Observational study finds kratom exposures increased 6,500% among U.S. poison center cases — Evidence Review
Published in Addiction, by researchers from Medical College of Wisconsin
Researched by
— the AI search engine for science
Table of Contents
Kratom poison center reports in the US have surged over the past decade, with a marked rise in severe medical cases, according to a new study published in Addiction. These findings are consistent with previous research documenting increasing kratom use and related adverse outcomes, especially in states lacking strict regulation (source).
- Multiple studies have documented a significant increase in kratom exposures and poison center reports in the US, with some linking kratom use to severe medical effects such as seizures, tachycardia, and even deaths, particularly when used with other substances 2 3 4 6 9.
- Related research indicates that while many kratom users report self-medicating for pain or opioid withdrawal, a substantial proportion experience negative effects—most commonly gastrointestinal, neurological, or cardiovascular symptoms—and a minority develop serious substance use problems 1 5 10 13.
- State-level regulatory differences influence the rate of kratom exposures and severe outcomes, with stricter bans associated with fewer poison center cases; this finding aligns with calls from prior research for enhanced regulation and product quality control 2 4.
Study Overview and Key Findings
Kratom, a psychoactive plant with opioid-like properties at high doses, has gained popularity in the US as an herbal supplement. Amid growing public and legislative debate over its safety and proper regulation, this new study provides timely data on exposure trends and medical outcomes linked to kratom. Notably, the study assesses differences across states with varying regulatory approaches, offering evidence relevant to ongoing policy discussions about kratom’s risks and oversight.
| Property | Value |
|---|---|
| Study Year | 2023 |
| Organization | Medical College of Wisconsin |
| Journal Name | Addiction |
| Authors | Dr. Ryan Feldman |
| Population | Kratom users reporting poison center cases |
| Sample Size | 1,242 cases |
| Methods | Observational Study |
| Outcome | Reported kratom exposures, severe medical outcomes |
| Results | Kratom exposures surged 6,500% from 19 cases in 2010 to 1,242 in 2023 |
Literature Review: Related Studies
To situate the new findings within the broader scientific landscape, we searched the Consensus database of over 200 million research papers. The following search queries were used:
- kratom exposure trends United States
- kratom poison center case studies
- health effects of kratom usage
Below, we group findings from related studies by major topic areas:
| Topic | Key Findings |
|---|---|
| What are the trends in kratom exposures and poison center reports? | - Kratom exposures in the US have increased sharply since 2010, with poison center reports and severe outcomes rising especially in recent years 2 3 4 10. - Regulatory differences at the state level affect exposure rates and outcomes 2 4. |
| What are the health risks and adverse effects associated with kratom? | - Kratom use is linked to a spectrum of adverse effects, from mild gastrointestinal symptoms to severe outcomes such as seizures, cardiac issues, and fatalities, especially at higher doses or with other drug use 2 4 6 8 9 12. - Most adverse events are mild, but a minority result in hospitalization or death 4 6 9 10. |
| Who uses kratom and for what reasons? | - Kratom is primarily used by adults for self-treatment of pain, mood disorders, and opioid withdrawal, with regular use common among White, middle-aged individuals 1 5 13. - While many report perceived benefits, a notable proportion also report negative effects or problematic use 1 5 13. |
| Does kratom have potential for harm reduction or substance use disorder? | - Some users successfully use kratom to manage opioid withdrawal and reduce opioid use, reporting mood benefits and mild withdrawal symptoms relative to opioids 1 11 13. - Serious substance use disorders related to kratom are relatively uncommon, but the risk is higher among polydrug users 5 13. |
What are the trends in kratom exposures and poison center reports?
The rising number of kratom exposures reported to US poison centers over the last decade is well documented. Multiple studies have observed a pronounced increase in both the absolute number of cases and the proportion of severe outcomes, with some research highlighting that regulatory approaches at the state level have a measurable impact on these trends. The new study’s finding of a 6,500% increase in exposures from 2010 to 2023 builds upon this established trajectory.
- National poison center data shows a steep upward trend in kratom exposures since 2010, with most cases reported among adults, and a growing number of severe or fatal outcomes 2 3 4 10.
