Kava-Kratom Combination Products Surge; Poison Center Reports Rise to 30% Co-Use in 2025

Why it matters

CDC poison center surveillance reveals that kava-kratom combination products are driving a new public health concern. By 2025, kratom co-use accounted for 30% of all kava exposures reported to poison centers—surpassing ethanol and benzodiazepines as the most common kava co-substance.

The big picture

After a sharp decline following the FDA's 2002 liver injury warning, kava exposures have resurged 383% since 2011, rising from 57 reports in 2011 to 203 in 2025. Notably, the demographic profile has shifted: early 2000s exposures were female-predominant and included many children, but recent exposures are predominantly men aged 20+. The emergence of kava-kratom products since 2017 has created new combinations with unclear interaction profiles and safety data.

Key findings

• Kava poisoning reports increased 383% from 2011 (57 cases) to 2025 (203 cases)
• Kratom co-use in kava exposures: emerged in 2017, surpassed ethanol/benzodiazepines by 2019, reached 30% (61 cases) by 2025
• Serious medical outcomes increased from 12% in 2000 to 32% in 2025, coinciding with kratom co-use rise
• Eight deaths reported during 2000-2025 period (0.25% fatality rate)
• Most common effects: gastrointestinal (nausea, vomiting), neurologic (drowsiness, dizziness), cardiovascular (tachycardia)

What they say

CDC authors state: 'These increases have coincided with higher rates of serious reported clinical outcomes in recent years. The reemergence of kava-related exposures with clinical effects reported to poison centers in the United States, coinciding with increased availability of commercial products with high kavalactone content and co-use with kratom, represents a public health concern.'

Bottom line

Unregulated kava-kratom combination products sold as alcohol alternatives have created a new public health surveillance signal, with serious outcomes rising as co-use becomes increasingly common.