La County stores must stop selling kratom and 7-OH, health department says

Los Angeles County officials are poised to pull kratom and its synthetic extract, sometimes called 7-OH, off the shelves immediately.

The LA County Department of Public Health said in a news release Friday morning that inspectors will be sent to retailers next week to begin targeting illegal products containing the compound. Shops that do not comply can face fines or other penalties.

Kratom is an herbal extract from the leaves Mitragyna speciosaA native tree of Southeast Asia. It is sold in stores and online in various forms, including powder, pills and liquid extracts. Brands selling kratom often claim that it can treat pain, anxiety, and mood disorders.

Natural kratom has been used in the United States for more than 50 years, and according to a 2020 Johns Hopkins survey, people use it to reduce anxiety and treat chronic pain, said Matthew Lowe, executive director of the Global Kratom Coalition.

In the past few years, a more potent, synthetic version of kratom with a boost in its psychoactive compound 7-hydroxymitraginine, or 7-OH, has been introduced across the United States.

7-OH products are often marketed as “plant alkaloids,” drawing criticism from some, including Lowe, who argue that the labeling misleads consumers into thinking it is identical to natural kratom.

When mixed with alcohol, drugs or illegal drugs, the county health department warns, 7-OH products “can cause severe respiratory depression and death. Importantly, these products are unregulated and may contain unknown concentrations of 7-OH, increasing the risk of unintentional overdose.”

There have been six reported kratom-related deaths in Los Angeles County in the past few months.

“Given that this is a new and emerging substance, it’s also since the medical examiner began tracking the 7-OH data,” the Los Angeles County Department of Public Health said in an email to The Times. Since the county only started tracking 7-OH deaths in April of this year, it’s unclear how many other overdoses may have occurred earlier.

After this article was published, the county medical examiner released the death reports to The Times. Each of the victims reportedly had kratom and 7-OH in their bodies, but it was not immediately clear what role they played in the deaths, as compared to other substances — including alcohol, prescription tranquilizers and muscle relaxants, and illegal drugs such as cocaine — that were also found in the six bodies. The Times first requested a coroner’s report for the kratom-related death on Oct. 24.

“Kratom and 7-OH products are sold as natural remedies, but they are illegal and unsafe,” said Dr. Monte Davis, the county’s health officer, in a statement. “They are sold at gas stations, smoke shops, online and other retailers. People should avoid using these products, and store owners/operators should remove them as soon as possible to prevent damage.”

Currently, consumers have no clarity on kratom, 7-OH or any other metabolites, said Yael Osowsky, vice president of the Center for Consumer Choice, a nonprofit consumer advocacy group.

“At every gas station or smoke shop, powder, liquid extract, and pills are all offered in different dosages, with different brands,” Osowski said. “This clearly leads to confused and uninformed consumer choices, wrong food and potentially bad experiences that smart regulations would prevent.”

The market for kratom and 7-OH has grown exponentially because people want targeted pain relief and treatments for their ailments, “but not necessarily the full effects of more powerful opioids that have the full effect on the body,” he said.

“Kratom has been used successfully as an opioid alternative for generations in other countries,” Ososki said. But highly concentrated 7-OH products are a different animal entirely.

According to the US Food and Drug Administration, kratom and 7-OH are not legally marketed in the United States as a drug product, dietary supplement or approved food additive.

California is adopting federal legislation on foods and dietary supplements, the California Department of Public Health told The Times in an email.

“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will be classified as additives in medicines, nutraceuticals and foods,” the department’s spokesperson said.

The spokesperson added that the department has been conducting investigative work related to kratom for the past two years and “continues to take appropriate action to protect the public against counterfeit products containing kratom or 7-OH.”

“CDPH bans or removes food and dietary supplements in the state that are adulterated with kratom or 7-OH when they are identified during investigations; however, we do not comment on the details of ongoing investigations,” the spokesperson said.

7-OH manufacturers have publicly defended their products in the face of lawsuits and FDA crackdowns, arguing that it is a safer alternative to illegal opioids like fentanyl and has saved, not taken, lives.

Vince Sanders, founder and CEO of CBD American Shaman, which helped develop the first 7-OH product, said the attack on 7-OH is being led by companies selling natural kratom, which have carved out their market share with what he says is “a very superior product.”

The Kansas City businessman said a nationwide ban would hurt people who use 7-OH to treat substance abuse disorders or chronic pain and now rely on the product as an alternative to expensive prescription drugs.

“People who have changed their lives using it are very concerned,” Sanders said. “They’re scared to death. I mean, there are people who are … planning to take money out of their 401Ks, or max out their credit cards, or whatever they have to buy years and years of supplies.”

He acknowledged that both kratom and 7-OH are frequently taken at higher doses than he recommends, but argued that manufacturers and retailers should not be held responsible for those decisions. He compared it to alcohol: “You buy a 750ml bottle, and if you go home and drink the whole bottle, and you do it every night, is it your fault, or is it Jim Beams’ fault?”

Communities across the state have taken it upon themselves to act in the absence of state and federal regulations. Orange County and the cities of Newport Beach, San Diego and Oceanside have all banned the sale, distribution or possession of kratom. Riverside County is looking to ban the sale and marketing of kratom and 7-OH products to people under the age of 21.

Los Angeles County does not have its own regulations for products.

“I think local action is a sign of intent. It tells the government [federal authorities]you need to do something about it,” Lowe said of synthetic 7-OH.

But apparently bans involving natural kratom could raise other issues, including whether local enforcement of the ban would even happen, and the possibility of a black market for the products.

“You leave people with no options, so they either find alternative options or they just drive on city lines or county lines and get it themselves,” Lowe said. In fact, kratom and 7-OH are widely available in online markets.