- State bans on kratom are associated with lower exposure rates and fewer severe medical outcomes compared to states with less strict regulation 2 4.
- The increase in cases is mirrored in international settings, such as Thailand, where kratom abuse and poisoning cases have also risen over time 7.
- Older adults are not immune; kratom exposures in people over 60 have increased, with some experiencing neurological or cardiovascular complications 10.
What are the health risks and adverse effects associated with kratom?
Kratom’s health effects range from mild to severe. While many users report only minor side effects, a substantial minority experience significant toxicity—particularly when kratom is taken in high doses or with other substances. The new study’s documentation of increased severe medical outcomes aligns with previous data on kratom’s potential for serious harm.
- Adverse effects include agitation, tachycardia, vomiting, seizures, liver injury, respiratory depression, and, rarely, death 2 4 6 8 9 12.
- Cardiotoxicity and death are more likely at higher doses or when kratom is used alongside other psychoactive drugs 6 9 12.
- While most poison center cases are mild, a significant proportion require hospitalization, and a small number are fatal 4 9 10.
- Withdrawal symptoms and toxicity can occur even in single-substance kratom exposures, though more serious effects are often linked to polysubstance use or underlying health conditions 2 6 8 12.
Who uses kratom and for what reasons?
Surveys and observational studies consistently show that kratom is predominantly used by adults—often White, middle-aged, and middle-income—for self-management of pain, mood disorders, and opioid withdrawal. Regular use is common, and most users report perceived benefits, though some report negative side effects or problematic use.
- The majority of kratom users are adults using the substance to manage pain, anxiety, depression, or opioid withdrawal 1 5 13.
- Most users report daily or regular use, with oral consumption being the most common route 1 13.
- Adverse effects are reported by a minority, typically mild and short-lived, though a small proportion seek medical treatment for more serious symptoms 1 13.
- Kratom use is often part of a broader pattern of substance use, with many users also using prescription or illicit opioids, cannabis, or other drugs 5 13.
Does kratom have potential for harm reduction or substance use disorder?
Some studies suggest kratom could serve as a harm reduction tool, particularly for individuals seeking to reduce or eliminate opioid use. While most users do not develop a substance use disorder related to kratom, the risk is higher among those with more severe substance abuse profiles or who engage in polydrug use.
- Kratom is used by some as an aid to reduce opioid withdrawal symptoms and cravings, with some individuals achieving sustained abstinence from opioids 1 11 13.
- Withdrawal from kratom is generally considered milder than from opioids but can be uncomfortable and difficult for some users 11.
- Serious kratom-related substance use disorder is relatively uncommon, but more likely among individuals with histories of substance abuse or polydrug use 5 13.
- The balance of risks and benefits remains contested, with reviews suggesting that while kratom may offer some harm reduction potential, adverse effects and toxicity are real concerns 12 13.
Future Research Questions
Despite recent advances, significant gaps remain in the scientific understanding of kratom’s health impacts, patterns of use, and regulatory outcomes. Future research is needed to clarify causality, quantify risks in different populations, and inform evidence-based policy. Below are several research questions that could help address these needs:
| Research Question | Relevance |
|---|---|
| What are the long-term health effects of regular kratom use? | Long-term safety data are lacking, especially regarding cardiovascular, hepatic, and neurological risks; most current knowledge comes from acute or cross-sectional studies 4 6 9 10 12. |
| How do state regulations impact kratom-related health outcomes? | The observed association between regulation and exposure/outcome rates needs deeper study to guide evidence-based policy and assess unintended consequences 2 4. |
| What are the risks of kratom use in older adults and those with chronic disease? | Older adults show a rising trend in kratom exposures and may be more vulnerable to adverse reactions and drug interactions, but data are limited 10. |
| Does kratom interact with common prescription medications? | Kratom’s potential to interfere with metabolic pathways and increase the risk of interactions is a significant concern, especially for those on multiple medications 2 6 10. |
| How effective is kratom as a harm reduction tool for opioid dependence? | While some users report success in reducing opioid use with kratom, robust, unbiased clinical trials are needed to assess its efficacy and risks in this context 1 11 13. |