A group that advocates for consumer access to the herbal supplement kratom says the State of Ohio Board of Pharmacy erred in approving a proposal to ban the product that has been touted as way to fight the opioid epidemic.

The board on Wednesday voted to approve its proposal to classify the Southeast Asian herb as a Schedule 1 Controlled Substance, which would place it in the same class as heroin, LSD and other illegal drugs. It now faces review by two other government bodies.

The board was not swayed by scientific studies that the association presented refuting U.S. Food and Drug Administration findings, said C.M. Haddow, a public policy fellow at the Virginia-based American Kratom Association. Opposed to bans, the association is lobbying in Ohio and elsewhere for laws that would make the product illegal for minors, require labeling and regulate for quality and purity.

Pharmacy board spokesman Cameron McNamee said staff members scoured medical journals to provide board members with scientific research and also presented them with the research provided by the Kratom Association.

He said regulation instead of a ban could represent a "middle ground," but "at this point the board feels the science behind it is more of a concern from a public health perspective."

Read more: Ohio pharmacy board proposes crackdown on kratom

The leaves of the tropical kratom tree, native to Southeast Asia, contain substances that can have mind-altering effects, according to the National Institute on Drug Abuse at the U.S. Department of Health & Human Services. Haddow said its use increased in the U.S. after soldiers who fought in Vietnam found it reduced fatigue and pain.

The Kratom Association estimates there are 5 million users in the U.S, and say it is sold by a number of retailers in central Ohio.

The herbal supplement is banned in six states and the District of Columbia.

The FDA has reported 44 deaths associated with kratom since 2011, but Haddow said a review by the Kratom Association shows that figure represents global deaths.

At least one of the deaths is being investigated as possible use of pure kratom, and most appear to have resulted from other drugs being mixed with kratom by the manufacturer or from using it with other substances or medications, such as illegal drugs or cough syrup, the National Institute on Drug Abuse says on its website.

Haddow said regulation is necessary to prevent a "Wild West marketplace" in which kratom can be spiked with anything from synthetic materials to heroin.

Read more: Thailand legislature legalizes medical marijuana and kratom

The pharmacy board vote came two weeks after a study published by the journal Clinical Toxicology showed that reports to U.S. poison-control centers about kratom rose from 13 in 2011 to 682 in 2017. In that period, there were 11 U.S. deaths associated with kratom exposure, including two after exposure to kratom only, according to the study by researchers at Nationwide Children's Hospital, Northeast Ohio Medical University, the Central Ohio Poison Center and Ohio State University.

The board vote also came two weeks after the Moritz College of Law at Ohio State hosted a panel discussion on kratom. Among panelists were Haddow and Dr. Robert Weber, administrator for pharmacy services at Ohio State's Wexner Medical Center, who has a far different opinion of the herb than Haddow.

Weber said in a Friday interview that kratom stimulates opiate receptors in the brain, making it similar in action to opioid medications. Overdoses have been documented, he said, and it is important to be careful about how kratom is used by the public.

"This should be considered to be a dangerous substance because of the fact that it has very similar characteristics to opiates," he said. "To protect the health of the public, I think there needs to be education, and there needs to be regulation."

Read more: Herbal supplement kratom contains opioids, regulators say

Doug Berman, executive director of the Drug Enforcement and Policy Center at the law college, moderated the panel, and he said issues discussed included the effect a ban would have on driving the product to the black market.

"The huge fundamental issue is do we want the government saying 'we're unsure about this, therefore we prohibit it until we can be sure it's safe'?" he said. "Or do we say 'some people are benefiting from this, even if there is risk, let it be legal until we get proof that it's more harmful than healthy'?'"

The proposed ban will be sent to the Common Sense Initiative in Gov. Mike DeWine's office, where it will by analyzed for how it will impact business, said board spokeswoman Ali Simon. If it is accepted there, the ban will move to the legislature's Joint Committee on Agency Rule Review, which would determine if the ban is within the board's rule-making authority.

Both reviews will involve public comment periods.

jviviano@dispatch.com

@JoAnneViviano