Kratom Poison Center Cases Surge 6,500% in U.S.: What To Know About the Risks

Kratom-related reports to U.S. poison centers rose from 19 cases in 2010 to 1,242 cases in 2023, an increase of about 6,500%, according to a study published April 21, 2026, in the journal Addiction. Researchers also found that severe medical outcomes linked to kratom exposures increased from no reported cases in 2010 to 158 cases in 2023.

The study analyzed 8,919 kratom-related exposures reported to poison centers across all 50 states and the District of Columbia from 2010 through 2023. Overall, 13% of reported exposures resulted in a severe medical outcome, which included life-threatening effects, significant residual disability, or death.

The researchers also found significantly higher rates of exposure, severe outcomes, health care use and hospitalization in states where kratom was not banned compared with states where retail sales were prohibited.

Kratom exposure reports rose sharply

Kratom is a plant that can produce psychoactive effects. Its use has increased in the United States, but it is not federally scheduled, leaving states to establish their own rules.

For the study, researchers classified states into four groups based on their regulatory approach: states with no kratom regulations, states with Kratom Consumer Protection Acts, states with local restrictions but no statewide regulation, and states where retail sales were banned.

The number of reports increased throughout the study period, reaching 1,242 cases in 2023 compared with 19 in 2010. Researchers calculated that the incidence rate in 2023 was 69 times higher than in 2010.

Severe outcomes also became more frequent. The first severe outcome was reported in 2012, and the number reached 158 by 2023. Researchers defined a severe outcome as a major medical effect that was life-threatening or caused significant lasting disability, as well as death.

Of the 8,919 exposures recorded during the study period, 5,452, or 61%, involved kratom as the only reported substance. Most cases involved adults, with 91% involving people age 18 or older. Males accounted for 69% of reported exposures.

What are the risks of kratom?

The study’s findings are important not only because of the increase in poison center reports but also because of the types of medical problems associated with kratom exposure.

According to Ryan Feldman of the Medical College of Wisconsin, the study’s senior author, reported health effects associated with kratom include seizures, irregular heart rhythms, liver damage, and breathing problems.

“Evidence shows kratom can cause serious health effects like seizures, irregular heart rhythms, liver damage, and breathing problems,” Feldman said.

Hospital treatment was also common among people whose exposures involved kratom alone. Feldman said nearly one in seven people with a single-substance kratom exposure were admitted to a hospital, while about one in 16 were admitted to a critical care unit.

The researchers also highlighted a potential concern when kratom is used alongside other drugs. Feldman said kratom can interfere with metabolic pathways, potentially increasing the risks associated with other substances taken at the same time.

That does not mean every person who uses kratom will experience a severe reaction. The study examined exposures reported to poison centers, so the data represent cases that came to the attention of those centers rather than the entire population of kratom users.

States with kratom bans had lower reported rates

The researchers found significant differences between states where kratom was banned and states with other regulatory approaches.

Compared with states where kratom retail sales were banned, states without bans had a 2.49-times higher rate of reported exposures. They also had a 3.19-times higher rate of severe medical outcomes, a 2.44-times higher rate of health care use, and a 2.45-times higher hospitalization rate.

The study did not find statistically significant differences among the other regulatory categories.
The findings show an association between state-level regulation and reported kratom outcomes, but they do not prove that banning kratom directly caused the lower rates. The researchers conducted a retrospective observational study using poison center data, and other differences between states could also influence the results.

Kratom regulation varies across the country. Some states have adopted consumer protection measures involving issues such as minimum age requirements, product purity and labeling, while others have imposed restrictions or bans.

Feldman said the findings come as lawmakers continue to debate how kratom should be regulated.

“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,” Feldman said.

He said the growing number of exposures and concerns about potential harms demonstrate the need for better evidence to guide those decisions.

“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,” Feldman said. “Ongoing policy debates reflect limited high-quality evidence, highlighting the need for more rigorous, unbiased research to guide legislation.”

The study used data from the National Poison Data System covering all 50 states and the District of Columbia between 2010 and 2023. The researchers reported no funding for the research.