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By Pat Anson

In what could be part of a new federal effort to ban kratom nationwide, the CDC has released a new study pointing to an exponential increase in kratom-related calls to U.S. poison control centers over the past decade.

There was a 1,200% increase in kratom-related reports to the National Poison Data System, from 258 in 2015 to 3,434 in 2025, including a “marked surge” last year. 

There was a similar 1,200% increase in kratom-related reports that resulted in adverse events and hospitalizations, from 43 cases in 2015 to 538 in 2025.

Over that 11-year period, there were a total of 233 kratom-related deaths. Most of the deaths and hospitalizations involved other drugs, such as alcohol, opioids, cannabis, stimulants and benzodiazepines. 

About half of the exposure reports were considered “intentional misuse” or suspected suicide attempts, researchers reported in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

“Kratom-related adverse effects are increasing in number and complexity in the United States. Increasing use, the availability of high-potency kratom, and frequent multiple-substance exposure reports contribute to hospitalizations from physical as well as psychiatric causes,” wrote lead author Christopher Holstege, MD, Professor of Emergency Medicine and Pediatrics at the University of Virginia School of Medicine.

Last summer, the FDA said it would seek to have the potent kratom alkaloid 7-hydroxymitragynine (7-OH) – but not whole leaf kratom – classified as an illegal Schedule One controlled substance. 

7-OH occurs naturally in kratom in trace amounts, but some kratom vendors are selling concentrated versions of 7-OH that boost its potency as a pain reliever and mood enhancer. The surge in poison control cases in 2025 is mainly attributed to the growing use of 7-OH products. 

“As FDA moves to regulate 7-hydroxymitragynine but not whole-leaf kratom products, surveillance should distinguish product types to assess risks. Building this evidence base is essential to promoting safe kratom use, identifying high-risk combinations of substances, and guiding public health action to prevent future health effects in this rapidly evolving drug landscape,” said Holstege. 

Misleading Numbers

It’s important to note that the growing number of kratom-related calls to poison control centers coincide with kratom’s increasing popularity in the United States. 

Kratom comes from the leaves of a tree in Southeast Asia, where it has been used for centuries as a natural stimulant and pain reliever. Kratom’s use began growing in the U.S during the 2010’s, as restrictions were placed on opioid analgesics and pain patients sought other ways to get relief. 

According to the MMWR, about 5 million Americans have used kratom, although some estimates are as high as 20 million..

The 14,449 kratom-related calls to poison centers over the 11-year period represents only a tiny fraction (0.28%) of the estimated 5 million kratom users.

Critics say calls to poison control centers are “notoriously unreliable” and an imperfect way to measure the risks associated with a substance, since most calls involve minor symptoms such as upset stomachs or dizziness.

The number of calls can also be misleading. For example, a study of poison control data from 2000 to 2017 found there were more calls about exposure to nutmeg than there were about kratom.  

Nevertheless, the poison control data is often used by federal health officials and law enforcement agencies to seek changes in the legal status of a substance.  In 2016, the DEA and FDA cited another MMRW study to justify their efforts to have 7-OH and the alkaloid mitragynine listed as Schedule One controlled substances, in the same category as heroin. Such a move would have effectively banned kratom.

“Evidence from poison control centers in the United States also shows that there is an increase in the number of individuals abusing kratom, which contains the main active alkaloids mitragynine and 7-hydroxymitragynine. As such, there has been a steady increase in the reporting of kratom exposures by poison control centers,” the DEA said in 2016.

The DEA dropped its proposal to schedule mitragynine and 7-hydroxymitragynine after a public outcry, saying a ban on kratom would have “significant risk of immediate adverse public health consequences.” 

A top federal health official later admitted the FDA and the DEA based their scheduling request on “embarrassingly poor evidence & data.”

The growing controversy over 7-OH has revived efforts to restrict or ban sales of kratom and 7-OH at the state and local level. It may only be a matter of time before the DEA joins that movement, by renewing its effort to schedule 7-OH, mitragynine, and perhaps kratom itself.