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Kratom Gaining Popularity As Opioid Alternative In Southern Arizona

In the midst of an opioid epidemic, an herbal drug called kratom is showing up as an alternative. It's from southeast Asia and now it's in Arizona. Some are calling this drug a lifesaver while others are saying it's not a safe substitute.

Robert Marquez, 26, started using heroin when he was 17 years old.

“I first started smoking it for like a year, and then I started shooting it and it’s just a vicious cycle, you know," he said. "I’ll get clean for a little bit and then I go back to it.”

He’s been to rehab a few times to treat his addiction, and it’s there he first heard about the herbal drug kratom.

“Yeah there’s never been a real easy way of getting off heroin I guess, because of the withdrawal and everything, but this kratom really helps a lot,” Marquez said.

This day he's come into a Tucson sandwich shop, but he’s not looking for a hoagie — he’s looking for a bag of kratom.

There’s a glowing vending machine set up in the back of the sub shop, and instead of chips or pop, it’s filled with different size bags of the herbal drug. They range from $10 to $50, depending on how many grams you want.

For Marquez, finding easily accessible kratom made all the difference.

“And it was like, really hard to find, mostly online or random smoke shops,” Marquez said.

Vending-Machine Kratom: Safe And Effective?

But just because some kratom is easy to come by doesn't mean the doses are quality, consistent, or have the intended effect.

“There is actually not a very rigorous testing done to see how much, for example, active ingredient of kratom, which is mitragynine, is actually present in each sample,” said Dr. Mazda Shirazi, medical director at University of Arizona’s poison and drug information center.

Shirazi said that active ingredient can act like an opioid in the brain. Kratom powder is made from crushed up leaves of a Southeast Asian tree. Thai workers for generations have used it like a stimulant, such as caffeine, and also as a sedative in larger doses.

When the U.S. Drug Enforcement Administration caught wind it was gaining popularity in America, they tried to list kratom as a Schedule-1 drug last year, which would have made it illegal.

The pushback was swift, with thousands of comments in support of the drug. So, the DEA withdrew the decision and opened a public comment period, which ended in December. The agency has not yet finished its review of kratom, which it considers a "Drug and Chemical of Concern." The DEA has attributed 15 deaths to kratom between 2014 and 2016. Several states have made it illegal.

But just because it’s legal here in Arizona doesn’t make it safe to substitute for painkillers, Shirazi said.

“Because there is no requirement or regulation on the content of these supplements and herbal remedies, they can find themselves in a problem that [users] are not getting a consistent dose so that they can treat themselves,” Shirazi said.

Stephanie Siete, who's done outreach with local substance abuse program Community Bridges for 15 years, said kratom’s effects are still unclear.

“That’s what really concerning, "she said, "A lot of drugs get categorized. This one’s a stimulant, this one’s a narcotic, this one seems to act like both."

Siete’s seen it sold as an energy drink, and has heard people using it as a substitute for prescription pills. Arizona Department of Health Services said last year, an average of two people died every day from opioid overdoses. But Siete thinks substituting one drug for another doesn’t solve widespread addiction problems.

“We really don’t need more opioids, we need to fix the problems as is, so yes being in the field for some time, there’s definite concerns,” she said.

Kratom Advocates: Herbal Drug A 'Lifesaver'

Back in Tucson, Arizona Kratom co-owner Jill Fickett-Sugarman, just a few blocks from the sandwich shop, has been selling the drug for a few years. In the back of her shop she opened huge plastic containers filled with different shades of green powders.

“This is a green, and then we’ve got the red, which is a red,” she said, as she showed the differnt types of kratom for sale.

The different powders are supposed to produce different effects. Fickett-Sugarman said she got into selling kratom because her husband used it to treat pain. And now, she feels like the business is providing a service to those looking to kick a drug habit.

“It’s all natural, people rely on it," Fickett-Sugarman said. "It saves lives, basically. I know that sounds very dramatic but, people, they get their lives back after taking kratom as opposed to being on pharmaceuticals.”

Michaela Morgan, another kratom vending machine customer, said she was prescribed percocets after being diagnosed with lupus.

“The more I was taking those the sicker I was getting, if I stopped taking them I couldn’t even go to work I couldn’t do anything," Morgan said, after being diagnosed two years ago. "I read online the alternative to opiates, it was kratom.”

Until there is more research done, kratom won’t be regulated and customers like Marquez are still free to get their kratom when and where they want.

EDITOR'S NOTE: This story was updated to clarify the type of container Jill Ficket-Sugarman keeps kratom in.

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Casey Kuhn was a senior field correspondent at KJZZ from 2015 to 2019.