(North Dakota Monitor) – North Dakota lawmakers are grappling with how to restrict kratom and related products after a stream of testimony Wednesday from people including a concerned mother, a smoke shop owner, medical professionals and others with varying views on the substance the governor recently banned.
The Legislature’s Kratom Working Group heard the testimony as it works on legislation for a September special session Gov. Kelly Armstrong has called for the Legislature to enact kratom restrictions.
Kratom, often taken as powder or capsules, is derived from the leaves of a tropical tree in Southeast Asia. People use kratom for pain relief, as an energy booster and to combat withdrawals from drugs such as heroin and fentanyl.
Two psychoactive ingredients known as mitragynine and 7-OH are found in kratom leaves. The latter is a frequent subject of officials’ concerns about addictive, potent, synthetic products that until recently were available at gas stations and smoke shops. The governor has linked overdoses and deaths to such items in banning kratom and related products by executive order earlier this month.
A key lawmaker said he supports a total ban on 7-OH and other synthetic derivatives of kratom.
“In my mind, my consensus is that we have to as a legislative body 100% ban synthetic kratom,” said Rep. Pat Heinert, R-Bismarck, a co-chair of the working group. He told the group he supports setting an age restriction of 21 and other guardrails on natural kratom, with more time to deal with kratom issues in the upcoming 2027 legislative session.
Lawmakers submitted 29 bill drafts on various topics for the Sept. 2 special session, proposals that will be made public sometime Friday.
Buyers and sellers
Presenters to the working group suggested the Legislature consider age restrictions, product registration, labeling, a 7-OH limit and QR codes on products linking to education and addiction resources.
“You need to make certain that the individual consumers can look at a label and know what’s in the product,” said Mac Haddow, senior fellow on public policy for the American Kratom Association.
Moe’s Smoke Shop owner Mohammed Wazwaz said he is against banning kratom and 7-OH. His customers have used kratom to get off of opioids and other drugs, he said. If kratom is outlawed, people will find other ways to obtain it or use heavy drugs, he said. He invited lawmakers to test or inspect his products to find anything wrong.
The U.S. Drug Enforcement Administration has temporarily classified 7-OH and three related substances as controlled substances. Armstrong has authorized an emergency pharmaceutical rule to outlaw 7-OH at the same level as heroin and LSD.
‘People should be cautious’
Since 2021, kratom-related compounds including mitragynine, 7-OH and mitragynine pseudoindoxyl have been part of the primary cause of 23 deaths in North Dakota, and a contributing cause in one additional death, according to the State Epidemiology Office.
“These deaths underscore the need for comprehensive action to reduce the potential harms associated with these products,” said Molly Howell, director of disease control and forensic pathology with the state Department of Health and Human Services.
An adjunct professor introduced by a lobbyist for the American Kratom Association described kratom as similar to caffeine “from a safety profile” in that it has a theoretical overdose level that is hard to actually achieve. Meanwhile, 7-OH functions more like morphine and causes “respiratory depression,” said Jack Edward Henningfield, a faculty member of the Johns Hopkins University School of Medicine. Mitragynine and kratom “by themselves” are difficult to overdose upon, he said.
“I’m not a kratom advocate. I think that people should be cautious. I think products should be labeled,” Henningfield said. A huge problem is “products masquerading as kratom,” making a mess of the marketplace, he said.
Some people who testified said kratom has helped them relieve pain and other medical conditions.
People suffering kratom withdrawals have compared it to the flu, said Dr. Melissa Henke, the Heartview Foundation’s chief medical officer. She saw her first patient for kratom addiction in 2017. Since then, she said she has seen kratom use intermittently but now on a regular basis, most commonly 7-OH. She described patients in long-term recovery who got hooked by kratom products in gas stations.
“That’s a problem for me. When someone works really hard to find recovery, it’s not fair that they get duped by going to the gas station and all of a sudden they’re spending $80 to $100 a day. That’s a drug habit. That’s not a caffeine habit,” Henke told lawmakers.
One family’s experience
Michele Gunderson of Mandan told members of the working group that her son, Nick Gunderson, 31, died in 2019 of an accidental kratom-related overdose in Montana.
She said injuries he suffered while playing high school football led to surgeries and chronic pain that he tried to manage throughout his life. In 2017, he went to rehab for opioid addiction in Billings and spent the next two years in recovery.
He was found dead in his Montana home by a friend, his mother said.
“No opioids were found in his system,” she said. “But mitragynine was.”
An autopsy also found alcohol and a prescribed nerve pain medication in his system, which Gunderson believes combined its depressing effects and led to his death.
Gunderson said she is heartbroken for people experiencing pain and trying to find solutions to manage their symptoms because that was the same path her son took.
“It’s just insidious how this whole product has been woven into the culture of ‘it’s OK,’” she said.
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