Kratom exposure cases reported to United States Poison Centers: 2016-July 2025.

INTRODUCTION: Kratom has a long history of use internationally. New formulations and extracts have recently come to the market and there has been an increase in interest and news around kratom and its alkaloids. This paper updates the epidemiology and clinical outcomes from kratom exposures reported to US Poison Centers.

METHODS: We analyzed kratom exposures reported to US Poison Centers from January 1, 2016 through July 31, 2025 to describe the epidemiology and compare the more recent exposures in 2025 to those reported before 2025.

RESULTS: There were 13,194 exposures over the period. There was a slow increase and steady report of exposures from 2016 through 2024, with an increase in 2025. Males accounted for 68% of the population and the mean age was 32 years. Most patients (11,205, 85.0%) were either in or referred to a healthcare facility. Of these, 16.5% were admitted to the intensive care unit, 15.1% to a non-intensive care unit, 6.2% to a psychiatric facility, and 46.1% were discharged from the emergency department. There were 219 (1.6%) deaths (43 single-substance and 176 polysubstance) and 1324 (10%) major effects (potentially life-threatening signs or symptoms) reported. We identified a difference in the distribution of outcomes comparing pre-2025 and 2025 exposures for single-substance exposures but not polysubstance. Clinical effects were largely similar over time.

CONCLUSION: There has been a significant increase in kratom exposures reported to US Poison Centers, but the overall outcomes have remained similar. Further investigation should be performed to identify the causes of the increase.