Unlabeled kratom alkaloids found in retail products marketed as kava

Why it matters

People buying products labeled kava may unknowingly receive opioid-active kratom compounds, complicating withdrawal assessment and toxicology.

The big picture

Alabama clinicians identified a cluster of opioid-like withdrawal cases in October 2025. Laboratory testing of five retail products found kratom alkaloids alongside, or instead of, kavalactones.

Key findings

• Three products contained both kavalactones and kratom alkaloids; one product contained mitragynine without detectable kavalactones; mitragynine pseudoindoxyl was the predominant identified derivative at 0.16-0.21 mg per bottle.

What they say

The authors concluded that unrecognized exposure to opioid-active kratom compounds may occur through products marketed as kava.

Bottom line

**Product labels can conceal exposure to potent kratom-related compounds, so clinicians need better surveillance and testing.**