Kratom Poisonings Surged 1,200% Over Past Decade as Regulators Struggle to Keep Pace with Rising Harms

Why it matters

An addiction medicine expert's analysis clarifies that kratom is an opioid despite being marketed as natural, that it does not treat opioid addiction (merely masks withdrawal), and that state bans show no adverse opioid-death outcomes—challenging industry claims.

The big picture

Kratom use has grown as people sought alternatives to prescription opioids, with about 1.7 million Americans reporting annual use. However, CDC data shows 1,200% increase in poison control calls since 2015. The opioid crisis context has created confusion about kratom's benefits; many assume "natural" means safe.

Key findings

• Kratom contains mitragynine (weak opioid) and 7-OH (strong opioid); 7-OH is metabolite of mitragynine; both bind opioid receptors; daily use leads to tolerance, withdrawal symptoms similar to oxycodone/heroin; kratom can cause liver disease, seizures, addiction, death; pregnant women: risk to fetus, opioid withdrawal in newborns; high lead levels documented in some products; Vermont (early kratom-banning state) has seen largest opioid death declines in country

What they say

Dr. Andrew Kolodny (addiction specialist): "The evidence shows that kratom is an opioid with real risks – not a harmless supplement"; FDA: "compounds in kratom make it so it isn't just a plant – it's an opioid"; On treatment claim: "Relief of withdrawal symptoms does not make a drug a treatment for opioid use disorder; it simply shows that the drug is an opioid."

Bottom line

**Despite marketing claims and industry advocacy, kratom is a potent opioid with documented risks; evidence does not support claims that it treats opioid addiction or prevents fentanyl deaths.**