Kratom-related exposure reports to poison-control centers increased by more than 1,200% between 2015 and 2025, according to a 2026 study published in the CDC’s “Morbidity and Mortality Weekly Report.”
The drug is derived from a tropical tree native to Southeast Asia, with leaves containing over 50 alkaloids, including the most abundant alkaloid in the plant, mitragynine and 7-hydroxymitragynine, or 7-OH, a minor alkaloid that comprises less than two percent of the total alkaloid content in natural kratom leaves.
As of January 2026, 30 states and the District of Columbia regulate kratom or its components in some manner. In six states — including Alabama, Arkansas, Indiana, Louisiana, Vermont and Wisconsin — mitragynine and 7-OH are considered controlled substances, which results in all kratom products being banned.
Here are four things to know:
1. Kratom is marketed for multiple uses but remains unproven. Users take kratom to boost energy, improve mood, relieve pain and ease opioid withdrawal symptoms. According to Rochester, Minn.-based Mayo Clinic’s website, there are too few studies to verify these claimed benefits. The substance begins working in minutes and can last a few hours.
In the U.S., Kratom is sold as capsules, extracts, powders and teas online and in brick-and-mortar stores, and its leaves can be crushed and smoked. The product is often marketed as a “natural” and “herbal supplement,” despite its side effects.
Individuals who use kratom report stimulant-like effects at lower doses, including increased alertness and energy. At higher doses, users report sedative effects such as pain relief and reduced anxiety. Due to a lack of regulation, Kratom products do not have clear labels establishing the level of active ingredients per dose.
A John Hopkins 2020 study of 2,798 kratom users found 91% of individuals used the substance for pain relief, 67% to treat anxiety, 64% to treat depression and 41% to treat opioid dependence. Kratom may be easier to obtain than prescription medicines, but carries risk of addiction, according to Mayo Clinic’s website.
Side effects include nausea, sweating, dry mouth, constipation, increased urination, tachycardia, vomiting, drowsiness and loss of appetite, according to the Drug Enforcement Administration. Mayo Clinic said it can also cause high blood pressure, liver damage, seizures, hallucinations, muscle pain, confusion, depression and breathing problems.
2. Safety concerns have prompted federal warnings. In 2016, the DEA proposed banning commercial sale and use. The FDA has advised categorizing it as a Schedule I drug, meaning it has no proven medical application and has a high risk of abuse.
A concentrated and sometimes synthetic derivative of the kratom plant, such as 7-OH, can be five to 50 times more potent than regular kratom. It is a highly potent, opioid-like compound, commonly sold in smoke shops and vape stores. In 2025, the FDA recommended that consumers avoid 7-OH products.
Hawaii’s Department of Health also warned residents about the increasing availability of 7-OH products, according to a May 11 news release from the department.
The DEA is reviewing the FDA’s recommendation to classify 7-OH as a Schedule I controlled substance, according to the release.
3. National and local exposure reports have risen. More than 5 million U.S. individuals have used the substance in their lifetimes, including more than 100,000 children ages 12 to 17.
At Aliso Viejo, Calif.-based Laguna Treatment Center, a provider of addiction and co-occurring disorder treatment, 25 patients sought treatment for kratom dependence in the first five months of 2026. That figure represented a 525% increase compared to the four patients who sought treatment for kratom dependence at the facility in all of 2025.
Poison control centers received more than 3,400 reports related to kratom use from 2014 through 2019, according to Mayo Clinic.
Kratom was found in the system of more than 5,200 people who died of drug overdoses from 2020 through 2024, according to data from the CDC.
Studies suggest long-term use may lead to dependence and withdrawal symptoms. Kratom products also have been found to contain contaminants, including lead and salmonella. The FDA has linked more than 35 deaths to salmonella-tainted kratom products, according to Mayo Clinic’s website.
4. The federal government’s stance. An investigation by The New York Times detailed interactions among HHS Secretary Robert F. Kennedy Jr., kratom industry executive Aaron Ross and federal agencies, including actions involving Botanic Tonics, a kratom company previously sued by the federal government.
The investigation, based on campaign finance data, lobbying disclosures, court filings, private correspondence and interviews, found Mr. Ross increased donations to Mr. Kennedy’s defunct presidential campaign after President Donald Trump selected him to serve as health secretary. Mr. Ross also privately said he was “working on a plan for Bobby,” according to the report.
The Times reported that in 2025 the FDA removed links from a kratom webpage that detailed a pending legal case against Botanic Tonics “after allies of Mr. Ross pushed for the change.” The Justice Department later moved in December to drop its lawsuit against the company, which has disputed allegations that it illegally sold kratom products not proven safe.
The investigation also found that Mr. Kenndy called Ohio’s governor in fall 2025 to try to prevent a state ban on kratom in the state. Months later, Botanic Tonics donated $1 million to a political action committee associated with Mr. Kennedy, the report said.
Mr. Ross and Ches McDowell, a lobbyist, also secured a private meeting with Vice President JD Vance, where they discussed kratom and urged a ban on synthetic products, according to the investigation.
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