A potent, opioid-like product called kratom is being sold at gas stations, convenience stores, and smoke shops across the US.
The largely unregulated drug has surged in popularity in recent years and has been linked to several deaths, raising concerns about its safety and availability.
In 2025, 3,434 cases of kratom exposure were reported to poison centers nationwide—a 1,200% increase in exposures compared to 2015. Kratom products were found during investigations into the September deaths of two students in Mississippi, although authorities have not confirmed whether kratom contributed to either death. Earlier this year, health officials in Utah linked four deaths to potent kratom-derived compounds found in mislabeled products.
Here, Caleb Alexander, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health and codirector of the Johns Hopkins Center for Drug Safety and Effectiveness, explains what kratom is, what the risks are of using it, and where regulation of the drug stands at the federal and state levels:
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