Though few studies have been conducted to evaluate kratom’s safety, the drug has been widely marketed as a dietary supplement and can easily be purchased online and in smoke shops in multiple states, including Washington.

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Ten participants in Skagit County drug court tested positive last month for kratom, a drug that is putting their status in the jail-alternative program in jeopardy.

Drug court is designed to try to rehabilitate people with addiction problems who are facing drug charges. Participants must abstain from mood- or mind-altering substances or risk termination from the program.

Skagit County Prosecuting Attorney Rich Weyrich said this is the first time he has come across kratom since taking the job in 2007.

Kratom is a tropical tree whose leaves have historically been used for medicinal purposes, according to the National Institute on Drug Abuse. At low doses, the drug produces stimulant effects, and at high doses it can cause hallucinations and effects similar to opioids.

Though few studies have been conducted to evaluate kratom’s safety, the drug has been widely marketed as a dietary supplement and can easily — and legally — be purchased online and in smoke shops in multiple states, including Washington. The substance may come in capsules, powder or leaf form.

Phoenix Recovery Services, the clinic Skagit County contracts with to work with those in drug court, first tested participants and some prospective participants for kratom June 15 after being made aware of the substance by the lab that processes its tests, therapeutic court specialist Bev Carman said.

Previously, the drug appeared mostly on the East Coast and was not listed as a substance to avoid for those in the drug-court program.

However, participants are required to inform their counselors of any type of supplements taken, Carman said, and failure to do so can result in jail time, moving backward in the program, an amended treatment plan and possible termination from the program.

Out of the 10 who tested positive, three knew they were taking kratom, but didn’t know of the drug’s mind-altering properties, Carman said.

“One man thought it was just a dietary supplement,” she said. “Two women thought it was an herbal tea.”

Since the tests came back, kratom has been added to the list of substances to avoid in the drug-court program.

The two who thought the drug was an herbal tea were prospective drug-court participants and did not have their treatment plans amended, Carman said. But the eight who were formally enrolled had their plans altered to include more random drug tests and daily contact with their sponsors.

One woman is now facing a termination hearing for failure to divulge using kratom.

“We run our program on being honest,” Carman said. “If they continue to lie, we don’t really have a client to work with.”

Two others may also face termination.

Carman has been dealing with the impact of the drug since the positive tests.

“The withdrawals were horrendous for my clients,” Carman said. “The ones who were taking them on a regular basis said the withdrawals were as intense or more intense than on heroin.”

Five of the 10 people ended up in the emergency room with uncontrollable spasms, nausea, body aches and severe sleep disturbances.

“I am very concerned about (kratom), particularly the accessibility of it and the fact that it’s been touted as a natural dietary supplement,” Carman said.

In a July 2 news release, the U.S. Food and Drug Administration warned against consumer use of kratom. Five months before, FDA Commissioner Scott Gottlieb released a statement about kratom.

“The extensive scientific data we’ve evaluated about kratom provides conclusive evidence that compounds contained in kratom are opioids and are expected to have similar addictive effects as well as risks of abuse, overdose and, in some cases, death,” he said in the release. “At the same time, there’s no evidence to indicate that kratom is safe or effective for any medical use.”

The American Kratom Association, a Colorado-based organization that formed in 2014, asserts the drug, when taken in appropriate amounts, can provide pain management, energy and relief from depression and anxiety.