Kratom Poisoning Reports Surge. Experts Say the Worst May Be Yet to Come.

The number of kratom poisoning cases reported to United States poison control centres rose by roughly 1,200% over the past decade, according to new federal health data. Ultra-potent kratom products have since flooded convenience stores, vape shops, and petrol stations, pushing that figure even higher.

The findings, published in the Morbidity and Mortality Weekly Report, paint a stark picture of a substance that millions of Americans use, yet few fully understand.

From Herbal Remedy to Public Health Concern

Kratom comes from Mitragyna speciosa, a plant native to Southeast Asia. Communities there have used it for generations to manage pain, low mood, and opioid withdrawal. In the United States, however, consumption habits have changed dramatically.

Manufacturers now sell kratom as gummies, tablets, powders, and energy shots rather than crushed leaves or brewed teas. These concentrated formats raise serious questions about toxicity, particularly among medical toxicologists.

Researchers at the University of Virginia tracked nearly 14,450 kratom exposure reports across 53 poison control centres between 2015 and 2025. In 2015, centres recorded just 258 cases. By 2025, that number had climbed to 3,434, a greater than tenfold increase in a single decade.

“Kratom use is increasing and expanding across demographic groups, underscoring a growing public health concern,” said lead author Eleanor Blair Towers, PhD, of the University of Virginia’s division of medical toxicology.

The 7-OH Factor Behind Rising Kratom Exposure Cases

One product appears to be driving much of the recent spike in kratom poisoning reports: 7-hydroxymitragynine, commonly known as 7-OH. Manufacturers engineer this semisynthetic formulation to be far more potent than natural kratom.

In July 2025, the US Food and Drug Administration moved to pull 7-OH from the commercial market. The FDA also asked the Drug Enforcement Agency to classify the compound as a Schedule I controlled substance, placing it alongside heroin and other high-abuse-risk drugs.

FDA Commissioner Martin Makary, MD, was direct: “7-OH binds to the mu receptor, which means scientifically, by definition, it is an opioid. And yet it is sold in vape stores, smoke shops, convenience stores and gas stations that are popping up all over the United States.”

Makary clarified that the FDA’s focus targets synthetic, concentrated kratom formulations rather than whole-leaf products.

Who Do Kratom Exposure Reports Involve?

The kratom exposure data reveals a clear picture of who ends up in hospital or reaching for the phone.

Men account for the majority of cases, up to 71% of single-substance reports and 76% of multiple-substance reports. In 56% of single-substance cases and 49% of multiple-substance cases, intentional misuse was the cited reason.

Around 23% of people in multiple-substance kratom exposure reports had a suspected suicide attempt on record. That figure falls to 6% for single-substance cases. Researchers said the pattern points to a real link between kratom use and mental health crises.

Kratom rarely appears alone. In 38% of all reports, users had taken other substances too. The most common were alcohol (22%), opioids (16%), antidepressants (14%), benzodiazepines (15%), cannabis or cannabinoids (12%), and stimulants (11%).

Hospitalisations and Deaths Are Rising

Kratom poisoning is producing increasingly severe outcomes. For single-substance cases, hospitalisations rose from 43 in 2015 to 538 in 2025. For multiple-substance cases, the figure jumped from 40 to 549 over the same period.

Serious outcomes followed the same pattern. Single-substance reports recorded a rise from 76 to 919 serious cases. For multiple-substance reports, the count climbed from 51 to 725.

The study identified 233 kratom-related deaths across the entire study period. Nearly 80% involved more than one substance. Opioids appeared in 62% of those fatal cases. Benzodiazepines and stimulants each featured in 20%, and alcohol in 19%.

What Comes Next?

The FDA’s decision to regulate 7-OH marks a significant step. But researchers are calling for more detailed surveillance going forward. Regulators are targeting synthetic formulations while leaving whole-leaf kratom products on shelves, which makes it harder to assess risk without knowing which product types drive harm.

“As FDA moves to regulate 7-hydroxymitragynine but not whole-leaf kratom products, surveillance should distinguish product types to assess risks,” the study authors wrote. “Building this evidence base is essential to promoting safe kratom use.”

This pattern is familiar. A product starts on the fringes, commercial availability grows, and hospital admissions follow before policymakers can act. Nearly 3,500 kratom poisoning cases in a single year. More than 1,000 hospitalisations. A synthetic variant that the FDA itself describes as an opioid, available next to energy drinks at the local petrol station.

Source: dbrecoveryresources