Science
Kratom was linked to 6 L.A. deaths and banned in the county. But the supplement’s actual health risks remain a mystery
Recently, the Los Angeles County Public Health Department reported it had linked the deaths of six L.A. County residents over the last spring and summer to the use of kratom, a widely available but unregulated supplement sold as a remedy for all sorts of health issues.
The deaths prompted public health officials to announce Nov. 7 that they would red-tag and pull from store shelves all products containing either kratom or the synthetic alkaloid 7-Hydroxymitragynine, also known as 7-OH, which is derived from kratom. Both are currently unregulated and not approved for use in the United States or the state of California as a drug product, dietary supplement or an approved food additive, according to the U.S. Food and Drug Administration.
For the record:
10:16 a.m. Nov. 20, 2025A previous version of this article misspelled Dee Macaluso’s last name as Mascalusco.
Unsurprisingly, business owners who sell kratom feel that the health department has overstepped, going too far without understanding how the supplement is helping many L.A. residents. The deaths, they say, are not necessarily due to kratom products, but to interactions with other substances.
Perhaps more important are the benefits that kratom users and some experts claim the drug provides. Many say the problem is with 7-OH — a highly concentrated, synthetic version of natural kratom that is subject to adulteration and fraudulent marketing — and that banning the sale of all kratom products could create an even more dangerous underground market of both kratom and 7-OH.
Indeed, many kratom sellers and users would welcome better regulation, so that they could continue to use the affordable, widely available substance as a way to treat physical pain and mental health issues with more confidence in the efficacy and safety of the products they are selling and buying.
During the months of April and July, a total of six L.A. County adults between the ages of 19 and 39 died with kratom and 7-OH in their bodies, along with other substances including alcohol, prescription sedatives and muscle relaxers, and cocaine.
In the medical examiner’s reports, the cause of death for five of the deceased was listed as a consequence of “mixed drug effects”; the sixth was listed as being caused by an overdose of cocaine.
The Times spoke with three different toxicologists to review these coroner’s reports and get a better understanding of what role kratom or 7-OH may have had in the deaths.
What the experts told The Times is that while toxicologists have an understanding of the possible effect that kratom alone can have on the body, the picture becomes unclear when other drugs are introduced.
Kratom is an herbal extract made from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It is sold in smoke shops and online in a variety of forms including powders, pills and liquid extracts.
At low doses, kratom causes a stimulant effect with users reporting an uptick in energy. At high doses it creates a sedative effect, said Donna Papsun, a forensic toxicologist with NMS Labs.
Researchers say a majority of kratom users consume the plant to relieve pain. In some cases, people report using it effectively to treat opioid dependence. Others use it to alleviate mental health challenges such as anxiety and depression.
In the last few years, a synthetic version of kratom refined to its psychoactive compound 7-Hydroxymitragynine, or 7-OH, has grown in popularity. The much more potent form of the largely unregulated drug has become a concern for public health officials and advocates.
But toxicologists say there isn’t enough research to provide a comprehensive understanding of what concentrations of kratom or 7-OH can be acutely toxic in the body when alone.
It’s likely they can also cause dangerous reactions when combined with other drugs that could amplify their effects, experts said, but the lack of research means doctors just don’t know what they are. That’s where the most concerning risks lie, said Craig Smollin, medical director of the San Francisco division of the California Poison Control System.
In cases where kratom and 7-OH are found in the bodies of a recent accidental death, typically toxicologists have found evidence of polysubstance use — when two or more drugs are taken together either intentionally or unintentionally.
“I don’t claim to have investigated all the reports about kratom deaths, but I haven’t seen too many reports of single-drug ingestions of kratom causing death,” Smollin said.
And while there’s an effective method to test for the quantity of kratom in the body, there isn’t a similarly accurate test for 7-OH. Current tests can only say whether or not it is present. In all six L.A. County deaths, it was.
But, Papsun notes, when kratom is metabolized in the body, part of the breakdown includes 7-OH, which means it will likely show up in medical exams whenever kratom does.
