Physicians and state health officials in Texas are warning residents about the dangers of kratom products, following a recent increase in cases of harm linked to exposure to chemicals found in the plant. The Texas Medical Association (TMA) and the Texas Department of State Health Services (DSHS) have issued guidance for those affected.
“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 with TMA’s Committee on Behavioral Health. “Just because something is ‘natural’ or legal does not mean that it is safe.”
Kratom products can be either semi-synthetic or synthetic, sometimes containing up to 98% of the psychoactive compound 7-hydroxymitragynine (7-OH), which may lead to significant health problems and carries a risk for dependence or abuse. Natural forms of kratom usually have much lower concentrations of this substance.
Despite being promoted as natural remedies for pain, anxiety, or easing opioid withdrawal symptoms, concentrated 7-OH products are available at gas stations, smoke shops, and online retailers in various forms such as pills, gummies, candies, and imitation ice cream cones. According to DSHS, symptoms associated with 7-OH exposure include high blood pressure, rapid heart rate, sweating, agitation, confusion, nausea or vomiting, and seizures.
In testimony before the Texas Legislature in 2025 supporting a bill aimed at prohibiting kratom and other hallucinogenic substances, TMA highlighted known risks including liver toxicity, seizures, and substance use disorders.
Although kratom has not been approved nor regulated by the U.S. Food and Drug Administration (FDA), approximately 1.7 million Americans aged 12 or older used it in 2021 according to TMA testimony. They noted that while more research is needed into its health effects, existing studies indicate risks such as addiction and possible long-term cognitive or behavioral issues among adolescents.
Recent data from August shows that reports of exposures involving kratom or related products are rising: The Texas Poison Center Network received 192 such reports so far this year—compared to 107 during all of last year and 122 throughout 2023. Of those exposed to concentrated 7-OH products in 2025 alone (19 patients), more than half required medical treatment at healthcare facilities.
Dr. Sprintz cautioned that people seeking relief from pain should be aware there are substantial dangers when using unregulated drugs like kratom with unknown potency levels.
“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 said. “They suffer from opioid-type withdrawal but also the kind of withdrawal that happens when people suddenly stop using 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.”
