The Journal. - This Opioid Alternative Is Fueling an Addiction Crisis

Episode Date: August 17, 2026

Millions of Americans take the herbal supplement kratom for everything from energy to pain relief to quitting opioids. But it has also been linked to growing addiction rates and fatal overdoses. WSJ��s Sumathi Reddy explains the regulatory battles playing out across the country as some officials consider bans. Jessica Mendoza hosts.   Further Listening: - Is the High Over for Hemp Drinks? - Peptides Are Everywhere. Businesses Are Cashing In. Sign up for WSJ’s free What’s News newsletter. Learn more about your ad choices. Visit megaphone.fm/adchoices

Over the past few years, an herbal product has been exploding in popularity. It's called Kratum. It's made from the leaf of a tree that grows in Southeast Asia, but you can buy it in most states across the U.S. Kratum can be bought almost everywhere in gas stations, online, and convenience stores. Our colleague Sumet-the-Ready writes about health and medicine. People say it can act like caffeine in small doses. It's like, you know, it just gives you more energy, maybe makes you more alert. It can be more sedative and have a different effect.

So there are some people who say that Kratum is a great product like pain relief. In June, Kratom was the subject of a city council meeting in Idaho. When this back injury, my app flares up, I can barely move. It is totally incapacitated for that time. But with Kratum, I can at least function. That's Chris Diotis, who runs a Kratum business. He was in the city of Idaho Falls to share why Kratom has been helpful for him. And he was wearing a t-shirt that read Kratom saves lives.

And he spoke about how Plain Leaf Kratom, you know, has kind of made his life bearable, particularly with a recurring back injury. People who used to take opioids also say it's like a good sort of alternative. They don't want to be in a bed or a wheelchair if they don't have to. They don't want to take prescription drugs. National Kratomhors for them and like that. The reason Chris was testifying is that the Idaho Falls City Council

was considering a citywide Kratum ban. Some doctors and public health officials say Kratom can have serious health risks, that it can be addictive and serve as a gateway drug. There have also been thousands of deaths associated with Kratom. One person speaking in favor of banning Kratom was Tia Rustici. Kratom killed my daughter.

Not in the legal straight jar. Not sometimes enough substance, it was cratim. It was this product that you can buy anywhere and that's marketed as natural and safe. And this is something she says over and over again. A lot of the parents do. This sort of disbelief that, like, why, how could my child have died from something that's just, like,

available, like a piece of candy. The reality is the parents of them do not know what victim is. Young-E-O-C-Lost stores don't assume it must be safe. In the aftermath of the opioid epidemic, Kratom has become a multi-billion dollar industry that's largely unregulated. And that city council meeting in Idaho captures a growing nationwide debate. Should Kratom be legal? Welcome to The Journal, our show about money, business, and power.

I'm Jessica Mendoza. It's Monday, August 17th. Coming up on the show, the fight over Kratom. Usually, Kratom comes in powder form. It can kind of look like macha, although it has a more bitter taste. These days, though, it comes in the form of gummies, seltzers, tablets. They're all kinds of products. Kratum kind of grew in popularity as opioids were becoming a big problem.

So doctors, you know, kind of stopped prescribing opioids and people needed something for pain relief. And so some people started turning to Kratom, which apparently can be pretty effective for chronic pain. Kratum has two key psychoactive consequences. compounds. They're called metragonein and 70H. They both bind to the same brain receptors as opioids. That's why many people say Kratum is great for pain relief. But it becomes addictive for some people, and you need larger and larger doses. And then there started being these newer

products that were more potent, which were causing even more addiction. And some people who wanted to stop taking these things found out that the withdrawal symptoms can be quite severe. In recent years, the Kratom market has been growing, with new products that are highly concentrated and sometimes made synthetically. Medical officials say these stronger products have dramatically increased the number of people reporting withdrawal symptoms and seeking help for addiction. In June, Sumithi flew to Idaho to hear from both sides of the Kratum debate.

While she was there, she visited Tia Rustici at home, the woman whose daughter, Kylie, died of a cratum overdose. They spoke in the backyard. So she would... She was very outgoing, very social. She grew up here in this house? We moved here in 2013. So, Colley was a 23-year-old.

She was attending online college. She wanted to be a forensic accountant. She was diagnosed with two chronic conditions, sort of in the later years of high school, maybe in her early 20s. So she, you know, dealt with a lot of pain from those conditions. Kylie Rusty's pain was debilitating,

enough that she needed to see a pain management specialist. She also had depression and was taking an antidepressant. At one point, she moved in with her grandmother. And so what happened once she was at Grandma's? I went there the week before to visit, and we went to the movies, and we went out to lunch. And then we just had a great visit, and she was just seemed like, just for her.

revitalized, I guess. And we were texting and the night before. And she seemed in good spirits, or? But it's hard to tell from the far. Tia Rusty didn't know that besides her antidepressant and some over-the-counter medications, her daughter had also started using Kratum. She kind of kept it a little secretive, but she was taking the powder only. And I guess it just sort of ramped up where she started taking more and more

more. On a Sunday evening in March, Kylie Ristisi was found dead on her bedroom floor. There were a few bags of natural leaf cratum powder on her dresser. She had overdosed. An autopsy report listed the cause of death as cratom intoxication. When they said cratom, what did you? I didn't know. I started Googling what's cradom. So, and then the more I found out, the more shocked I was. Reports to poison control centers involving Kratum have been on the rise. And between 2020 and 2024, the CDC recorded more than 5,000 fatal overdoses in which Kratom was detected. Though Sumethe says it's not always clear if Kratom is the sole cause of death. In many cases, there are other substances involved.