Toxicology labs face significant challenges when trying to quickly develop tests for emerging drugs like 7-OH for use in post-mortem medical examinations, Papsun said. “Adding something to a scope of testing is not easy from a forensic point of view because you have to develop it, validate the test, have available commercial material and it has to be scientifically rigorous because these results can end up in court,” Papsun said.
A further challenge to testing for 7-OH, specifically, is that the compound is “incredibly unstable,” she said. It can be detected in the body at the time of death but by the time the sample is collected and tested, the compound may have started to break down already, leading to inaccurate results.
Robert Powers, a forensic toxicologist at the University of New Haven, agreed that it was difficult to tell whether kratom and 7-OH played a direct role in the L.A. County deaths. “Most of the problems that arise with this drug are in combination with other respiratory depressant type drugs: opiates, benzodiazepines, alcohol,” he said, though he added that the deaths are “not an easy picture” to understand.
That’s why, he said, the L.A. County health department’s move to pull these products off the shelves makes sense. “I think it’s reasonable to recognize that in these cases, kratom could have indeed played a contributory role. And I understand the interest in trying to limit the potential effects of this drug in those mixed cases, so I understand why people would be interested in controlling this drug.”
Smollin, the San Francisco poison center director, concurred, pointing out how much the county still might not know about kratom and 7-OH.
That lack of information trickles down to consumers, who often rely on guidance from local, state and federal agencies about the risks of products like kratom and 7-OH.
Indeed, Dee Macaluso, 74, said she’s had to take it upon herself to seek out other sources of guidance, and experiment with different amounts of daily dosage to alleviate her symptoms of fatigue and trouble breathing from years of chronic lung illnesses.
When she learned of the county’s decision, “it scared me to death that they were going to pull” kratom products. “I told my husband, I don’t know what I’m going to do if I don’t have it and then I won’t be able to get out of bed, or paint or do the little bit that I can do,” she said.
Macaluso was an actor and comedian who in her 60s lived in Park City, Utah, but more recently moved to L.A. when her health declined due to pneumonia that progressed to debilitating infections in her lungs.
Macaluso used to have an active lifestyle, but the damage to her lungs made it so she could barely go up and down the stairs of her Utah home without feeling winded. She also felt the elevation in Park City was straining her health — it’s one reason she chose to move to Los Angeles, which is mostly low-altitude.
She saw a number of specialists, but none offered any options that helped alleviate her symptoms. Then, she stumbled on a documentary that highlighted the benefits of kratom in regards to chronic pain and mental health. She decided to try it.
“I didn’t use it very often, but when I did I found that it helped so many of my issues,” Macaluso said.
She described the effect as a boost of energy that in turn gave her the motivation and strength to get out of bed. “This was much more of a subtle feeling of just relief from being in a state of someone who is unwell and tired,” Macaluso said. “I loved it and I still use it.”
As her illness has progressed, Macaluso has continued to rely on kratom whenever she knows she’ll have a long day or has to attend a function and be sociable.
“It made me feel like my old self — smart mouth, funny and quick. I was a stand-up comic, I did all these things and I was becoming this old tired lady that got winded going up a few stairs and it pissed me off,” she said.
Macaluso doesn’t advocate for 7-OH but she doesn’t want kratom to be banned; she’d rather it be regulated and available to the public.
“I think the government should give us the leeway to educate ourselves,” she said. ”There’s always going to be people that misuse it but I don’t think that those of us who are using it responsibly and getting benefit from it should be penalized.”
Business owners like Abdullah Mamun, who started the company Authentic Kratom 12 years ago, agree with Macaluso’s perspective.
Authentic Kratom began as an e-commerce business based in Canoga Park, and has since grown into three brick-and-mortar locations in Canoga Park, Woodland Hills and Hollywood.
