Gas station heroin?
Recently, two University of Mississippi students were found dead in their homes in Oxford. The common denominator seems to be the presence of packaged kratom, an herbal supplement available for sale in most gas stations and convenience stores. At present, it’s uncertain whether the students had kratom in their systems. While toxicology results are pending, the press is sounding the alarm over what it’s calling “gas station heroin.”
Advertisement
Kratom comes from the leaves of 0, a tree native to Southeast Asia. Its main active compounds are mitragynine and (in much smaller amounts) 7-hydroxymitragynine. These substances act on opioid receptors in the brain just like how heroin and morphine do. Kratom, however, is not an opiate. It’s actually a member of the coffee family.
Despite similar names, the active compounds in kratom are not the same. Mitragynine has a mild stimulant effect at lower doses, whereas 7-hydroxymitragynine has stronger, opioid-like effects like sedation, euphoria, and pain relief. 7-hydroxymitragynine also has a higher risk of physical dependence, tolerance, and severe withdrawal symptoms.
Advertisement
Kratom is not new on the scene. It’s been used by many people who swear by its effect on pain. Others have used it to replace a heroin or other opiate addiction. Despite this, kratom is not approved by the FDA for any medical use, and warnings exist due to its own addictive potential. In fact, some states have banned products containing kratom completely. By prohibiting the possession and use of mitragynine and the more potent 7-hydroxymitragynine, the state can make it illegal even to possess the plant.
The question is whether kratom is as lethal as the opioids it replaces. It seems the number of fatal “poisonings” are small compared to the number of people damaged by other substances like fentanyl. The hard scientific evidence doesn’t seem to confirm the level of lethality suggested by the conventional wisdom.
Advertisement
A CDC analysis of National Poison Data System (NPDS) records from 2015 through 2025 documented 233 kratom-associated fatalities. Kratom is listed as the sole cause of death in 21 percent of these cases. In another CDC report, kratom was listed as a cause of death in 91 cases. Of these, 7 involved kratom alone with no co-occurring substances.
The State Unintentional Drug Overdose Reporting System is a surveillance system under the CDC that analyzes fatal drug events in participating states. Overdose data found roughly 800 to 1,150 deaths annually in which kratom was detected but not confirmed as a factor in the cause of death.
Advertisement
We still don’t know enough about the fatalities at the University of Mississippi, but kratom (still in the package) at the scene doesn’t rule out several possibilities:
1) Polysubstance Use: Pure kratom overdoses are considered rare. In around 80 to 90 percent of documented fatalities, other potent substances were also involved. These were most commonly fentanyl, heroin, benzodiazepines, prescription opioids, or alcohol.
Advertisement
2) Product Contamination: A portion of deaths associated with kratom have resulted from adulterated products (e.g., kratom laced with synthetic opioids like tramadol), contamination with heavy metals (lead or nickel), or bacteria like salmonella.
3) Detection vs. Causation: If postmortem toxicology confirms that the person ingested kratom, there is always a debate as to whether 7-hydroxymitragynine was the direct cause of death or simply an incidental finding alongside other toxic drugs.
Advertisement
In any case, the FDA has taken up an anti-kratom stance after several states banned the plant. Indeed, enough 7-hydroxynitragynine can possibly cause life-threatening respiratory depression and other ill effects.
The Department of Health and Human Services is studying kratom, and its final determination will decide if the plant is banned forever.
What if the FDA does ban kratom? Since kratom is addictive, outlawing it could cause thousands to undergo some kind of withdrawal. How many will turn to actual opioids like heroin? The end result might be an increase in opiate overdose deaths, already an epidemic.
What if there is no ban? Although there are deaths recorded as caused by kratom use, the numbers are small compared to, say, opioids like fentanyl.
It seems that, while it might be easy for the FDA to ban what detractors call “gas station heroin,” this would be a disaster for those who rely on it to keep them off opioids. Why not study kratom and establish standards? Currently, the lack of regulation allows a myriad of iffy Kratom supplements to be available wherever it’s sold. Make sure of actual contents, purity, and concentration, and institute strict instructions for use. Then maybe we won’t have to wonder if kratom kills college students.
Image: ThorPorre via Wikimedia Commons, CC BY 3.0.
