Poison control centers across the United States documented 14,449 kratom-related exposures between 2015 and 2025, with annual cases climbing from 258 to 3,434—an approximately 1,200% increase , according to a new federal study that has intensified calls for stricter regulation of the widely available herbal supplement.

The study, published March 26 in the CDC’s Morbidity and Mortality Weekly Report , reveals a marked surge in 2025 that exceeded all previous years, with exposure rates jumping from 2,171 per 1 million drug exposure reports in 2024 to 4,445 per 1 million in 2025 .

The rise was accompanied by parallel increases in hospitalizations and severe outcomes, including 233 deaths during the study period, with 184 involving multiple substances . Hospitalizations involving only kratom rose more than 1,150% over the decade, climbing from 43 cases in 2015 to 538 in 2025 .

“The data reflects a concerning trend,” said Dr. Chris Holstege, director of the Blue Ridge Poison Center at the University of Virginia School of Medicine and lead author of the study . “This trend found in the national data is also occurring in our local clinical practice, with more patients presenting to UVA Health following serious complications associated with kratom products.”

The surge comes as federal health officials are moving to regulate concentrated kratom products for the first time. The FDA in 2025 recommended scheduling 7-hydroxymitragynine (7-OH)—a concentrated byproduct of the kratom plant—under the Controlled Substances Act, specifically targeting 7-OH rather than 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. “We will protect the health of our nation’s youth as we advance our mission to Make America Healthy Again.”

Growing Market, Rising Risks

Kratom comes from the tropical tree Mitragyna speciosa, native to Southeast Asia. Its leaves contain psychoactive compounds, primarily mitragynine and 7-hydroxymitragynine, that act on opioid receptors. Traditionally consumed as brewed tea, it is now widely available in the US as powders, capsules, and concentrated liquid shots .

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, loose-leaf teas, capsules, tablets and concentrates . A 2024 study estimated nearly 2 million Americans use kratom regularly .

The increase in exposures coincided with broader kratom availability and the emergence of higher-potency products that are largely unregulated at the federal level . The shift from natural leaf to high-potency alkaloid extracts has heightened concerns about significant health risks, including liver toxicity and seizures .

Polysubstance Use Drives Worst Outcomes

The study showed that polysubstance use posed the greatest risk in kratom-related exposures. Although 62% of exposures involved kratom alone, those involving additional substances were more likely to result in hospitalization and death. Hospitalization rates were consistently higher in polysubstance exposures (44%-56%) than in single-substance cases (24%-29%) .

Among kratom-associated deaths, opioids were reported in 62 percent of fatalities, followed by benzodiazepines at 20 percent, stimulants at 20 percent and ethanol at 19 percent .

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 .

Demographic Shifts Signal Broader Appeal

The largest rise in reports was in adults aged 40-59 years, with rates comparable to younger adults for the first time . 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 .

Intentional misuse accounted for about half of exposures. Suspected suicide attempts were reported in 23% of multiple substance exposures versus 6% of single-substance cases .

Federal Action Targets High-Potency Products

The CDC findings come amid intensifying federal efforts to regulate kratom’s most potent compounds.