Kratom, a psychoactive plant that can produce opioid-like effects at high doses, has been linked to a sharp increase in poison center reports and serious medical outcomes across the United States. New research published in Addiction found that reported exposures to kratom have increased dramatically over the past decade.
According to the study, kratom exposures reported to US Poison Control Centers increased from just 19 cases in 2010 to 1,242 cases in 2023. That represents a more than 65-fold (6,500%) increase.
Severe cases also became much more common. There were no serious outcomes reported in 2010 (2012 was the first year a serious outcome was reported), compared to 158 serious cases in 2023. Researchers classified a serious medical outcome as one involving life-threatening effects, significant lasting disability, or death.
The researchers also found notable differences between states based on how kratom is regulated. States that consistently banned kratom had lower rates of reported exposure, serious medical outcomes, and health care use than states with consumer protection policies or no kratom regulations.
Kratom Risks and State Regulations
Lead author Dr. Ryan Feldman of the Medical College of Wisconsin comments: “Kratom is not included in the US Controlled Substances Act nor is it approved for medical use by the FDA, leaving US states to set their own regulations. Or not: Several US states do not regulate kratom at all, and consistently performed worse in this study than states that banned kratom use.
“Evidence shows that kratom can cause serious health effects, such as seizures, irregular heart rhythms, liver damage, and breathing problems. Nearly one in seven cases reported to a poison center with exposure to a single substance was admitted to a hospital, and one in 16 was admitted to an intensive care unit. If kratom is used in combination with other drugs, as is often the case, kratom’s tendency to interfere with metabolic pathways may increase the risks of the drugs that accompany it.
“As kratom use increases and concerns about kratom and its risks mount, legislatures across the country are debating the best ways to regulate its use. Ongoing policy debates reflect limited high-quality evidence, highlighting the need for more rigorous and unbiased research to guide legislation. As our research here shows, the kratom problem is not going away anytime soon.”