You're welcome.

This meeting is being recorded and summarized.

Good morning, everyone.

I'm Edwin Williams Johnson, Chair of the Board of Legislators Committee on Health.

Today is April 29th, and we'll officially start by taking attendance and working myself as present.

Really vice chair Barr.

President, legislative in the Moir, legislative peers, used, legislator Uli, and Chairman Bashi.

We are officially opened at 118 a.m.

Um, and I'm really really uh please um and thank our committee coordinator Diana Golmes and Dean for um arranging this meeting.

Um uh community mental health at the table before speaking about um Kratum and the dangers of it, and we are especially um excited and grateful to have Dr.

Jonathan Avery with us virtually, who is the vice chair of addiction psychiatry.

Um with uh Wild Cornell Medicine.

He has many titles.

Uh he's also been professor in consultation liaison psychiatry and the program director for addiction psychiatry fellowship, as well as the program director for opial overdose prevention program, also at Cornell.

And we um glad to have a good friend Ellen Wloom, who is the director of community affairs with New York Presbyterian, um Hudson Valley Hospital and the Westchester Behavioral Health, and we're especially an always glad to have our commissioners with us, Dr.

Sherida Amler, Commissioner Department of Health, and um Dr.

Michael Orth, who doesn't sleep, commission of community, and uh Trevor Payne, we love, and so glad that you're here because you're the one that um really talked passionately about this uh first time we spoke about it.

Then you have a director of sub-use services with the uh department for movement and mental health.

Um so um Dr.

Avery, you don't have a presentation, so this is gonna be a really good full-coded uh conversation, and everyone just please feel free to jump in as we go along.

Um, but um for anyone listening out there who's like, what is she talking about Kraton?

Can you give us the basics, please?

Sure.

Thanks for thanks for having me.

Um we're seeing Kratom all the time in the hospital with people with intoxication states from it.

So I'm I'm glad you guys are tackling this.

You know, it comes from the leaves of this plant called Metragena speciosa, which is a tree that's in the coffee family.

Um we need coffee, um, but but we don't need we don't need this um because it's works a little more complicated than coffee does.

And you know, people picked up on that early where it's made in Thailand, Malaysia, Indonesia, and they actually banned it in a lot of those those countries because of some of the toxic effects of it.

Um but in the age of sort of the internet and um the ability to ship these substances around the country.

Um Kratum has really picked up in in Europe and now the United States and and then certainly here locally.

Um and it's a very unique um plant that has these the main two properties are this metragenine and then the seven hydroxy mitrogenine, which is the 70H that you've heard of, and how it works is that at low doses, it's a stimulant, so not unlike coffee, although it works different than coffee.

Um, but as you increase the dose, it's also a partial opiate uh working on the opiate system like oxycodone and uh fentanyl and things like that, and as you escalate the dose, it gets even more potent.

And you know, they've manufactured it so that it to isolate some of these properties that are especially potent, especially the 70H, making it even more opiate-like as the years have gone on and with the different preparations.

And I think part of the concern is that it's often sold as this wellness product, and people don't realize people sort of view that as stimulating, maybe having some pain relief, but they don't realize that it's really moved into opiate territory.

Um it's but it's easy to buy, poorly labeled, marked as natural, and it's really not natural.

It's been synthesized into all these pills and powders that have increasing toxicity.

And so we've seen people overdose come into the hospital with it, especially when combining with other substances, but even people who say they're just taking 70H, especially have come in with very severe overdose states and then in our ICU and things like that.

So it's I think a major public health concern that not just us, but everyone around the country is waking up to I saw thank you for that.

I saw both commissioners nodding uh their heads when you indicated that it's marketed as uh natural, and it's really not.

Um how's it allowed to what what are there any regulations?

How is it allowed to be marketed as natural and uh with the added and the increased dosage, it's not well, I think I mean uh it's good uh even even uh internationally it's people have gone back and forth on it.

I think uh I don't know the whole history of of the legislation, but I I know it was initially tried to be made into a schedule one like a decade ago, but there was pushback.

I think I know there's always like big big uh there's big tobacco, there's big alcohol, there's there's sort of big crater.

I mean, there's people with financial interests, and so um it was ultimately not, and um, but I think New York State now prohibits cratem sales of people under 21, if I'm not mistaken, requires warning labels.

And Governor Hockel, she signed these in the bill in December 2025, I think.

And there's penalties now, like 500 fines for for sales to minors, is is my my understanding.

Um, but it's still largely unregulated.

You can really get it in in any as I wait for for uh John my daughter off at the bus stop uh every morning right out right outside a deli, there's all these different Kratom products that you can buy combined with caffeine or kava or different stuff, and I mean there's so there's so many preparations and they look kid-friendly and safe, and they look like you're you might as well just take it instead of taking a five-hour energy drink.

Um, but there's there's much more risk.

And I should say that um NASA County has banned it in the county, and this meeting is leading up to us uh proposing the band here in Westchester.

If I right before this meeting, I actually reached out to Bob Bellot.

Bob works for me for our tuber program.

He's in charge when we take the miners out to try to buy vape products, and you know, uh he says this product is everywhere, it's in the bodegas, it's in the grocery stores, it's everywhere.

He says that mostly what he sees, a lot of what he sees now are become blister packs, and they'll be like, you know, three or four pills in there, and they'll be scored, and the dose is supposed to be half of it, it's cheap, it's um you know, it's not a problem to buy, and uh seems like it's just like the wild west.

But when you read about it, it is a very concerning drug, and um, you know, I think sometimes people use it to as a stimulant.

Sometimes they use it to self-medicate for mental health issues, which probably just aggravates and is not really improving anything.

Um just in the small amount of times that I had to look over uh the material that I offer is you know, this is a really scary drug.

Uh in addition, I saw where there was uh uh an incidence where it was contaminated with salmonella, and a number of people died from natural product being contaminated with salmonella.

Um but that's a side note, in and of itself, it it is not a safe drug for people to be taken, in my opinion, for one or three.