Kratom cases are exploding across the U.S. and doctors are alarmed

In 2025, poison centers recorded a peak of 3,434 cases, compared to just 258 in 2015. Researchers say the rapid increase -- including a significant spike last year -- is tied to wider availability of kratom and the growing strength of newer products.

Hospitalizations and Deaths Climb Sharply

Serious health outcomes linked to kratom have also surged. Hospitalizations involving only kratom rose more than 1,150% over the decade, climbing from 43 cases in 2015 to 538 in 2025. When kratom was combined with other substances, such as illegal drugs or antidepressants, hospitalizations increased nearly 1,300%, from 40 to 549.

During the study period, 233 deaths were associated with kratom use. Of those, 184 involved multiple substances.

"The data reflects a concerning trend," said researcher Chris Holstege, MD, the director of UVA Health's Blue Ridge Poison Center. "This trend found in the national data is also occurring in our local clinical practice, with more patients presenting to UVA Health following serious complications associated with kratom products."

What Is Kratom and How It Is Used

Kratom is derived from the leaves of a tropical evergreen tree native to Southeast Asia. Traditionally, people have used the leaves by chewing them, crushing them, or brewing them into tea for pain relief and mood enhancement. The substance can act as both a stimulant, increasing energy, and a sedative, helping users feel calmer and less anxious.

It has also been used for pain management, and some individuals have turned to kratom to ease opioid withdrawal symptoms. (Its effectiveness in reducing opioid cravings has not been thoroughly evaluated.)

Unregulated Products Raise Safety Concerns

In the United States, kratom is widely sold in forms that are often far more potent than natural leaves. These include pills and extracts that may contain undisclosed ingredients. Because the products are not regulated, consumers cannot be sure what they are taking. Kratom itself has also been linked to possible liver damage.

To better understand the trend, UVA Health researchers led by Rita Farah, PhD, MPH, PharmD, analyzed kratom-related calls reported to the National Poison Data System. They found a steady rise from 2015 through 2019, followed by a plateau from 2020 to 2024, and then a sharp surge in 2025.

Who Is Using Kratom and Why Experts Are Concerned

Over the 10-year period, more than 14,400 kratom exposures were reported. Most cases involved men, especially those in their 20s and 30s. However, reports also increased significantly among people ages 40 to 59, indicating broader use across age groups.

Researchers describe the trend as concerning. In 2025, 60% of cases involving multiple substances resulted in "serious medical outcomes," and about half required hospitalization.

Based on these findings, experts are calling for closer monitoring of kratom products and increased public education. They emphasize that using kratom can lead to serious and even fatal outcomes, particularly when combined with alcohol, medications, or illicit drugs.

"We are experiencing a marked increase in kratom associated products being sold in the U.S market," Holstege said. "We want the public to be aware that these products contain chemicals of varying concentrations such as mitragynine and 7-hydroxymitragynine that have complex pharmacological actions and can cause drug interactions and adverse consequences in humans."