Safety · 2026-04-07
CDC MMWR: Kava-Kratom Combined Use Surged to 30% of All Kava Reports by 2025, Serious Outcomes Double
Source: CDC MMWR / Drugs.com
Why it matters
Combined kava-kratom products are now a major driver of poison center calls and serious adverse events, yet remain poorly understood by clinicians — many of whom are unfamiliar with either substance and unaware their interaction may amplify toxicity.
The big picture
Kava (Piper methysticum) and kratom are both plant-based substances sold as supplements in the U.S. and increasingly marketed together in shots and drinks. CDC researchers tracked more than 25 years of kava-related poison center reports and found a new wave of adverse events beginning around 2017 as kava-kratom combination products proliferated. By 2025, 30 percent of all kava exposure reports involved concurrent kratom use — up from near zero before 2017 — and serious outcomes nearly tripled compared to earlier years.
Key findings
- University of Virginia researchers analyzed National Poison Data System reports for kava from January 2000 to December 2025.
- Kava-related exposure reports declined sharply after a 2002 FDA liver injury advisory but have risen steadily since 2011, reaching 203 exposures in 2025.
- Reports of combined kava-kratom use began increasing in 2017 and reached 30 percent of all kava reports in 2025.
- Serious clinical outcomes were reported in 32 percent of cases in 2025, compared to 12 percent in 2000 — a nearly three-fold increase.
- Demographic shift: post-2013 reports involve predominantly adult males; earlier reports more often involved females and younger users.
What they say
"We are now experiencing an increase in calls again as new kava products enter the market, including products mixed with other substances such as kratom that can cause adverse interactions," said Chris Holstege, M.D., director of the Blue Ridge Poison Center at the University of Virginia.
Bottom line
**CDC data show kava-kratom combination products have driven a dramatic rise in serious adverse events, with combined-use reports jumping from near zero in 2017 to 30% of all kava poison calls by 2025.**