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However, health representatives have still not recognized a precise brand or supplier of kratom supplements tied to the outbreak.

Last month, the CDC sent out a warning about raw sprouts. California is reporting the highest number of cases (28). Before it can be legally marketed for therapeutic uses in the USA, kratom's risks and benefits must be evaluated as part of the regulatory process for drugs established by Congress.

Nevertheless, the supplement is available widely online and was even being sold for a time out of an Arizona vending machine.

And, the FDA says after supplements Botany Bay, Enhance Your Life and Divinity get yanked off the market, Divinity won't include kratom in any more products. It can cause psychosis, seizure and death, according to the CDC. A few months later, in the autumn of 2016, the DEA said it would delay rendering a decision on kratom until the FDA was able to complete a scientific evaluation of the supplement. Additionally, kratom should not be used to treat any medical conditions, nor should it be used as an alternative to prescription opioids. According to an FDA analysis, also released on February 6, one of the main compounds in kratom-mitragynine-may bind to the same kinds of receptors in the body as an opioid. The regulator has earlier said it was aware of 36 deaths associated with the plant, however declined to say over what period the deaths occurred.

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It says kratom is illegal in Indiana, Tennessee, Wisconsin, Vermont, Arkansas, Alabama and Rhode Island, as well as some local jurisdictions including Sarasota County in Florida, San Diego and Washington, D.C.

The CDC report is the latest in a string of advisories about kratom issued by federal agencies including the Food and Drug Administration, which likened the substance to an addictive opioid, and the Drug Enforcement Agency, which moved to criminalize it.

Gottlieb acknowledged that some may be using kratom to wean themselves off of more powerful opioids.

  • Myrtle Hill