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Kratom boom raises alarm as poison center cases surge in the US
Study finds 65-fold increase in exposures and growing number of severe medical outcomes linked to plant-based psychoactive substance
A plant-derived psychoactive substance is raising growing concern across the United States. Known as kratom, the compound can produce opioid-like effects when taken in high doses and is now at the center of a sharp increase in health-related incidents.
According to a new study published in the journal Addiction, cases involving kratom exposure reported to US poison control centers have surged dramatically over the past decade—rising up to 65 times in just over ten years.
The increase is described as “dramatic,” both in terms of reported exposures and the number of users experiencing severe medical consequences. Specifically, cases reported to poison centers rose from just 19 in 2010 to 1,242 in 2023—a 6,500% increase. Severe medical outcomes—defined as life-threatening effects, significant disability, or death—climbed from zero cases in 2010 (with the first reported in 2012) to 158 in 2023.
“Kratom is not included in the list of controlled substances under the Controlled Substances Act, nor is it approved for medical use by the Food and Drug Administration,” explained Ryan Feldman, senior author of the study and professor at the Medical College of Wisconsin. “This leaves individual US states free to regulate it—or not regulate it at all.”
Indeed, several states currently have no specific regulations governing kratom. The study found that these areas consistently report worse outcomes compared to states that have banned the substance. Prohibitions, researchers note, are associated with lower rates of exposure, fewer severe cases, and reduced reliance on healthcare services.
Health risks linked to kratom are significant. “Evidence shows that kratom can cause serious health effects, including seizures, cardiac arrhythmias, liver damage, and respiratory problems,” Feldman said. Nearly one in seven cases involving kratom as the sole substance required hospitalization, while one in sixteen required admission to intensive care.
The risks increase further when kratom is used in combination with other drugs—a common occurrence. Its interaction with metabolic processes can amplify the effects and dangers of other substances taken at the same time.
With consumption rising and concerns mounting, lawmakers across the United States are debating how best to regulate the substance. However, ongoing policy discussions are complicated by a lack of high-quality scientific evidence.
“The current debates reflect the need for more rigorous and unbiased research to support effective legislation,” Feldman concluded. “As our findings show, the kratom issue is not going away anytime soon.”
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