I mean, sometimes, you know, it's something like heroin or fentanyl, but other times it's something like Benadryl or an antidepressant. So there are questions about, well, does creatum interact with some of these other things that people routinely take? Like a lot of people take antidepressants or benedril or antihistamines. So is that raising the health risks? And we don't really know because that research hasn't been done. What about Tia Rastisi? What has she decided to do?

So she's become quite an advocate for Creighton bands. There's a bunch of parents that she's become close with. Some of them have started organizations. and they kind of just go and testify at every hearing that they can. Like at the City Council meeting in Idaho Falls. Who are anti-cratum advocates up against? That's next. Ready to take your investing knowledge to pro-level?

This is Fidelity Connects, your daily edge in the markets. Get deep insights on real-time market topics that may impact your investment portfolio. Listen to Fidelity Connects on Spotify today, and power your next move tomorrow. During her trip to Idaho, Sumiti also went to visit one of the biggest cratum companies in the U.S. It's called Happy Hippo.

The company runs a 20,000 square foot facility with colorful signs that say things like live happy. So Happy Hippo, it's a very cheerful place. They definitely mark themselves as like a wellness company. Okay. And one of the big things they do is distribute cratum. While she was there, Sumitzi,

met CEO Chris Diotis, who had spoken at that same Idaho Falls City Council meeting. Well, I want to hear both about the company as well as your story, so I don't know which one you want to start with. Yeah, I'll start with mine. Chris describes himself as like a fitness bro. So he had a lot of injuries just from sports and exercise. And in 2006, he had a bad knee injury. I really got injury playing a football game.

The silly football game. It was on Memorial Day weekend. Tackle football. Chris says he was prescribed percassette, an opioid. And after about five or six months of taking it, he started to feel like he was building a dependence on the drug. And being there so a school, 20-year-old that I was, I was looking for alternatives.

And I found cradone, and I tried it. And I was just like, wow, this does really dull. Because at the time, it was probably like mild to moderate pain. It wasn't being intense. pain coming off post-op. I was like, this is really good. It doesn't impair me. And I was like, there's really

something with this. Chris still uses Kratom today to treat chronic pain from a back injury. He founded Happy Hippo in 2013. These days, the company ships out more than 100 kilograms of Kratum a day. It specializes in plain leaf

Kratum powder and capsules, but also sells things like Kratum Gummies and Taffy. Their products are, you know, they're marketed in a very sort of friendly way. They're very colorful and they have cool flavors and stuff. And he says that, you know, his clients or customers are, you know, there's a very wellness, fitness sort of driven demographic. Like a lot of middle-aged moms taking this for energy

or to improve their sleep or, you know, those kinds of things, wellness type things. But Chris says when it comes to Kratum, there's a line he won't cross. You know, one of the things he stressed a lot when I was there, was that they've taken a sort of hardline stance against manufacturing products that are like 70H. 70H, one of the psychoactive compounds naturally found in Kratom in very trace amounts.

And over the last few years, some companies have started focusing on concentrated 70H products. They're way more potent than natural Kratom. Chris says these products are giving his industry a bad rap. Pratom is closer to a food or dietary something like more of a beverage.

And 7.O.H is closer to a drug. Mm-hmm. It is, especially how it's made these days. And once upon a time, the 7-O-H on the market was possibly extracted from cratum leaf. Mm-hmm. But the proliferation of it now, it's all just made in the lab. These 70H and sort of stronger products are definitely causing addiction and other health issues. When you talk about natural cratum, there is a little more of a divide. Some of the people I've

talked to will say that they see problems with 70H, but they also see it with natural cratum. So they would support a broader ban. But others will say, I think if we solve the issue with 70H and the stronger products, we'll be okay. In the end, the city of Idaho Falls voted unanimously to ban all cratom products. That ban went into effect in July. That city joins a growing list of places in the U.S. that are cracking down on cratim. And while a few states have banned it statewide, a lot of this action is happening from town to town. Idaho does not have an all-cratum ban. They considered one. But because some of the states are not acting, there are a lot of cities and towns who are acting on their own. And Idaho Falls is one. Why is this being discussed, you know, at the local

and state level? I mean, isn't this something that could or should be regulated at the federal level? There had been attempts to regulate Kratom before. The most serious one was back in 2016, and there was such intense backlash in opposition that the federal government sort of backed down. A lot of that backlash in opposition was coming from lobbying groups. One group in particular, the American Kratom Association, has played a major role in keeping Kratom on store shelves. They have a Consumer Protection Act.

They kind of drafted, and they give to a lot of the same. states that introduce these acts. And so it's various things to, like, have a minimum age for people, you know, who can buy this stuff, to have labels that reflect what's in it and the strength and the dose to be more clear on the labels, like, is the 708, you know, what's in here, and some other things. And there's a number of states that they've been able to get the regulation acts passed in. While the American Kratum Association lobbies to keep Kratum access, it supports banning stronger products like 70H. Federal regulation could echo that line of thinking.

The Drug Enforcement Administration is now considering placing those stronger products under Schedule 1, which basically means they'd be considered as dangerous as heroin. What are you watching for in terms of how this debate develops, how the regulation evolves? You know, I think one of the things is that we don't know a lot about Kratum, and how it impacts our health. I mean, there really isn't much research. This is a problem we had with cannabis too, right? It was illegal, so we had never done any research on it.

I'm hoping this will lead to consumers like understanding what this is better. Like, what is this, is it dangerous? Can I interact with the antidepressants? You know, what's the highest dose we can take? What's the toxic dose? We don't have answers to any of these questions. So hopefully, hopefully,

Hopefully we'll get some answers. That's all for today, Monday, August 17th. The journal is a co-production of Spotify and the Wall Street Journal. If you like our show, follow us on Spotify or wherever you get your podcasts. We're out every weekday afternoon. Thanks for listening. See you tomorrow.