North Dakota Health Officials: Narcan Should Be on Hand for Kratom Overdoses

Why it matters

North Dakotas ban on kratom and 7-OH took effect August 5, creating an immediate withdrawal crisis among dependent users. Public health guidance on using naloxone for kratom overdose is clinically significant: it suggests first responders and bystanders should treat suspected kratom overdose the same way they would an opioid emergency.

The big picture

After North Dakota Governor Kelly Armstrong declared a public health emergency and banned all kratom and 7-OH products on August 3, health officials in Fargo moved quickly to issue harm-reduction guidance for a population that had been purchasing these substances legally at local shops. The state recorded 23 kratom-related deaths since 2019. A special legislative session is scheduled for September 2 to codify penalties into state law.

Key findings

• Fargo Cass Public Health recommends that Narcan (naloxone) be administered if someone is suspected of a kratom or 7-OH overdose, because the drug mimics opioid receptor effects
• Kratom in low doses acts as a stimulant, but high doses — particularly from synthetic 7-OH — can cause opioid-like respiratory depression
• North Dakota recorded 23 kratom-related deaths since 2019 according to the governors office
• The Clay County Withdrawal Management and Detox Center is available for medically supervised kratom withdrawal care
• North Dakotas overdose immunity law protects people who call 911 during an overdose from criminal prosecution
• A special legislative session on September 2 will establish formal criminal penalties for kratom violations

What they say

"Although it is not an opioid, kratom symptoms are similar and using Narcan could help save a life," said Robyn Litke-Sall, Fargo Cass Public Health prevention coordinator.

Bottom line

North Dakota public health officials say treat a kratom overdose like an opioid emergency — give Narcan, call 911, and know that immunity laws protect the caller.