A herbal product sold legally at gas stations, smoke shops and convenience stores across the country has been linked to overdoses and is sparking a crackdown. Kratom, long marketed as a natural remedy for pain, fatigue and sleep, is being taken by millions of Americans, despite FDA warnings linking products to liver toxicity, dependence, and in some cases, death. Lawmakers in several states have begun considering bans or stricter regulations, while retailers argue the product offers a legal alternative to prescription opioids.

Reports to U.S. poison‑control centers involving Kratom have surged about 12‑fold over the past decade, and a national debate is growing over the multibillion‑dollar, largely unregulated industry operating in the shadow of the opioid crisis. Derived from a Southeast Asian tree leaf, kratom contains the psychoactive compound mitragynine and trace amounts of 7‑hydroxymitragynine (7‑OH), both of which bind to the same brain receptors as opioids. Scientists warn that the lack of standardized dosing and quality control makes it difficult to assess safety, and anecdotal reports of severe withdrawal symptoms complicate the public health picture.

Initially sold in powder form, kratom products evolved into concentrated extracts, and more recently, potent synthetic and semi‑synthetic derivatives, like 7‑OH, have appeared. These newer formulations can be significantly stronger than traditional leaf preparations, increasing the likelihood of accidental overdose among users seeking heightened effects.