UNC Lineberger’s Rebecca S. Williams, PhD, MHS, was first author of a study published in the International Journal of Drug Policy on online sales of kratom, a plant-based product that people are “turning to for self-treatment of pain, opioid addiction and for recreational use.”

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UNC Lineberger’s Rebecca Williams, PhD, MHS.

The study found that online vendors of “unregulated, intoxicating” kratom products have poor age verification practices and low adherence to federal, state and local restrictions in the United States.

They also reported there was a high prevalence of vendors featuring health claims forbidden by the U.S. Food and Drug Administration.

The top three health claims featured by online vendors were: claims that the product could increase energy; claims that it could be used as a relaxation or sleep aid; and claims about pain relief.

Four vendors claimed kratom had “cancer preventative properties.”

Twenty-five percent of vendors had claims related to treatment of opioid withdrawal symptoms. Amid increasing numbers of deaths linked to prescription and illegal opioid use, researchers reported that people with substance abuse problems turned to kratom, which can activate central opioid receptors to reduce pain.

While it has been used by some to wean themselves from other addictions, researchers also reported that “kratom itself can be addictive and has associated withdrawal symptoms such as nausea, vomiting, diarrhea and constipation.”

Eighty-one percent of vendors made statements that kratom is addictive and warned that the product was not recommended for people under age 18 or 21 years.

Researchers reported that lessons could be learned from regulating cigarette online sales could be applies to online sales of kratom.

“Without regulation and enforcement at the federal level, this industry is unlikely to implement effective age verification practices to prevent sales of this intoxicating and potentially addictive product to minors or to restrict the claims they make about what these products can do,” said Williams, who is a UNC Lineberger member and research associate with the UNC School of Medicine, and directs the federally funded Internet Tobacco Vendors Study.

Authors and Disclosures

Dmitriy Nikitin, formerly of UNC Lineberger and the UNC Gillings School of Global Public Health, was co-author.

The study did not receive any specific grant support, however, it was supported in party by existing resources, such as proprietary software, of the Internet Tobacco Vendors Study through a grant from the National Cancer Institute.