Mississippi Restricts Kratom Sales After Pleas from Health Leaders

Marie Cochran’s husband, Jeremy Cochran, suddenly passed away on his 43rd birthday on Dec. 23, 2019. The Purvis, Mississippi, resident was a U.S. Marine and a health-conscious marathon and triathlon athlete who had never broken a bone and rarely got sick. He had struggled with addictions to cannabis, opioids and cocaine, his wife said, but he “was still able to function” as a husband and father. 

“It wasn’t until Jeremy got ahold of kratom, a substance he thought to be natural, that I began to see a significant and drastic change in him,” Marie Cochran told the Mississippi House Drug Policy Committee meeting on Jan. 28. “I watched him become distant, detached. He developed poor hygiene and anorexia, hallucinations and paranoia, and even lost all of his teeth. In one year, Jeremy spent $50,000 on kratom alone.”

She said Jeremy lost everything—his kids and family, his friends, his job and, eventually, his life—“all because of kratom.”

“When he was found deceased, he was surrounded by kratom. Following an autopsy, his death certificate listed kratom intoxication as his cause of death. No one can tell me that kratom does not kill because I can tell you firsthand and show you a death certificate that proves otherwise,” Marie Cochran said.

Kratom is a plant-based substance available in liquid, pill and edible forms that convenience stores across Mississippi have sold as an over-the-counter supplement for years with no safeguards or regulations.

Mississippi State Medical Association President Dr. Jennifer Bryan, Mississippi State Health Officer Dr. Daniel Edney and other opponents of kratom also spoke at the Jan. 28 committee meeting to advocate for the Legislature to classify kratom as a Schedule III drug under state law, which would have prevented people from obtaining the substance without a prescription from a medical doctor. 

While lawmakers did not ultimately pass legislation to put kratom in the Schedule III category during this year’s session, lawmakers did successfully pass two House bills: one that requires kratom purchasers to be 21 and older and another that adds an excise tax to kratom. Those new regulations took effect on July 1.

“Kratom is marketed as a natural and harmless supplement, but it’s very dangerous, highly addictive and it binds the opioid receptors with opioid-like effects,” Dr. Jennifer Bryan said at a House Drug Policy Committee meeting on Jan. 28.

What Is Kratom?

Kratom is made from the leaves of the tropical evergreen tree Mitragyna speciosa in Southeast Asia. For years, gas stations and vape shops have sold kratom products over the counter without an age restriction. Kratom can be ingested; many users swallow the substance by itself or add it to hot tea.

“It is deceptive in that it is plant-based. It comes from Southeast Asia, but I would remind you that cocaine is plant-based. I will remind you that heroin comes from the poppy plant,” Dr. Daniel Edney said.

American veterans of the Vietnam War and Southeast Asian immigrants introduced kratom to the U.S. after the war ended. Anywhere between two million to 15 million Americans use kratom, Harvard Medical School research estimates.

Andrew Yockey, an assistant professor of public health at the University of Mississippi, is researching substance use prevention, mental health and health equity, focusing primarily on young adults and adolescents. He said many kratom users take the substance to help them relax, boost their mood, feel more social or relieve pain.

The National Institute on Drug Abuse says kratom can make a person feel similar effects to opioids and stimulants. Many kratom users take the herbal substance to curb cravings from opioids and other substance addictions, the institute reports.

“If you take an opioid, it affects certain parts of the brain, those receptors, but if you take kratom as well, it affects those same receptors in the brain,” Yockey told the Mississippi Free Press on Jan. 31.

Yockey said some side effects of kratom use are liver damage, muscle pain, confusion, tremors and difficulty breathing. Overconsumption of kratom can be fatal in some cases, though the National Institute on Drug Abuse says it has a smaller death rate than opioids. 

However, Yockey said most kratom products sold in gas stations and vape shops across the country are not actually 100% kratom. He said kratom products are often infested with metals and bacteria. Many people dying and being hospitalized were using synthetic products marketed as kratom that had low levels of actual kratom.

“Not all kratom is bad kratom. Low doses of kratom are safe. Low doses of methamphetamine, for example, are safe. I think there’s this misconception that all drugs are bad, and that’s just not true. If you look at kratom, I would want kratom to be regulated, but it’s also safe,” Yockey said.

Jones County Drug Court Saw Rise in Kratom Use

Consuelo Walley is the coordinator for the 18th Judicial District Intervention Drug Court in Jones County, Mississippi, and serves on the State Intervention Court Advisory Committee. She has volunteered and worked in the drug recovery field for about 15 years and said she was introduced to “the dangers and consequences” of kratom about eight years ago.

She told lawmakers that she observed a “significant problem” with kratom in her drug court in 2019, noticing several participants had not been able to pay their drug court fees or circuit court fines despite having “really good” jobs that court administrators had helped them obtain.

“Their physical appearance would drastically change, and when you’re drug testing somebody randomly twice a week, you see and you know when there’s something wrong. So, red flags began to appear, and I knew something was going on among my participants, but they were passing their drug tests. So, as a coordinator and being actively involved in my court, I began to listen, I began to put my ear to the ground and I realized we might have a problem with kratom and tianeptine as well,” Walley said at the Jan. 28 House Drug Policy Committee meeting. Tianeptine is a supplement used to treat depression.

