Supplement that suspect’s mom said may have played a role in Lebanon stabbing is facing regulatory scrutiny

WEST LEBANON — Dr. Corneliu Stanciu, an addiction psychiatrist with Dartmouth Health, began researching the herbal supplement kratom over a decade ago when a patient who had no history of using opioids came in experiencing opioid withdrawal symptoms.

Kratom acts on numerous receptors in the brain including the serotonin and opioid receptor.

“It’s an addictive substance,” said Stanciu, also an assistant professor at Geisel School of Medicine at Dartmouth. “Individuals who started off using in attempts to self manage mood states or pain end up needing more and more.”

Kratom garnered attention in the Upper Valley recently after the mother of a 29-year-old accused of stabbing another man in Colburn Park two weeks ago alleged the supplement may have exacerbated her son’s mental illness.

In an interview after the stabbing and Dahlton Fairbank’s arrest, Amy Fairbank told the Valley News that her son, who she said suffers from a “delusional disorder,” also used kratom.

Dahlton Fairbank, of Bristol, N.H., entered no plea on felony charges of first-degree assault, second-degree assault, felon in possession of a dangerous weapon and reckless conduct with a deadly weapon at his arraignment on Aug. 4.

He remains held in preventive detention at Grafton County jail in North Haverhill. The next court date had yet to be scheduled as of Thursday afternoon.

The victim of the stabbing, identified in court documents as Jefry Morgan, remained unconscious at Dartmouth Hitchcock Medical Center as of the morning of Aug. 4. Since then, neither the police nor the hospital have released information about his health status.

Details of Fairbank’s alleged use of the substance and any role it may have played in the stabbing are unclear. Police have not released information about the motive.

The Lebanon police have not seen kratom usage involved in other crimes, police chief Phillip Roberts said.

Side effects

Made from the leaves of a tropical tree native to Southeast Asia called Mitragyna speciosa, kratom is often turned into a powder and sold that way or turned into a variety of different products such as capsules, drinks and gummies. Such products are readily available in New Hampshire.

In low doses, kratom produces stimulant effects with those who use it reporting increased energy and alertness. At higher doses, the substance produces effects similar to opioid drugs, acting as a sedative.

While kratom has been marketed as a means of easing withdrawal symptoms from opioids, Stanciu does not recommend it.

“Exposure to kratom in someone who has a prior addictive disorder can lead to relapse to their prior substance of choice or development of another addictive disorder to kratom,” he said.

There are some isolated case reports that show that the short-term effects of kratom can include not being aware of one’s environment, Stanciu said. “Confusion is one of the acute side affects,” he said. “It can mimic psychosis.”

It would be “very, very difficult” to overdose on kratom, Stanciu said.

However, kratom does change the way the body processes other drugs, often raising their toxicity level. There have been cases of kratom showing up in toxicology reports, but “there’s always another substance” present in the body as well, Stanciu said.

Increased use

Since 2015, there’s been an “exponential increase” in kratom users in the U.S., Stanciu said.

It’s estimated that between two and 15 million Americans use kratom, according to a 2024 article from Harvard Medical School.

As prescription opioids have become harder to source, “a lot of people are trying it out in an attempt to manage pain and opioid withdrawal,” Stanciu said.

There are currently no restrictions on kratom on the national level. But the U.S. Food and Drug Administration, or FDA, has warned consumers not to use it due to risks of liver toxicity, seizures and developing a substance use disorder.

The substance is illegal in Vermont as of 2016, but can be purchased by those 18 and older in New Hampshire (except for in Franklin N.H. which outlawed kratom in 2019) at smoke shops and some gas stations.

In West Lebanon, there are three places to buy kratom all in a 2-mile radius. Un-Dun’ and NH-VT Smoke & Beverage Outlet Inc., both located on Main Street, and Vapor World Smoke Shop in the Staples Plaza all sell a variety of kratom products. The three businesses declined to comment for this story.

Because there’s no regulatory oversight of the substance, “consumers don’t really know what they’re buying,” Stanciu said. “There’s kratom the plant as it’s been grown and used in Southeast Asia but kratom products are sometimes completely different.”

In the U.S., manufacturers sometimes take thousands of kratom leaves to make concentrates of 7-hydroxymitragynine, a byproduct found in 0.01% of the plant that Stanciu described as “liquid heroin.”

At such concentrates, the drug is “13 times more potent on the opioid receptor than morphine,” Stanciu said.

Regulatory efforts

On July 29, the FDA announced its recommendation for a scheduling action to control certain 7-hydroxymitragynine, also known as 7-OH.

“Vape stores are popping up in every neighborhood in America, and many are selling addictive products like concentrated 7-OH. After the last wave of the opioid epidemic, we cannot get caught flat-footed again,” Marty Makary, the FDA Commissioner said in a July 29 news release. “7-OH is an opioid that can be more potent than morphine. We need regulation and public education to prevent another wave of the opioid epidemic.”

On Wednesday, Florida became the seventh state following Vermont, Alabama, Arkansas, Indiana, Rhode Island and Wisconsin to classify certain concentrated forms of 7-OH, as a Schedule I controlled substance in the state.