Brandeis Expert: Kratom Is Repeating the Opioid Crisis Playbook — Regulatory Approaches That Preserve Access Won't Prevent Harm

Why it matters

Published in a leading peer-reviewed addiction journal, this commentary from Brandeis University's Opioid Policy Research Collaborative argues that early warning signs of a new opioid-like crisis are already present with kratom — and that lessons from OxyContin's rise are being ignored.

The big picture

Dr. Andrew Kolodny, a prominent opioid policy researcher, draws direct parallels between the early opioid epidemic and current kratom trends. He argues that the kratom industry's narrative — attributing harms only to concentrated 7-OH products, not whole-leaf kratom — mirrors tactics used by opioid manufacturers to delay regulation. The commentary responds to a new large-scale study (Comstock et al., 2026) showing that KCPA states have similar harm rates to unregulated states.

Key findings

• States adopting KCPA showed no statistically significant reduction in severe kratom outcomes compared to unregulated states
• States that previously banned kratom and shifted to KCPA are likely to see increases in adverse events and deaths
• Serious kratom-related harms were increasing before concentrated 7-OH products appeared in 2023, undermining industry framing
• The opioid epidemic demonstrated: when availability increases, use disorder increases — kratom is following this pattern
• The FDA concluded in 2018 that mitragynine and 7-OH are opioids, yet kratom remains widely sold over the counter

What they say

Dr. Kolodny writes: 'Kratom availability is associated with increased serious public health harms, including death. Regulatory approaches that preserve access, such as the Kratom Consumer Protection Act, do not reduce adverse outcomes. Policymakers should apply lessons from the opioid crisis, reject industry narratives and limit availability to prevent rising morbidity and mortality.'

Bottom line

**A Brandeis University opioid policy expert argues in a peer-reviewed journal that kratom is following the same dangerous availability-harm pattern as prescription opioids — and that regulations preserving access won't prevent the escalating public health toll.**