The plant is believed to be a cause of death in at least 91 cases.

Kratom, a mind-altering drug sold legally and openly in the United States as an “herbal supplement,” played a direct role in at least 91 fatal overdose deaths, calling into question its purported safety as well as its status as a legal product.

As USA Today reports, between July 2016 and December 2017, at least 91 people overdosed on kratom. Another 152 people were known to have kratom in their system at the time of their deaths, but those deaths weren’t directly attributed to the substance.

What Is Kratom?

Kratom is a powder, derived from a plant that grows in Thailand and other parts of Southeast Asia, where it has been used for centuries. Acting similarly to an opioid, the plant can give the users a “high” that is not unlike that of other opioids, according to American Addiction Centers. The substance can also be used to treat withdrawal symptoms from dependence on actual opioids, as well as treat pain, coughing, and diarrhea.

It’s sold legally and openly in most jurisdictions in the U.S., usually at head shops or gas stations, as well as online. It is often ground into a powder and sealed in capsules, which can be swallowed whole or dissolved in a tea.

Is Kratom Safe?

That largely depends on whom you ask, as well as the definition of “safe.”

Charles Haddow, of the American Kratom Association, certainly thinks so. He says that kratom is no more addictive than caffeine, which is present in coffee and sodas, among other products.

“Follow the science. Kratom itself is safe.”

As far as the federal government is concerned, kratom is “safe,” inasmuch as it doesn’t appear on the list of Controlled Substances, and can be sold legally anywhere, assuming state or local laws haven’t banned it.

However, the Food and Drug Administration’s (FDA) current thinking on the matter stands in sharp contrast to its attempt to ban the substance. As Discover magazine reported in November 2018, the FDA actually tried to have kratom designated as a controlled substance in 2016. However, that move drew sharp resistance from users, sellers, and even some members of Congress — it was ultimately withdrawn.

If It’s Safe, Why Are People Overdosing On It?

Henry Miller, Director of the Central Ohio Poison Center, posits that the increase in the number of kratom overdoses is likely a result of two factors: more people using it, and users consuming more of it. And while Miller doesn’t explicitly call for the government to try to ban the substance again, he warns users that just because it’s “natural,” doesn’t mean that there’s no need to be careful with it.

“There’s a general feeling, I think, that this is a natural substance, so it’s safe. But we need to get across there are risks with this. If use continues to grow, we’re going to see these problems because it is a real potent substance.”