Mamun believes 7-OH is a real risk, and that L.A. County should focus its efforts there. A blanket ban on all kratom products, however, is counterproductive, he said. First of all, based on what his customers have told him over the past decade or so, he believes “kratom doesn’t cure you, but it gives people the relief that they’re looking for and the ability to manage their pain.” Second, red-tagging kratom products would directly affect his Authentic Kratom and the livelihood of his seven full-time employees.
And he welcomes regulation on kratom products.
“We want them to be properly labeled for customers because people should know what they’re putting in their body,” he said.
Science
A flesh-eating worm from the 1960s is re-invading the U.S. Are CA cattle at risk?
Federal agricultural inspectors detected a case of New World screwworm larvae — maggots that burrow into the flesh of living animals and sometimes humans — on a 3-week-old calf in south Texas, near the U.S.-Mexico border. Officials anticipated the arrival of screwworm in the United States and say they’re prepared to contain it.
New World screwworm, also known as Cochliomyia hominivorax, is starkly different from the average maggot that feeds on decaying organic matter such as garbage, rotting food or dead animals, said Tom Talbot, veterinarian and member of the California Cattlemen’s Assn.
That’s because a screwworm larva “attacks living flesh,” Talbot said.
On Thursday, the U.S. Department of Agriculture confirmed the detection of New World screwworm in the umbilical area of a bovine in Zavala County, Texas, more than 60 miles from the northern Mexico border.
As of Friday morning, there have been no additional cases of infected animals reported.
Screwworm is endemic in South America and parts of the Caribbean, according to the Centers for Disease Control and Prevention. However, the parasitic fly has been steadily moving north from Central America to Mexico since 2023.
The USDA says it has actively monitored the fly’s movement. Last month, the USDA was aware of more than 200 active screwworm infestation cases in the border states of Nuevo León and Tamaulipas, according to Mexico’s Secretary of Agriculture and Rural Development dashboard. There are currently more than 2,000 active cases throughout Mexico.
It was believed that the New World screwworm would enter the U.S. in 2025, “however, thanks to the hard work across the entire Trump administration and our industry, state, and local partners, we were able to buy time for this moment,” said Dudley Hoskins, undersecretary for Marketing and Regulatory Programs for the USDA, in a statement.
The potential economic impact of New World screwworm on the cattle industry due to import restrictions, reduced productivity and animal loss is substantial, said Sally DeNotta, director of the University of Florida’s Equine Performance Laboratory.
Last year, 175 key agricultural organizations signed a letter urging additional federal funding for screwworm-control measures, emphasizing USDA estimates that a New World screwworm outbreak in the U.S. could cost producers $4.3 billion annually and cause economic losses of more than $10.6 billion across the southern United States.
“While the fly does not survive at temperatures at or below freezing, infected animals could carry the parasite northward and spread infection during the summer months, and the temperate climate of Southern California could certainly support year-round New World screwworm populations,” DeNotta said.
Talbot said from the federal to the local level, everyone in the ranching community has been talking about the arrival of screwworm and how to combat it.
“My expectation is that there will be a minimal number of cases of [New World screwworm] in California,” he said.
That’s because there are several stations on the border in Southern California, he said, that are collecting data, monitoring for any incidents of the parasitic fly and trapping them.
Talbot says he’s confident that the proactive measures on behalf of the federal government will mitigate the screwworm’s reach and therefore not impact the beef supply locally or nationally.
How screwworm infection spreads
Female screwworm flies are attracted to the smell of wounds — that can be as small as a tick bite — and body openings such as the nose, eyes, ears and mouth where they can lay eggs, according to the CDC.
A female screwworm fly can lay 200 to 300 eggs at a time and may lay up to 3,000 eggs during her 10 to 30-day lifespan.
When the eggs hatch into maggots, the maggots eat live tissue, causing a worsening, often painful and foul-smelling wound, according to the CDC.
Screwworm has hit the United States before
There was a screwworm outbreak in the southwestern region of the United States in 1965 that prompted Mexican and U.S. livestock producers to sign a declaration to establish a joint program for the eradication of the screwworm from the states on either side of the Mexico-U.S. border, according to the National Agricultural Library.
