South Dakota’s House of Representatives voted unanimously on Wednesday in Pierre to advance House Bill 1056, a measure that would regulate kratom products by prohibiting the preparation, sale or distribution of certain types that do not meet specific safety standards.
HB 1056 was first discussed during Tuesday’s House & Health Human Services Committee hearing, where it passed 11-0, with one excused. It passed once again with 66 votes (three excused) during Wednesday’s House of Representatives hearing.
Rep. Brian Mulder, R-Sioux Falls, introduced the bill to address rising concerns over the safety, lack of packing label information and potential for abuse of the herbal substance.
What is kratom?
Kratom is known for its stimulant and opioid-like effects and is derived from the leaves of a tree in the coffee family, the Southeast Asian tree Mitragyna speciosa. This differs from another natural substance, cannabidiol (CBD), which comes from the cannabis plant called hemp.
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The two main psychoactive chemicals in kratom leaves are mitragynine and 7-Hydroxymitragynine (7-OH), which can act as a stimulant in small amounts and as a sedative in larger doses. Recent studies show that people use kratom to manage pain, opioid withdrawal symptoms and anxiety and depression, according to the United Nations Commission on Narcotic Drugs.
Kratom can be purchased online and in smoke shops and other convenience stores by those 21 years of age and older in South Dakota.
The plant can be ingested as a tablet/capsule, crushed and smoked, brewed as a tea or by chewing raw leaves, according to a fact sheet produced in April 2020 by the United States Drug Enforcement Administration or DEA.
However, the DEA has also listed kratom as a Drug and Chemical of Concern. Adverse effects, according to the FDA, include “classic opioid-related effects such as sedation, nausea/vomiting, constipation, physical dependence/withdrawal and respiratory depression that may lead to death,” depending on how much of the drug is consumed.
There is also some evidence that kratom can potentially cause individuals to develop substance abuse disorders.
The FDA has yet to approve kratom for medicinal use.
What would HB 1056 do for South Dakota?
If the bill is signed into law, South Dakotans would not be able to prepare, sell or distribute kratom products that contain more than a 2% level of 7-OH or any synthetic alkaloid derived from the plant.
Kratom products will also need to include:
- A recommended dosage label for safe consumption
- Number of servings per container
- Amount of Mitragynine and 7-OH it contains
- A warning statement saying, “Consult a licensed, qualified healthcare professional before consuming this product. Not for use by women who are pregnant, nursing or trying to become pregnant.”
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Violation of this would result in a Class 2 misdemeanor charge, the lowest-level crime in the state, punishable by up to 30 days in jail and/or a $500 fine.
All proponents, no opponents
Mulder said HB 1056 is a “consumer protection bill” on kratom, saying there have been six deaths linked to kratom overdose in South Dakota alone, according to the South Dakota Department of Health.
Both Avera Health and Sanford Health supported HB 1056, emphasizing the dangers to babies born to mothers who use kratom excessively.
“Infants who are born to mothers who are heavy users of kratom are actually having withdrawal symptoms,” said Dr. Katherine Wang of Neonatology and clinical vice president of Women’s and Children’s Health at Avera Health. “It’s very similar to those infants born to moms who have an opioid addiction.”
Wang, who has worked in the NICU for 12 years, gave an example of a mother who purchased what she thought to be naturally-produced kratom for chronic back pain, only for her newborn child to be treated in the NICU for more than a month for opioid-type withdrawal symptoms.
“Kratom is not federally regulated,” said Rep. Mulder during Tuesday’s hearing. “This means that no government body has checks or guarantees on the quality and safety of the kratom product, which is purchased in the U.S., including online.”
Senior Fellow in Public Policy with the American Kratom Association Matt Caddo also supports the bill, saying there needs to be more regulation to protect consumers.
“When someone synthesizes a kratom product with 7-Hydroxymitragynine and spikes it with a synthesized version that is above that 2% level, then you have an issue about its safety, and it’s no longer a kratom product,” Caddo said.
There were no opponents who spoke against the bill on Tuesday or Wednesday.
What happens next?
Mulder said there is hope that more research on the effects of kratom will be done.
“Nora Volkow, the director of the National Institute on Drug Abuse, has commissioned more than $100 million of our tax money to study kratom, and one of the issues they’re looking at is the effect it has on pregnant women. So we look forward to additional science that will inform us on this issue,” Mulder said.
The FDA, U.S. Centers for Disease Control and Prevention and National Institute on Drug Use (NIDA) also continue to conduct research to better understand the safety risks of using kratom.
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HB 1056 now moves to the Senate floor for debate and a potential vote, where it will also be read for the first time and then assigned to a Senate Committee to vote.
If the bill is amended in the Senate Committee and passes, the Senate will then take up the bill and go to a joint conference committee to negotiate the changes.
If the bill passes in the Senate, it is then sent to the governor to review and sign or veto.
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