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Maryland man’s death linked to kratom; herbal substance center of heated debate

Posted at 12:37 PM, Nov 16, 2023

BALTIMORE — Rhoda Hall remembers the day police found her son’s body.

“I saw the helicopters flying right down past my house towards the woods. And they were just hovering over the area. And I said, yep, they found him,” Hall recalled.

She reported John Talbert III missing on October 20, 2022.

"He started saying, 'I hear loud sounds' and seeing beams of light. And he said, 'The sounds are getting louder.' And he kept saying, 'I'm going to have to leave.' And I didn't think he really was going to leave," Hall said.

Eight days later, police found him not far from the Owings Mills home he shared with his mom.

“That's where they found him in the creek back there,” said Hall.

A toxicology test turned up traces of several medications plus mitragynine or kratom, "a plant-based psychoactive drug that has been associated with both stimulant and sedative effects resulting in death," according to the Medical Examiner’s Office, who ruled Talbert died from mitragynine use complicated by hypothermia and drowning.

“Did he tell you about kratom?” WMAR-2 News Mallory Sofastaii asked Hall.
“He said it’s a herbal remedy, would’ve been something he thought was safe,” Hall responded.

Kratom comes from a plant native to Southeast Asia. It can be found at gas stations or online in powder, capsule, gummy, or liquid form. It's often used to self-treat pain, opioid withdrawal, anxiety, depression, or to boost energy and focus.

At Talbert’s request, Hall placed an order for 350 capsules in May of 2022. He then asked for 500 grams of powder in June. Talbert later bought 700 more capsules over the following 3 months.

“I don't know how many he was taking,” Hall admitted.

And it’s unclear how many capsules he should’ve been taking. According to the label on the bag from the manufacturer, there’s a disclaimer that states “this product comes with no directions for use.”

“What's this last year been like for you?” Sofastaii asked Hall.
“It's been hard. Had some times where I said I’d rather not wake up, and I’d just rather die,” Hall responded.

Hall shares this grief with a group of parents on Facebook. More than a thousand people have joined “Kratom Danger Awareness,” with members sharing photos of their loved ones whose death they believe was linked to kratom use.

“A lot of us had these made of our children with a picture of them,” said Hall displaying a blanket with her son’s face on her bed.

Various families have since filed lawsuits with several of them resulting in multi-million dollar judgments against kratom manufacturers.

And yet, fatal overdoses from kratom alone are still considered rare. According to the Maryland Department of Health, from 2015 to 2020 there were 78 unintentional drug intoxication deaths in Maryland with mitragynine detected. In all but 4 of those cases, mitragynine was listed in combination with other substances.

In contrast, the Maryland health department said there have been over 11,000 deaths from opioid-related overdoses with illicitly-manufactured fentanyl, the leading cause of drug-and-alcohol related deaths for over 6 years.

Kratom not regulated at the federal level

However, concerns still surround kratom use, including how it's regulated, or not, and by whom.

“It is absolutely not approved as a drug by the FDA, nor is it approved as a dietary supplement. In fact, the Food and Drug Administration considers kratom to be an unregulated, new dietary ingredient, and they have warned consumers not to take it,” said Kirsten Smith, assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. Smith has been studying kratom since 2017.

“Initially, we first learned about people using kratom in the United States because they were either chronic pain patients or they were on prescription opioids and they were using kratom to substitute opioids or to help mitigate their pain,” said Smith.

In 2016, the Drug Enforcement Agency announced its intent to schedule kratom as a Schedule I substance due to its ability to produce opioid-like effects, high potential for abuse, and it being marketed as a legal alternative to controlled substances.

But a few months later, the agency reversed course after public opposition leaving its status in a sort of limbo.

“A lot of substances in this country fall into this, kratom is not the only one. They fall into this really murky gray market, and consumers are left to kind of try to figure out for themselves what is in this product and what do I think the benefits versus risks are?” said Smith.

While the American Kratom Association opposes bans of the substance, it is in favor of some regulations. In July, the group issued a consumer advisory in response to recent product liability lawsuits and the “FDA’s failure to properly regulate kratom products.”

The AKA called on the FDA to immediately publish product manufacturing standards for kratom products and encourage the removal of products that do not provide adequate labeling instructions including recommended serving sizes, ingredients, and warnings on condition of use.

WMAR-2 News reached out to the FDA for its response to the AKA’s remarks. A FDA spokesperson sent the statement below:

"The agency doesn’t generally provide response to third-party comments. … The FDA has warned consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures, and substance use disorder. The agency has also taken steps to limit the availability of unlawful kratom products in the U.S. The FDA will continue to work with our federal partners to warn the public about risks associated with use of kratom and warn the public against the use of kratom for medical treatment. The agency will also continue to monitor emerging data trends to better understand the substance and its components."

“If a friend were to come to you and say, ‘You know, I want to try it, what would you tell them?’” Sofastaii asked Smith.

“It's a really tricky thing. I think I'd want to know what their intention was,” Smith replied. “We have a good understanding of the pharmacology of kratom, but we do not yet have a good understanding of the effects in humans … it's a very complex plant. And we have a very complicated situation. And I think the story of kratom in the United States is really a story about people.”

According to the American Kratom Association, 5 states have banned kratom, 8 others have local bans, and 11 states passed the Kratom Consumer Protection Act, which regulates the sale of kratom.

In Maryland, there were attempts to ban kratom, but they failed in the General Assembly.

In October, federal lawmakers introduced the Kratom Consumer Protection Act. The bill calls for further evaluation of the health and safety of kratom, creates a research task force, and prevents the Department of Health and Human Services from imposing certain restrictions on it. The bill's now being reviewed by committees in the House and Senate.