that didn’t mean that Smith was able to definitively attribute those 33 deaths to kratom.
“Can’t answer the question,” he said. “There may have been comorbidities as well.”
He later added context about those numbers, as an answer to a question about a comparison: “In the context of what we’re seeing at the state medical examiner’s office, mitragynine frankly pales in significance in comparison to fentanyl, methamphetamine, and cocaine.”
The other expert who had worked with Townsend, Gaylord Lopez from the Georgia Poison Center, also testified in favor of the bill. Lopez referenced inconsistencies in labeling and potency—issues that advocates have tried to address with regulation—as reasons that he favored scheduling kratom.
Despite his support for the measure, Lopez’s testimony came to the same conclusion as many who opposed a ban: Without enforcement mechanisms for labeling requirements, consumers cannot be sure what they are ingesting in kratom products.
He used an example that a bottle of drain cleaner could include the instruction to drink the product, and he would know as a clinician not to drink the cleaner.
“I could pick up a bottle of Drain-O, and there could be perfect labeling instructions, but there are some bottles of Drain-O that could say ‘mix with one raw egg, take and drink it.’ I’m not going to follow that instruction as a clinician, because that could do more harm than good.”
After the committee had allocated time for Townsend and his experts, who were allowed to testify first due to busy schedules, experts opposed to the bill had a chance to weigh in.
Haddow was one of the first few to testify against the bill, claiming that passing this measure would immediately criminalize 200,000 Geogians, and said that simply enacting a ban would only make the issues of “quality control” and adulterated products worse.
“This bill would open up a black market, Georgians will die,” Haddow said
A criminal lawyer from Georgia also testified about the harm of potentially criminalizing the sizable number of Georgians who use kratom, and said it would only further complicate a backlog in the criminal justice system that started with the COVID-19 pandemic. From a medical perspective, a researcher from Johns Hopkins said kratom did not carry the same risk as substances it was being compared to.
Marilyn Heustis, a professor of toxicology and forensic toxicologist with 50 years of experience, testified that claims of kratom’s risk and opioid-like property were not substantiated by studies, and told the committee that kratom does not affect the same respiratory pathways that contribute to opioid overdose.
In the end, the committee decided to table the measure in favor of more research and consideration. Despite testimony and personal stories of family members who had lost loved ones to a perceived kratom overdose, the committee took a look at the science and numbers presented, and ruled in favor of those who saw kratom as a net positive.
For voices like Rep. Tanya Miller, the question came down to science, rather than anecdotal evidence, and even the experts testifying in favor of the measure had to admit: the science separates kratom from current Schedule I substances.
“In your mind, when you think of drugs that are Schedule I now—heroin, etc.—do you, Dr. Jeffrey Smith, equate kratom to those?” Miller asked.
Smith sat back in his chair, readjusted and let out a wry laugh before answering.
“The short answer to that is ‘no,’ simply because of the lack of data and the small numbers,” Smith said. “I don’t want to minimize the small numbers, but if you look at the number of cases that we unfortunately deal with on a daily basis, where the death is due to powerful drugs such as fentanyl, methamphetamine, cocaine and on occasion heroin, kratom is a small number.”