Over the past decade, poison control centers across the country have received thousands of calls from consumers of kratom products reporting adverse and life-threatening health effects, with researchers saying reports are expected to reach a new level in 2025. California’s poison center is reporting similar findings.
Last month, researchers analyzed information from the National Poison Data System and found that between 2015 and 2025, poison control centers across the country received 14,449 calls related to kratom. According to a published report, more than 23% or 3,434 of these calls were made last year Report to the Centers for Disease Control and Prevention. This represents an increase of more than 1,200% from 2015, when only 258 calls were reported.
Authorities gathered illegally grown kratom plants in Thailand’s Phang Nha province in 2019. The country decriminalized the possession and sale of kratom in 2021.
(associated Press)
Derived from kratom leaves Mitragyna speciosa, a tree native to southeast asia. It has a long history of being used for chronic pain or to increase energy and research in the US suggests that Americans also use it to reduce anxiety. In low doses, kratom appears to act as a stimulant but in higher doses, its effects may be more like an opioid.
But in the past few years, a synthetic form of kratom refined for its psychoactive compound, 7-hydroxymitragynine or 7-OH, has entered the market that is highly concentrated and not clearly labeled, causing confusion and problems for consumers. The synthetic form increasingly on the market is raising concerns among public health officials because of its ability to bind to opioid receptors in the body, making it more likely to be abused.
Los Angeles County leaders, meanwhile, are struggling to both isolate and regulate the products that come in the form of powders, capsules and drinks and have been linked to six county deaths. The sale of kratom and 7-OH products was banned in the county in November.
In reviewing the data, which did not differentiate whether callers had consumed natural or synthetic kratom, researchers worked to understand the impact of the “rapidly growing kratom market” and highlighted the role of poison centers as an early warning monitoring system to detect new trends.
National Poison Data System findings
Data showed that over the past 10 years, 62% of kratom-related calls to poison control centers were from people who said they had consumed the drug by itself, and another 38% were from people who mixed it with another substance or substances.
People who use kratom with any other substance often mix it with one or a combination of the following: alcohol, opioids, benzodiazepines (such as Xanax or Valium), cannabis and cannabinoids, stimulants, and antidepressants.
The data also broke down cases of kratom-related hospitalizations — adults who took it alone or in combination and experienced “adverse” health effects; and adults who took it alone or in combination and experienced more serious “moderate” or “major” health effects, including death.
Kratom powder products will be on display at a smoke shop in Los Angeles in 2024.
(Michael Blackshire/Los Angeles Times)
The number of hospitalizations among adults who consumed kratom alone and experienced adverse effects increased from 43 in 2015 to 538 in 2025. The total number of adults who took it in combination and were hospitalized with adverse health effects rose from 40 in 2015 to 549 last year.
Hospitalizations were even higher where health effects were more severe or fatal.
In 2015, there were 76 reports of people being hospitalized after taking kratom alone and experiencing serious health effects or dying. By last year, this number had increased to 919. Among people who took kratom in combination with another substance, reports of serious health effects, including death, increased from 51 in 2015 to 725 last year.
The research doesn’t break down kratom-related deaths by year, but reports that 233 deaths occurred over the 10-year study period, or just over 3% of all 7,287 serious medical outcomes. Of the total number of kratom-related deaths, 184 cases involved the consumption of multiple substances.
What California’s poison control system found in its state data
The California Poison Control System is currently reviewing its data related to kratom-related calls, but preliminary analysis shows similarities to national reports, said Rais Vohra, medical director of the state poison control system.
“We have about 10% of the national population and about 10% of the national call volume under poison control,” Vohra said. “And so, not surprisingly, we were able to identify over 900 cases of kratom-related calls over that same period.”
Local researchers are still deciphering state data but have also found that kratom-related calls are increasing.
“It is accelerating, which I think is one of the main points of the (published) report,” Vohra said.
The majority of calls received by poison control come from health care facilities, Vohra said, where “someone is potentially having a problem … so severe that it becomes necessary to call 911 or go to the emergency room, and that’s when our agency gets involved.”
Kat Brown, clinical managing director of the US Poison Control Centers, said the fact that kratom and 7-OH are federally unregulated products that are sold online, in gas stations and smoke shops gives people across the country easy access.
And while kratom enthusiasts believe it has been used in its natural form for hundreds of years, “there are newer formulations that are a little different from the way people have used it, at least historically,” said William Eggleston, MD, pharmacist and assistant clinical director of the Upstate New York Poison Center in Syracuse.
People are now consuming Kratom not only in powder or capsule form, but also in the form of energy shots or extracts; This is similar to synthetic, more concentrated 7-OH products.
When regional poison centers compare their findings and experiences to an analysis of calls in the National Poison Data System, Eggleston said, “There is undoubtedly an increase in kratom-related calls.”
“But when you put it in the larger perspective of all the calls… it’s still a very small percentage of what we’re dealing with on a day-to-day basis,” he said.
