Colorado is one of the leading states in estimated usage of kratom, a federally-legal drug that can cause effects similar to opioids and that the U.S. Drug Enforcement Administration has labeled a “drug of concern.”

In a new report from the drug-testing company Millennium Health, 2.3% of anonymized urine samples tested in Colorado between 2017 and 2019 contained kratom, giving the state the fourth-highest positivity rate. Nationally, usage of the substance doubled in that time period.

A U.S. Food and Drug Administration analysis in 2019 found that various kratom products contained “significant levels of lead and nickel at concentrations that exceed safe exposure for oral daily drug intake.” The potential effects include metal poisoning, kidney damage and increased risk of certain cancers among long-term users.

Kratom, a tree native to southeast Asia, is available for purchase through the Internet in powder, capsule and extract form, commonly for purposes of pain management.

The Millennium Health report also noted that drug overdose deaths nationally declined in 2018 due to reductions in prescription-opioid and heroin-involved fatalities. However, synthetic opioid-related deaths are rising. The occurrence of fentanyl in people who also use heroin rose a staggering 6,480% in the Mountain states region between 2015 and 2019.

Drug overdoses are the leading cause of injury-related death, and the synthetic, highly-potent opioid fentanyl accounts for approximately 40% of such fatalities. Fentanyl is also cheap to produce, with the DEA estimating that a price of $3,300 to $5,000 for one kilogram of fentanyl can net a drug trafficking organization up to $2 million.

In its analysis of over 1 million urine tests, Millennium Health found heroin to be “falling out of favor” while methamphetamine use has “exploded” across the country. Among the top 10 states in each category of tested drug use – cocaine, methamphetamine, heroin and fentanyl – there were 24 states across eight regions, suggesting that there is no straightforward regional pattern to illicit drug consumption.

“While shifts in regional patterns may be explained by several factors, the DEA primarily identifies drug trafficking patterns and user preference as driving forces behind regional drug availability,” the report concluded.

Millennium Health report