The rising practice of combining kratom, a permitted botanical, with opioid medication – often referred to as "Kratom Lean" – presents a challenging legal lacuna. Currently, the countrywide regulated status of kratom is in flux, varying significantly by state across localities, while codeine’s controlled nature adds another layer of regulator

The increasing popularity of "legal lean" syrup, a concoction with codeine and copyright, is creating a seriously risky situation when mixed with kratom. These act on the body in different ways, but their joint effects can be unpredictable. Users may experience dangerous respiratory slowdown, significant sedation, and a greater risk of serious harm