Ohio Kratom Overdose Deaths Rose 180% from 2019 to 2024, Prompting Board of Pharmacy to Seek Schedule I Status

Why it matters

Ohio's state-level data showing a 180% increase in kratom-related overdose deaths from 2019 to 2024 is one of the most concrete state-specific trend lines available, supporting the case for accelerated regulatory action. The Ohio Board of Pharmacy is now seeking to classify all forms of kratom as Schedule I controlled substances — a step that would make Ohio one of the strictest states in the country.

The big picture

Ohio has been at the forefront of state-level drug policy responses to kratom. In December 2025, Governor Mike DeWine issued an executive order banning synthetic kratom. The Board of Pharmacy then recommended extending that prohibition to all kratom, including natural leaf products containing mitragynine. That recommendation is now proceeding through Ohio's regulatory review process, which includes the Common Sense Initiative and the Joint Committee on Agency Rule Review.

Key findings

• RecoveryOhio data shows kratom-involved accidental overdose deaths increased 180% between 2019 and 2024 in Ohio
• Kratom still accounts for less than 1% of all accidental drug overdose deaths in Ohio
• Governor DeWine's December 2025 executive order banned synthetic kratom products in the state
• The Ohio Board of Pharmacy recommended in January 2026 that all kratom be reclassified as Schedule I controlled substances
• Final rules banning mitragynine require review by the Common Sense Initiative and Joint Committee on Agency Rule Review before taking effect

What they say

The Health Policy Institute of Ohio noted that kratom overdose deaths remain a small fraction of Ohio's overall drug deaths, but the 180% increase from 2019 to 2024 reflects "a rapidly rising trend that warrants urgent policy attention."

Bottom line

Ohio's state data reveals kratom-involved overdose deaths nearly tripled from 2019 to 2024, driving the Board of Pharmacy to seek Schedule I classification for all kratom — including natural leaf — a move that could reshape policy in other states.