Kratom does not show up on a typical five, seven or 12-panel drug test, so Walley implemented a new policy and began to send participants’ urine samples to a toxicologist who could determine if the person was using kratom or tianeptine. Sending samples to a toxicologist costs $100 per sample, and it quickly became a large expense for the Jones County drug court, Walley said.

“And we began to see that we had a very large problem in our drug court. They had learned that they could take this drug, and because it would not show up on an instant cup test in our office, that they could beat the drug test and still get high,” she said.

Regulating Kratom

People must now be 21 or older to purchase kratom products under a bill Gov. Tate Reeves signed into law on April 17 and which took effect on July 1. House Bill 1077 also bans synthetic kratom products. 

The psychoactive component of Mitragyna speciosa leaves is called 7-hydroxymitragynine. H.B. 1077 specifically bans kratom products that have 7-hydroxymitragynine in the alkaloid fraction greater than 1% of the alkaloid composition. Alkaloid is a wide classification of organic compounds made of nitrogen that produce psychoactive effects. 

Kratom products that contain any controlled substances listed in the Uniform Controlled Substances Act are also banned under the legislation.

“As 7-hydroxymitragynine builds up in your system, then it is very toxic,” Dr. Daniel Edney said.

To be sold legally, all kratom products must have a label that depicts the full ingredient list along with the business name, address and telephone number of the manufacturer. Kratom product manufacturers and retailers must register their products with the Mississippi Department of Revenue and gain approval to sell them, the law says.

“Regulating purchasing age does not protect the adults that we have who are accessing something that is so addictive that it can cause a fatal overdose,” Consuelo Walley said.

More than 36 Mississippi cities and counties have banned purchasing, using and possessing kratom, including Oxford, Ridgeland, Lowndes County and Jones County. H.B. 1077 allows those cities and counties to continue to uphold kratom bans as long as the city or county started enforcing the ban before July 1.

Kratom Excise Tax

Mississippi will now tax kratom products using a 25% excise tax under a law the governor signed on April 17. House Bill 1896 imposes a steeper tax on kratom than the 15% tobacco excise tax.

Mississippi Sen. Joey Fillingane, R-Sumrall, said the House and Senate had been negotiating the definition of kratom and how to tax it, noting that the two bodies came to an agreement during conference negotiations.

The legislation also says retailers that sell cigars, smoking tobacco, chewing tobacco, snuff or any other tobacco products must pay the tobacco excise tax to the Mississippi Department of Revenue by the 20th of each month after the sale of the product to a Mississippi customer. Cigarettes and heated tobacco products that came from an out-of-state manufacturer are exempt.

Any person making retail purchases of out-of-state tobacco products, except cigarettes and heated tobacco products, for their store must pay the tobacco excise tax to the Department of Revenue within 48 hours of purchase under the law.

“The only other change in this conference report is on the excise taxes that are being paid on some of these other tobacco-related products. The Department of Revenue wanted to be able to impose those at the point of the retail sale,” Fillingane said on the Senate floor on March 31.

Dead Kratom Bills

Dr. Jennifer Bryan told members of the House Drug Policy Committee on Jan. 28 that she wanted the Legislature to classify kratom as a Schedule III drug. The Legislature similarly classified Tianeptine as a Schedule III drug in 2023; it’s a dietary supplement marked for self-treatment for anxiety, depression and irritable bowel syndrome.

“There is no reason for people to be getting kratom off the street, in a gas station, in a dispensary. If they are in pain, their doctor can take care of their pain,” she said.

The Drug Enforcement Administration says Schedule III drugs are “drugs with a moderate to low potential for physical and psychological dependence.” Drugs classified as Schedule III usually require a doctor’s prescription and include stimulants, depressants, narcotics and anabolic steroids, including ketamine, testosterone and Tylenol with codeine.

Senate Bill 2355 would have added synthetic kratom products to the Schedule III classification. The Senate passed it by a 51-0 vote on Feb. 11, but it died on March 4 in the House Judiciary A and Drug Policy committees on a legislative deadline. 

Three other bills that would have classified kratom as a Schedule III drug all died in their respective committees without a vote: House Bill 1121, House Bill 1122 and Senate Bill 2214.

Andrew Yockey said he wanted lawmakers to put kratom in the even more restrictive Schedule II because researchers do not have enough information for it to be a Schedule III drug. He said Mississippi needs a kratom research center to study the substance and lawmakers need to regulate kratom products so that they do not have toxic materials in them. 

“We don’t know much about patterns, we don’t know much about risk factors, we actually don’t know much about treatment,” Yockey said.

Bryan said she does not want kratom to be available in Mississippi for people to freely purchase. Rep. Lee Yancey, R-Flowood, mentioned that the House passed legislation in 2022 to ban kratom by an 81-30 vote, but the Senate Drug Policy and Judiciary B committee chairmen let the bills die.

“The House has already banned kratom a couple years ago, and the Senate chose not to even take up the bill. So, the problem here at the Capitol with kratom is the Senate,” Rep. Lee Yancey, R-Flowood, said at the Jan. 28 House Drug Policy Committee meeting.

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