By 1966, the United States had eradicated screwworms, but livestock remained vulnerable to reinfestation from screwworms migrating from Mexico.
Eradication was possible through the sterile insect technique, which uses gamma radiation to irradiate screwworm pupae and create sterile male flies.
The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service maintains a screwworm pupae sterilization facility in North America and is currently building a new center in southern Texas.
When produced and released in large numbers, sterile male flies mate with wild female flies, which then lay unfertilized eggs, according to the USDA.
“Since female screwworm flies normally mate only once, the population progressively reduces and is, ultimately, eradicated,” according to USDA officials.
Last year, the Trump administration cut thousands of grants and programs from the U.S. Agency for International Development, which includes U.S.-funded animal disease monitoring projects operated by the United Nations Food and Agriculture Organization, Argi-Pulse Communications reported. Among the slashed programs were some dedicated to monitoring and containing New World screwworm in Central America.
Today, screwworm infestations aren’t a regular occurrence in the U.S., but cases have occurred in travelers returning from areas where the flies are present, according to the CDC.
Can infected animals be treated?
Infected wounds are cleaned and debrided to remove any screwworm larvae, after which the animal is treated with an approved insecticide, DeNotta said.
Last month, the U.S. Food and Drug Administration issued an emergency use authorization for several insecticides known to be effective against screwworm.
There are approved systemic and topical options for a variety of species, including cattle, horses, small ruminants, cats and dogs, DeNotta said.
“Multiple days of treatment are often required, and antibiotics and analgesics may also be administered to treat secondary infection and control pain,” she said.
If left untreated, the tissue destruction caused by flesh-eating larvae can be extensive and severe, often resulting in debilitation and eventual death of the host, DeNotta said.
“Animals that survive may suffer weight loss, poor growth and reduced productivity as a result of pain and discomfort,” she said.
Screwworm can infect humans
Human infection is rare, DeNotta said, but it can happen.
Humans are at risk of being infected by screwworms if they travel to an area where the flies are present, such as South America and the Caribbean, according to the CDC.
CDC officials said your risk of screwworm infection increases when you:
- Spend a lot of time outdoors during the day, especially if sleeping or unable to keep the flies at bay.
- Have any open wounds. A small break in the skin, including from a scratch, insect bite or recent surgery, may attract screwworm flies.
- Have a medical condition that causes bleeding or open sores, such as from skin or sinus cancer, or from treatments that can create breaks in the skin.
- Live, work or spend an extended amount of time with or near, livestock or other warm-blooded animals in areas where screwworm flies are present.
The symptoms humans experience when infected by screwworm
The following are symptoms of screwworm according to the CDC:
- Feeling maggots move or seeing maggots within a skin wound, sore or body opening.
- Painful skin wounds or sores that worsen within a few days.
- Foul-smelling odor from the site of the infestation.
- Bleeding from open sores.
Bacteria can also infect wounds where screwworm maggots are present and may cause an infection that can lead to symptoms like fever or chills.
To treat a screwworm infection, DeNotta said, people undergo the same combination of wound debridement and insecticides used in animals.
Science
One label, many risks: how grouping Asian Americans hides deadly cancer patterns
California researchers are leading a nationwide effort to find out why some Asian American communities have high rates of certain cancers.
It comes as health experts see rising rates of lung cancer among Asian American women who have never smoked and increasing rates of early-onset breast cancer.
“Asian Americans are actually the first racial and ethnic group for whom cancer is the leading cause of death,” said Scarlett Gomez, a cancer epidemiologist at UC San Francisco and a lead on the project.
UCSF joins researchers from UC Irvine, UC Davis, Cedars-Sinai and Temple University in launching a $12.5 million National Cancer Institute-funded study called the ASPIRE Cohort, that will follow 20,000 Asian Americans over time. Researchers say it’s the first large-scale longitudinal cancer study focused on Asian Americans.
