The developing practice of combining kratom, a legal botanical, with pain reliever – often referred to as "Kratom Lean" – presents a intricate legal ambiguity. At present, the federally regulated status of kratom stays in flux, varying greatly by state and localities, while codeine’s controlled nature adds another aspect of legal uncertainty.

The growing popularity of "legal lean" syrup, a concoction made of codeine and copyright, is creating a especially dangerous situation when mixed with kratom. The substances act on the central nervous system in separate ways, but their concurrent effects can be unpredictable. People may experience exacerbated respiratory slowdown, increased sedatio