Kratom, a psychoactive plant that can produce opioid like effects at high doses, has been linked to a sharp rise in poison center reports and serious medical outcomes across the United States. New research published in Addiction found that reported kratom exposures have increased dramatically over the past decade.
According to the study, kratom exposures reported to America’s Poison Centers climbed from just 19 cases in 2010 to 1,242 cases in 2023. That represents an increase of more than 65 times (6,500%).
Serious cases also became much more common. There were no severe outcomes reported in 2010 (2012 was the first year in which a severe outcome was reported), compared with 158 severe cases in 2023. Researchers classified a severe medical outcome as one involving life-threatening effects, significant lasting disability, or death.
The researchers also found notable differences among states based on how kratom is regulated. States that banned kratom consistently had lower rates of reported exposure, severe medical outcomes, and healthcare use than states with consumer protection policies or no kratom regulations.
Kratom Risks and State Regulations
Senior author Dr. Ryan Feldman, of the Medical College of Wisconsin, comments: “Kratom is not scheduled under the US Controlled Substances Act or approved for medical use by the FDA, which leaves US states to set their own regulations. Or not: several US states do not regulate kratom at all, and they consistently had worse outcomes in this study than states that banned kratom use.
“Evidence shows kratom can cause serious health effects like seizures, irregular heart rhythms, liver damage, and breathing problems. Nearly one in seven cases reported to a poison center with a single-substance kratom exposure were admitted to a hospital, and one in 16 were admitted to a critical care unit. If kratom is used in combination with other drugs, as it often is, kratom’s tendency to interfere with metabolic pathways can heighten the risks of the accompanying drugs.
“As kratom use rises, and concerns over kratom and its risks increase, 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, unbiased research to guide legislation. As our research here shows, the kratom problem is not going away anytime soon.”