What is kratom, the substance US officials are calling 'gas station heroin'?

Kratom, a plant-based substance that has been sold across the United States for around a decade, is drawing fresh scrutiny from officials after being found during an investigation into the deaths of two college students. Some officials have taken to calling it "gas station heroin," reflecting both its opioid-like effects and its wide availability in convenience stores and gas stations.

Kratom comes from the leaves of a tree native to Southeast Asia, and has traditionally been used in the region for its stimulant and pain-relieving properties. In the United States, it has been sold largely unregulated as a supplement, available in various forms including powders, capsules and extracts, often marketed for pain relief, energy or help with opioid withdrawal.

The substance's effects vary by dose: at lower doses it is generally described as having a mild stimulant effect, while at higher doses it can produce sedative and opioid-like effects. This dual nature has fuelled debate among health officials, researchers and consumers about its safety and appropriate regulation.

Its ready availability at gas stations and convenience stores, often with minimal restrictions on age or dosage, has raised concern among public health officials, particularly given reports linking it to serious health incidents, including the case involving two college students that has drawn renewed attention to the substance.

Regulatory approaches to kratom vary considerably, with some US states and countries restricting or banning its sale, while others allow it to be sold with few restrictions. The renewed scrutiny following the college students' deaths is likely to intensify calls for clearer federal guidance on how kratom should be regulated and sold.