Orange County will no longer allow the sale of synthetic kratom products in its unincorporated communities, hoping to curb the use of the addictive substance commonly sold at local corner stores and smoke shops.
Kratom is most often sold in tablet or powdered form. The ban finalized on Aug. 26 by the OC Board of Supervisors will outlaw the sale in parts of the county where there is no city, mostly in sporadic pockets throughout OC, but largely in south county.
Kratom comes from the leaves of a tropical tree native to Southeast Asia. A chemical that comes from kratom, 7-hydroxymitragynine, more commonly known as 7-OH, is concentrated and put into synthetic products that have the potential for abuse and harm to public health, according to the law passed by county supervisors.
The law approved Tuesday bans the selling of any kratom product to people under 21 and says businesses can’t sell any product that have more than 2% of 7-OH. Violations are misdemeanors and punishable with a fine of up to $1,000 and/or up to six months in the county jail. Any violation could also result in a loss of a business license.
The product is sold as a pain reliever, mood booster and stimulant. That chemical compound binds to opioid receptors in the brain and can have mood-boosting effects in high doses.
Its side effects can include nausea, itching, sweating, dry mouth, constipation, vomiting, loss of appetite and more, according to a Justice Department fact sheet. Its users can also experience anorexia, insomnia, seizures and hallucinations.
In serious and rare cases, deaths have been associated with kratom use, according to the Food and Drug Administration.
First District Supervisor Janet Nguyen introduced the law.
“It’s the highly concentrated synthetically made 7-OH products that we need to get rid of,” Nguyen said.
Fifth District Supervisor Katrina Foley said synthetic kratom products can be easily purchased at gas stations. She noted that the bottles typically have the words “natural” written on them and deceive people who might not realize it can be harmful.
“It is a fast-spreading drug because individuals, they start to become very addicted to it,” Foley said. “They don’t even know that it’s a drug.”
The county isn’t the only municipality that has banned kratom or is considering its prohibition. In March, Newport Beach banned the sale. And Huntington Beach on Sept. 2 will consider enacting its own ban. The cities of San Diego and Oceanside have passed a complete ban on the sale and possession of kratom products.
Dr. Steven Ey, chief of service at Hoag Addiction Treatment Centers, said he has seen nearly as many patients needing detox from kratom as from fentanyl over the past year, with the sharpest increase in the last six months.
“You get pain relief, stimulation and a serotonin boost,” he said. “That’s why it’s so addicting.”
Ey said many patients don’t realize there is a difference between kratom and hydroxy kratom. Kratom has been used in low doses as a stimulant or brewed into tea. Hydroxy kratom, by contrast, refers to 7-OH — the chemical created by applying an oxidation process to kratom. Ey said the result is “50 to 100 times stronger” than the plant itself.
“The withdrawal looks just like someone coming off fentanyl,” he said.
Earlier this summer, Ey visited a Costa Mesa smoke shop and said he was handed free samples without being asked for ID or given any warnings.
“The first thing he tried to give me was hydroxy kratom,” he said.
When he returned a few days ago, Ey said the clerk told him the products would still be available despite the pending ordinance, since the rules apply only in unincorporated areas of the county.
Foley, who is a former mayor of Costa Mesa, said she’s working with city officials there to also block the sale in that city.
The FDA in July stepped up its efforts to regulate the drug by recommending certain 7-OH products be scheduled under the Controlled Substances Act.
The FDA says there’s been a recent “concerning proliferation” of 7-OH products sold over the counter and online. Regulatory gaps, according to an FDA report, have allowed widespread availability of synthetic kratom products, making it emerge as a “dangerous substance.”
The Drug Enforcement Administration is reviewing the FDA’s recommendation and will decide the severity of its classification. The FDA has recommended that the DEA classify 7-OH as a Schedule I substance, which would place it in the same category as heroin.
In a May letter, OC Sheriff Don Barnes put his support behind the county’s new law and said he was “particularly concerned with how this substance can impact young people.”
“While there are no known deaths caused by kratom in Orange County, other jurisdictions have reported deaths caused by a kratom overdose,” Barnes wrote.
District Attorney Todd Spitzer, in a post online Thursday, said the kratom is “more potent than morphine” and is “aggressively marketed to individuals in sobriety as a cure-all for chronic pain and sold in gas stations and smoke shops.”
Foley said anyone who might be addicted to the drug can contact the 24-hour OC Links hotline at 855-625-4657. Any businesses selling the products can be reported to 714-835-3550.
Ey has treated patients ranging from their early 20s to their 60s, he said. Some had prior opioid addictions and turned to kratom after losing access to prescriptions. Others tried it as a pain reliever. Many of his patients, he said, are in their 20s and 30s and began using kratom in an effort to get off other opioids.
A California bill, AB 1088, would also set age restrictions on kratom sales — something Ey said is urgently needed, since “it’s easier for our teenagers probably to get this than it is to go buy a six pack of beer.”
It’s also not frequently detectable, since it doesn’t show up on routine drug tests.
“I’m very pleased with how proactive Orange County is being to try and address this,” Ey said. “I think we’re getting on it quickly, and I’m very happy that people are taking it seriously.”