Over the last decade, poison control centers around the country have received tens of thousands of calls from consumers of kratom products reporting adverse and life-threatening health effects, with researchers saying reports in 2025 reached a new level. California’s poison center is reporting similar findings.

Last month, researchers analyzed information from the National Poison Data System and found that between 2015 and 2025, poison control centers across the nation received 14,449 calls related to kratom. More than 23% of those calls, or 3,434, were made last year, according to a published report in the Centers for Disease Control and Prevention. That represents a more than 1,200% increase from 2015, when only 258 calls were reported.

Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It has a long history of being used for chronic pain or to boost energy and in the U.S., research points to Americans also using it to alleviate anxiety. In low doses, kratom appears to act as a stimulant but in high doses, it can have effects more like opioids.

But in the last few years, a synthetic form of kratom refined for its psychoactive compound, 7-hydroxymitragynine or 7-OH, has entered the market that is highly concentrated and not clearly labeled, leading to confusion and problems for consumers. The synthetic form gaining momentum in the market is sparking concern among public health officials because of its ability to bind to opioid receptors in the body, causing it to have a higher potential for abuse.

Los Angeles County leaders, meanwhile, have grappled with differentiating the two and regulating the products that come in the form of powder, capsules and drinks and have been linked to six county deaths. Sales of kratom and 7-OH products were banned in the county in November.

In reviewing the data, which did not differentiate whether callers had consumed natural or synthetic kratom, researchers set out to understand the effect of what they believe is a “rapidly evolving kratom market,” and highlight the role poison centers can play as an early warning surveillance system to detect new trends.

National Poison Data System findings

The data showed that over the last 10 years, 62% of the kratom-related calls to poison control centers were from people who said they consumed the drug by itself, and the other 38% were from people who combined it with another substance or substances.

Those who consumed kratom with another substance combined it most frequently with one or a combination of the following: alcohol, opioids, benzodiazepines (like Xanax or Valium), cannabis and cannabinoids, stimulants and antidepressants.

The data also broke down hospitalizations related to kratom — adults who took it alone or in combination and experienced “adverse” health effects; and adults who took it alone or in combination and experienced more serious “moderate” or “major” health effects, including death.

Kratom powder products are displayed in a smoke shop in Los Angeles in 2024.

(Michael Blackshire/Los Angeles Times)

Hospitalizations for adults who had consumed kratom alone and experienced adverse effects increased from 43 in 2015 to 538 in 2025. For those who took it in combination and were hospitalized with an adverse health effect, the total jumped from 40 in 2015 to 549 last year.

The numbers were even higher for hospitalizations where the health effects were more serious or fatal.

In 2015, there were 76 reports of people being hospitalized after taking kratom alone and experiencing a serious health effect or dying. By last year, that number had climbed to 919. The reports of serious health effects, including death, for those who took kratom in combination with another substance grew from 51 in 2015 to 725 last year.

The research does not break down kratom-related deaths by year but states that there were 233 deaths over the 10-year study period, or just over 3% of all 7,287 serious medical outcomes. Of the total number of kratom-related deaths, 184 cases involved the consumption of multiple substances.

What California’s poison control system found in its state data

The California Poison Control System is currently reviewing its data concerning kratom-related calls but an initial analysis shows parallels to the national report, said Rais Vohra, medical director of the state poison control system.

“We have about 10% of the national population and about 10% of the national call volume with poison control,” Vohra said. “And so, not surprisingly, we were able to identify over 900 cases of calls related to kratom in that same period.”

Local researchers are still deciphering the state data but they too have found that kratom-related calls are climbing.

“It’s accelerating, which I think is one of the main points of the [published] report,” Vohra said.

A majority of calls received by poison control come from healthcare facilities where “presumably someone has a problem … severe enough to warrant calling 911 or going to the emergency room, and that’s when our agency gets involved,” Vohra said.

Kait Brown, clinical managing director for America’s Poison Control Centers, said the fact that kratom and 7-OH are federally unregulated products sold online, in gas stations and smoke shops gives people across the country easy access.

And while kratom enthusiasts maintain that it has been used in its natural form for hundreds of years, “there are new formulations that are a little bit different than how people have used it, at least historically,” said William Eggleston, a pharmacist and the assistant clinical director of the Upstate New York Poison Center in Syracuse.

People are no longer consuming kratom only as a powder or capsule but also in the form of an energy shot or extract; it’s similar for synthetic, more concentrated 7-OH products.

When regional poison centers compare their findings and experiences with the analysis of calls in the National Poison Data System, Eggleston said, “undeniably there is an increase in calls related to kratom.”

“But when you put it in the bigger perspective of all the calls … this is still a very small percentage of what we’re dealing with on a day to day basis,” he said.