Kratom Exposures Surge 65-Fold in 13 Years; States With Bans Show Significantly Lower Harm Rates, Medical College of Wisconsin Study Finds

Why it matters

This is the first large-scale study to compare kratom-related harm outcomes across different state regulatory models—banning, consumer protection laws, local restrictions, and no regulation. Its findings provide policymakers with direct evidence about which regulatory approach most reduces poison center calls and hospitalizations.

The big picture

Kratom remains unscheduled at the federal level, leaving states to craft their own policies. As of 2026, states range from complete bans to no regulation whatsoever. Advocates for the Kratom Consumer Protection Act (KCPA) argue that regulation—not prohibition—is the most effective approach, while anti-kratom advocates push for Schedule I status. This retrospective study, drawing on nearly 9,000 poison center cases from 2010 to 2023, is the largest policy-comparative analysis to date.

Key findings

• Kratom-related poison center exposures grew from 19 in 2010 to 1,242 in 2023, a 65-fold increase
• Overall, 72.5% of cases were evaluated in healthcare settings; 34% required hospitalization, with 44.5% needing critical care
• Total kratom-related mortality rate was 2% across all reported cases over 13 years
• Compared to states with bans, all other regulatory categories combined showed 2.5x higher exposure incidence, 3.2x higher severe outcomes, 2.4x higher healthcare use, and 2.45x higher hospitalization rates
• Severe outcomes were more likely when kratom was combined with other substances (13%) versus used alone (9%)
• No statistically significant differences in outcomes were found between KCPA states, locally restricted states, and completely unregulated states

What they say

"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," said study investigator Ryan Feldman, PharmD, Medical College of Wisconsin. "Ongoing policy debates reflect limited high-quality evidence, highlighting the need for more rigorous, unbiased research to guide legislation."

Bottom line

The largest state-by-state policy comparison to date found that kratom bans—not consumer protection acts—were associated with the lowest rates of poison center calls, hospitalizations, and severe outcomes, but the study's passive reporting design limits causal conclusions.