A Washington Post review of federal and state statistics shows that medical examiners and coroners are increasingly blaming deaths on kratom, an herbal product used to manage pain from surgeries. It was listed as contributing to or causing at least 4,100 deaths in 44 states and Washington, D.C., between 2020 and 2022. The vast majority of those cases involved other drugs in addition to kratom, which is made from the leaves of tropical trees. The kratom-involved deaths account for a small fraction of the more than 300,000 U.S. overdose deaths recorded in those three years. Dozens of wrongful death lawsuits involving kratom have been filed nationwide The suits illustrate increased scrutiny of deaths involving products made from kratom, which six states have banned but remains widely available online and in vape and convenience stores despite warnings from federal authorities.
Public health officials express alarm because companies sell products that contain kratom concentrates far more potent than the leaves plucked from trees. Some come packaged with insufficient warning labels and with uncertain health consequences. Users consume kratom to relieve pain, ease anxiety, boost energy or wean themselves off opioids or other drugs. Nearly 2 million people 12 and older had used kratom within the past year, according to a 2022 federal estimate. Kratom advocates say death statistics are misleading because the cases nearly always involve other drugs that can be lethal. They blame Food and Drug Administration warnings for causing medical examiners to include kratom among causes of death. The American Kratom Association, an advocacy group that has fought federal efforts to prohibit kratom, insists the herb is safe and that dangerous products come from unscrupulous companies. Health officials have for years expressed concern over kratom’s potential harms. The Centers for Disease Control and Prevention listed kratom was a cause of death in 91 overdose cases in 27 states from July 2016 through December 2017. Experts say the number of cases involving kratom are probably undercounts because not all coroners and medical examiners test for the substance. Kratom comes from the tropical tree Mitragyna speciosa, native to Indonesia, Malaysia and Thailand. Kratom products in the U.S. began proliferating in the mid-2000s as the opioid crisis, fueled by prescription pain pills, escalated, prompting users to seek alternatives for pain or relief from withdrawal symptoms.