Cato Institute: State Kratom Bans Named for Overdose Victims Obscure Polysubstance Toxicology Evidence

Why it matters

A wave of state bills banning kratom or 7-OH have been named after individuals who died in incidents attributed to the substances. A Cato Institute analysis examines the underlying autopsy evidence and argues policymakers are responding to anecdote rather than population-level data — with potentially harmful consequences.

The big picture

Multiple states including Tennessee, New Jersey, Michigan, and Colorado have advanced or enacted kratom restrictions following high-profile fatalities attributed to 7-hydroxymitragynine. The FDA and HHS have also pushed for DEA Schedule I classification of 7-OH. The Cato analysis — published in the Washington Examiner — draws on publicly released autopsy reports and CDC overdose mortality data to challenge the causal narrative underlying these policy pushes.

Key findings

• Fatal overdoses involving 7-OH as a contributing factor are described as exceedingly rare compared to other substances
• CDC data shows roughly two-thirds of kratom-involved deaths had fentanyl present; about one-third had heroin; approximately 80% had documented histories of substance misuse
• Autopsy reports from several named overdose victims reveal polysubstance exposure alongside 7-OH, including fentanyl, Adderall, Benadryl, antidepressants, anticonvulsants, and cannabinoids
• Tennessee decedent Matthew Davenport had diphenhydramine and psychiatric medications in addition to 7-OH
• New Jersey CJ Holowach had Adderall, kratom, tranquilizers, cannabinoids, and fentanyl in his system
• Colorado, which enacted the Daniel Bregger Act, restricts but does not ban kratom and caps 7-OH at 2% in products
• The author argues Schedule I classification would shift consumers to illicit markets where potency is unverified and adulteration is common

What they say

Cato Institute Senior Fellow Jeffrey A. Singer writes: "Policymakers confronting a fentanyl-driven overdose crisis understandably feel pressure to act, and emotionally charged cases can illuminate real risks. But they should resist the temptation to legislate by anecdote when broader population-level evidence points in a more complicated direction."

Bottom line

Autopsy evidence in high-profile kratom-related deaths consistently reveals polysubstance involvement, complicating the legal and scientific basis for sweeping 7-OH prohibition.