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Kratom Regulatory Review

Poison Control • Kratom (Mitragyna speciosa)

This page summarizes U.S. poison-center (NPDS) exposure data for kratom, including annual call volume, single-substance exposures, pediatric involvement, healthcare utilization, and severity outcomes.

NPDS (National Poison Data System) data are based on calls to U.S. poison centers. These data describe reported exposures and clinical outcomes as recorded by poison centers.

Kratom Poison Control Data (U.S. Poison Centers, 2019–2024)
Annual NPDS counts and outcomes for kratom exposures. “Single-substance” indicates kratom was the only substance reported in the exposure. Pediatric counts combine ages ≤5, 6–12, and 13–19. HCF = treated/managed in a Health Care Facility.
Year Total cases (case mentions) Single-substance Pediatric <20 yrs (≤5 + 6–12 + 13–19) Adults ≥20 Intentional Treated in HCF Outcome: None Minor Moderate Major Deaths
20191,35788510273354071363203275783
20201,26279410363751361459175259665
20211,52494813974158871269213305674
20221,27879410758649758666167248553
20231,48988010672351967160184305705
20241,6451,02714982060880392233332767
Sources: America’s Poison Centers® NPDS Annual Reports, Appendix B (Table 22A/22B) 2019–2023. Pediatric counts are combined (≤5 + 6–12 + 13–19). HCF = treated/managed in a Health Care Facility.
total case mentions: 8,555 single-substance totals: 5,328 serious outcomes remain common
Pediatric Kratom Exposures (NPDS, 2019–2024)
Reported pediatric exposures to U.S. poison centers, categorized by age group. Data derived from NPDS Annual Reports (Appendix B, Table 22A/22B).
Year <5 yrs 6–12 yrs 13–19 yrs Total Pediatric
201960339102
202063535103
202191543139
202267337107
202371332106
2024107637150
Source: America’s Poison Centers® NPDS Annual Reports, 2019–2024.
Observed Trends

Children under 5 years old represent the largest pediatric exposure group each year. After relative stability in 2019–2020, exposures increased sharply in 2021, declined modestly in 2022–2023, and reached a new high in 2024 (107 cases).

Exposures among ages 6–12 remain consistently low and relatively stable. Adolescent exposures (13–19) fluctuate moderately but do not show the same upward pattern observed in the youngest age group.

Overall pediatric totals increased from 102 in 2019 to 150 in 2024, with most of that increase attributable to children under five.

Neonatal Considerations

Poison center annual reports capture exposures reported directly to poison centers. Neonatal cases (including potential withdrawal) would only be included in the <5 category if a poison center call was made and the case was coded as an exposure.

Many neonatal withdrawal cases are managed in hospital settings without poison center involvement. Those cases may appear in hospital discharge data or neonatal abstinence surveillance systems, but not necessarily within NPDS exposure totals.

2023 “New & Emerging” Findings (NPDS)
Key findings summarized from NPDS “Emerging Trends” analysis (2023) regarding kratom exposures and healthcare utilization.
  • Severity: Among single-substance cases with known outcomes, 57.6% resulted in a moderate/major/fatal effect (reported as third-highest after tianeptine and phenibut).
  • Hospitalization: 34.3% of kratom exposures resulted in hospital admission.
  • Withdrawal: 4.76% of all kratom exposures were coded for withdrawal; among those seen in healthcare, 33.5% were admitted; 13.5% of withdrawal calls originated from home.
  • Bottom line: Reported exposures show a high rate of clinically significant toxicity and frequent healthcare utilization; poison-center data include both acute overdose and withdrawal management scenarios.
Extracted from the 2023 NPDS Annual Report “Emerging Trends” analysis of kratom, phenibut, tianeptine, and nitrous oxide.
Poison-Center & Toxicology Literature (PubMed / PMC)
  • Kratom exposures reported to U.S. poison control centers (2011–2017)
    A poison-center analysis of 1,807 reported kratom exposures. Most cases involved adults and many were intentional. About one-third of first-ranked kratom exposures resulted in admission to a healthcare facility, and serious medical outcomes were common. The report also documented deaths (including a small number where kratom was the only reported substance) and noted neonatal exposures, including withdrawal.
    Open PubMed →
  • Kratom exposures among older adults reported to U.S. poison centers (2014–2019)
    A poison-center study focusing on adults over 60. It reported increasing kratom exposures over time and noted that many calls originated from healthcare facilities. Older adults had higher rates of adverse reactions (including medication interactions) and the paper documented deaths among older-adult exposures.
    Open PubMed →
  • Characteristics of deaths associated with kratom use
    A review describing patterns seen in kratom-associated deaths. It reports that polysubstance use was common and that many decedents had a prior history of substance use. The paper emphasizes that toxicology often involves multiple substances and that consistent death investigation and reporting practices matter for interpretation.
    Open PubMed →
  • A case of kratom overdose in a pediatric patient
    A case report of a 15-year-old who ingested a large number of kratom capsules in a suicide attempt. Symptoms included nausea/vomiting, tremor, fast heart rate, and lab abnormalities. The patient required emergency monitoring and psychiatric hospitalization. The case highlights household access and the risk of pediatric exposure.
    Open PMC →
  • Legally lethal kratom: a herbal supplement with overdose potential
    A severe overdose case in which a patient was found unresponsive with breathing failure and required intubation. The report describes multi-organ stress (abnormal labs affecting multiple systems) and prolonged recovery with supportive care. It underscores that very high-dose exposures can present like opioid-type toxicity and require critical care.
    Open PubMed →