Lung cancer incidence has declined across much of the United States as smoking rates have fallen. However, researchers have observed a slight increase among Asian Americans, despite relatively low smoking rates, particularly among women. More than half of Asian American women diagnosed with lung cancer are nonsmokers, they say.
Many existing studies of lung cancer risk among nonsmokers have been conducted in Asia, where exposure patterns can differ significantly from those in the United States, said Iona Cheng, a molecular epidemiologist at UCSF and also a lead on the project.
Researchers know that outdoor air pollution, secondhand smoke and cooking oil fumes can contribute to lung cancer risk. But it’s not clear if these explain disease patterns among Asian Americans in the United States.
Rising rates of breast cancer among Asian American women are also driving the push.
“Early onset breast cancer” — diagnosed before age 50 — “is going up the fastest among Asian Americans,” Gomez said. Recent data show rates among Asian Americans, Native Hawaiians and Pacific Islanders are approaching those of non-Hispanic white women, she said. Cancer experts don’t know why.
One of the central goals of the ASPIRE study is to move beyond treating Asian Americans as a single category. The term can include people with roots in dozens of countries from Sri Lanka to China’s border with Russia to Pacific islands, with completely different exposure patterns and cuisines.
“When we separate and look at all the distinct Asian ethnicities, we see a wide variation,” Cheng said.
Filipino women have a higher incidence of thyroid cancer, and stomach cancer has been more common among some Korean and Japanese people. Combining all Asian Americans into one category can make those differences impossible to detect.
The study also seeks to address longstanding gaps in representation. Although Asian Americans make up nearly 8% of the U.S. population, they have historically received little research funding.
Existing cancer studies have also often included too few Asian Americans to draw meaningful conclusions about specific ethnic groups, researchers said. Salma Shariff-Marco, a social and behavioral scientist at UCSF and also a lead on the projects, aid that has made it hard to show the need for more targeted research. The ASPIRE cohort, she said, is designed to show the variation by including a broader range of ethnic groups and more contemporary exposures than previous work.
Science
Scientists probe cosmic visitor from deep space, come up empty in search for alien life
Last summer, a NASA-funded asteroid impact warning system detected a mysterious object speeding through the solar system.
Scientists determined the object had entered the solar system from deep space, making it the third known object to have come from another star system.
NASA called it Comet 3I/ATLAS and said it didn’t pose a threat. But its discovery in July led to wild speculation that the object was a piece of extraterrestrial technology — maybe even an alien spacecraft.
The SETI Institute, a nonprofit that explores the origins of life and searches for extraterrestrial intelligence, said this week that a team of scientists had used a radio telescope to try to detect signals that could indicate extraterrestrial life on the comet.
But they found none.
“While observations strongly indicate that 3I/ATLAS is a natural object, interstellar visitors are also compelling technosignature targets because an artificial object — however unlikely — could represent detectable extraterrestrial technology and potentially provide the first evidence of life beyond Earth,” the institute said in a news release.
SETI scientists said they used the Allen Telescope Array at the Hat Creek Radio Observatory in Northern California to scan the object for seven hours, covering a spectrum of 1 to 9 gigahertz.
“This broad range allows scientists to search for narrowband radio signals, which are not produced in nature and would be evidence of technology,” the news release said.
The institute said the team identified nearly 74 million narrowband signals, but ultimately traced them back to technology on the Earth’s surface or orbiting satellites.
“The results from 3I/ATLAS show how realistic it is to detect a signal with the technology we have today,” said Valeria Garcia Lopez, one of scientists on the SETI team. “That is why it is important to keep searching for technosignatures, even from objects we might not expect to have signals.”
The institute said the researchers also can learn more about the natural properties of interstellar objects as they travel through our solar system.
“As more interstellar objects are discovered, each offers a new opportunity to probe the cosmos for technosignatures, advancing our understanding of both natural and possible technological phenomena beyond our Solar System,” the SETI statement said.
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