Physicians and state health officials in Texas are warning residents about the dangers associated with kratom products following a recent increase in reported health issues linked to exposure to the substance. Kratom, a plant-based product often marketed as a natural remedy for pain, anxiety, and opioid withdrawal, contains an opioid-like chemical that can cause serious health risks.
“Using kratom is like buying an opioid on the street, with the same risks – and harder to stop using,” said Dr. Michael P. Sprintz, a pain and addiction medicine specialist who serves on the Texas Medical Association (TMA) Committee on Behavioral Health. “Just because something is ‘natural’ or legal does not mean that it is safe.”
Kratom products that are semi-synthetic or synthetic can contain up to 98% of 7-hydroxymitragynine (7-OH), the main psychoactive compound, significantly higher than the less than 2% typically found in unsynthesized forms. These concentrated versions have been linked to significant health problems and potential for dependence or abuse.
The Texas Department of State Health Services (DSHS) reports that products containing high levels of 7-OH are sold at gas stations, smoke shops, and online as pills, gummies, candies, and imitation ice cream cones. Symptoms associated with these products include high blood pressure, rapid heart rate, sweating, agitation, confusion, nausea or vomiting, and seizures.
Earlier this year, TMA presented evidence of kratom’s risks—including liver toxicity and seizures—to lawmakers in support of legislation aimed at banning kratom and other hallucinogenic substances.
Despite not being approved or regulated by the U.S. Food and Drug Administration (FDA), an estimated 1.7 million Americans aged 12 years or older used kratom in 2021 according to testimony from TMA. The association also cited studies indicating possible addiction risks as well as cognitive and behavioral impacts among adolescents.
Reports from DSHS show that as of late August this year there were 192 cases involving exposures to kratom or similar substances reported by the Texas Poison Center Network—up from 107 cases during all of last year and 122 cases in all of 2023. Of those exposed to concentrated forms of 7-OH so far this year, more than half required treatment at a healthcare facility.
Dr. Sprintz cautioned against turning to kratom for pain relief due to its unregulated production process: “When someone uses kratom and its metabolites like 7-OH for a period of time, they develop dependence so if they suddenly try to stop using kratom, they will go into withdrawal,” he explained. He described withdrawal symptoms similar both to opioids and certain antidepressants.
“My recommendation to the public is not to start using kratom because it is not safe to use and does cause dependence,” Dr. Sprintz added. “Additionally, the dose of active drug is variable so the overdose risk is high.”
