Kratom use has become more common despite warnings that it's addictive

Kratom, a psychoactive substance that's legal in most U.S. states, including Pennsylvania and New Jersey, has become increasing popular in recent years. But many public health officials are alarmed by the risks it poses. 

Kratom has been designated a "chemical of concern" by the U.S. Drug Enforcement Administration. In March, the U.S. Food and Drug Administration released a report discouraging the public from using kratom, noting it has addictive properties.

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Earlier this week, the Pennsylvania house passed a bill that would ban the sale of kratom to anyone younger than 18 by a 197-3 vote. Businesses that violate the law would be subject to fines ranging from $100 to $500 for a first-time offense.

In small doses kratom is said to act like a stimulant, increasing alertness and sociability. In large doses it acts like an opiate, with a relaxing, euphoric high reminiscent of opium or heroin. It's sometimes used as a sedative.

Many kratom users are simply trying to get high without using an illegal substance, but advocates say it's medically valuable, as well.

Historically, kratom has been indigenous populations in Southeast Asia to enhance stamina and reduce fatigue. Today, many Americans with depression and anxiety use it to help manage their symptoms. Others use it as a replacement for caffeine or claim it helps them with a wide array of ailments ranging from poor eyesight to skin issues.

The drug is synthesized from a Southeast Asian tree related to the coffee plant. The leaves can be chewed or brewed into a tea, but in the U.S. they're generally processed into a capsule, pill or extract that users can swallow. These products are readily available at gas stations, supplement stores and smoke shops across Pennsylvania and much of the nation.

In recent years, the plant also has gotten attention for the relief it provides people suffering from opiate withdrawal symptoms. This use is particularly common in rural areas, where drugs like suboxone and methadone are less readily available.

But many medical professionals are deeply concerned about the risks kratom use poses.

The Mayo Clinic says kratom is a risky solution for opiate withdrawal symptoms, because patients often become dependent on it and suffer withdrawals from the new substance instead. Other negative side effects include nausea, liver damage, hallucinations and seizures.

Kratom overdoses are rare, but they do happen. The drug was deemed a cause of death for 91 Americans between July 2016 and December 2017, a CDC report found. Only seven of those people died after exposure to kratom alone, but it becomes more dangerous when combined with other substances, like alcohol.

The drug remains largely unregulated in the U.S. due in part to the robust lobbying operation the $1.3 billion kratom industry has funded to fend off unfavorable legislation.

But the lobbyists weren't able to stop legislation in Radnor Township that banned the sale of the substance within 1,000 feet of a school, playground or daycare center and to people younger than 21.

The new law, enacted in April, was a direct response to nationwide retailer CBD Kratom's plans to open a new store on Lancaster Avenue. CBD Kratom promptly sued the township, alleging the Board of Commissioners unfairly targeted it through illegal spot zoning. They're seeking that Radnor issue it a certificate of occupancy.

Nationwide, six states have banned the sale, possession and use of kratom – Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin.

The Pennsylvania house bill was sent to the state Senate's Committee of Health and Human Services on Wednesday.