Calls to U.S. poison centers about kratom rose more than 1,200 percent between 2015 and 2025, reaching a record 3,434 exposure reports last year , according to a new analysis published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report last week.

The agency reported parallel surges in hospitalizations and severe outcomes, including 233 deaths linked to kratom during the study period, the majority involving multiple substances such as opioids, benzodiazepines, stimulants, ethanol, and antidepressants . This rise corresponded with a nearly equal uptick in hospitalizations linked to kratom alone, from 43 admissions in 2015 to 538 in 2025 .

The dramatic spike raises urgent questions about the growing availability and potency of kratom products, particularly synthetic derivatives that federal regulators are moving to restrict. “This data reflects a concerning trend,” study coauthor Dr. Christopher Holstege, director of the Blue Ridge Poison Center at the University of Virginia, said in a news release .

The research was published Thursday in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report . “These findings indicate that kratom use is increasing and expanding across demographic groups, underscoring a growing public health concern,” lead author Chris Holstege, MD, director of the Blue Ridge Poison Center at the University of Virginia School of Medicine, Charlottesville, Virginia, and colleagues wrote .

During 2015–2025, U.S. poison centers documented 14,449 kratom exposures; the 3,434 exposures reported in 2025 represent an increase of approximately 1,200% compared with the 258 reported in 2015. Exposure report rates increased in parallel with the number of exposure reports, from 412 to 4,445 per 1 million drug exposure reports, with a steady increase through 2019, a plateau during 2020–2024, and a marked surge in 2025 .

Rising Deaths and Multi-Drug Complications

Among 233 reported kratom-associated deaths from the last 10 years, 184, about 79 percent, involved multiple substances. Opioids were reported in 62 percent of fatalities, followed by benzodiazepines at 20 percent, stimulants at 20 percent and ethanol at 19 percent .

Most exposure reports involved males and adults aged 20–39, with sharp increases among adults aged 40–59 by 2025, indicating broader uptake across demographic groups . Meanwhile, 233 people died from kratom use during this time, with 184 of those deaths also involving other substances. Most kratom exposures were among men in their 20s and 30s, but there were also significant increases among people ages 40 to 59 .

Signs of kratom poisoning can include high blood pressure, vomiting, heart attack, tremors, seizures, delusions, hallucinations, liver damage and an increased heart rate, known as tachycardia. That can cause heart palpitations, dizziness or lightheadedness, shortness of breath, fainting and chest pain .

Federal Scrutiny of High-Potency Products

The timing of the study coincides with federal efforts to restrict concentrated kratom derivatives. The 2025 surge coincided with the emergence of higher-potency alkaloid products, including those enriched with 7-hydroxymitragynine, and record demand evidenced by federal import actions .

In July 2025, the Food and Drug Administration recommended that the Drug Enforcement Administration schedule 7-hydroxymitragynine (7-OH) as a Schedule I controlled substance. The U.S. Food and Drug Administration today is taking a bold step to protect Americans from dangerous, illegal opioids by recommending a scheduling action to control certain 7-hydroxymitragynine (also known as 7-OH) products under the Controlled Substances Act (CSA). The FDA is specifically targeting 7-OH, a concentrated byproduct of the kratom plant; it is not focused on natural kratom leaf products .

“Today, we’re taking action on 7-OH as a critical step in the fight against opioid addiction,” said HHS Secretary Robert F. Kennedy, Jr .

From Traditional Medicine to Gas Station Supplements

Kratom is an herb from the leaves of the tropical tree Mitragyna speciosa native to Southeast Asia. It has both stimulant and sedative effects and carries a risk of addiction due to how it interacts with the brain , according to Dr. Oliver Grundmann, a leading kratom researcher and clinical professor in the department of medicinal chemistry at the University of Florida.

The psychoactive herb isn’t federally regulated and thus isn’t “lawfully marketed in the U.S. as a drug product, a dietary supplement, or a food additive in conventional food,” according to the US Food and Drug Administration. But in states that haven’t banned kratom, it’s sold at gas stations, smoke shops and convenience, grocery and health food stores in various forms, including powders