CDC Report

What the Centers for Disease Control and Prevention (CDC) has officially published about selected substances. If CDC has not addressed a substance, we say so and move on. References are listed below (no links).

Last updated: October 21, 2025
Context: CDC publications include MMWR analyses, Health Alerts, outbreak pages, and CDC program content. These summarize surveillance and health risks from real-world data; they do not endorse use.
Herbal • Mitragynine

Kratom

  • CDC identified kratom in overdose death analyses (2016–2017); most deaths involved co-exposures (fentanyl, heroin, benzodiazepines).
  • Poison center calls rose markedly (2010–2015) with tachycardia, agitation, drowsiness, hypertension; ~7% major effects reported.
  • CDC led a 2018 multistate Salmonella outbreak investigation linked to kratom products and advised avoiding kratom during the outbreak.

Status: Addressed by CDC (MMWR analyses; outbreak advisory).

Unapproved Antidepressant

Tianeptine

  • CDC documented a surge in U.S. tianeptine exposures (post-2014) with opioid-like toxicity and withdrawal.
  • CDC reported severe outcomes, including toxic leukoencephalopathy and 2024 poisonings tied to adulterated “Neptune’s Fix.”
  • CDC characterizes tianeptine as an emerging public health risk; urges clinician and public awareness.

Status: Addressed by CDC (MMWR; alerts/investigations).

GABA Analog

Phenibut

  • CDC MMWR (2020) reported sharp increases in phenibut exposure calls (2009–2019), many in young adult males.
  • Reported effects: profound CNS depression (sedation, confusion, coma); ~10–13% major effects; deaths reported.
  • Withdrawal syndromes documented; CDC warns of misuse/availability despite no approved medical use in U.S.

Status: Addressed by CDC (MMWR).

Cannabis • Concentrates

THC Extracts (incl. Delta-8)

  • CDC notes high-THC concentrates (dabbing/vapes) carry unique risks; higher addiction potential; contaminants implicated in EVALI (2019).
  • Delta-8 THC advisory: rising poisonings, mislabeled products, severe pediatric intoxications.
  • CDC emphasizes no form of THC use is risk-free; warns about additives/unknown by-products in unregulated products.

Status: Addressed by CDC (Cannabis & Public Health; health alerts).

Hallucinogenic Plant

Salvia divinorum

  • CDC does not have a standalone advisory focused on salvia.
  • Mentioned in CDC materials as a hallucinogen with risks similar to other psychedelics; travel guidance cautions against use.

Status: CDC has not issued a dedicated salvia bulletin; referenced generally.

Class Overview

Hallucinogens (General)

  • CDC reports increasing U.S. hallucinogen use (survey data); warns of unpredictable effects and injuries.
  • 2024 cluster: severe illnesses from “psychedelic” mushroom chocolates/gummies; national recall and health alerts coordinated.
  • Travel guidance highlights risks with ayahuasca/peyote/psilocybin ceremonies (agitation, seizures, arrhythmias, deaths reported).

Status: Addressed by CDC (MMWRs; Yellow Book; outbreak/recall notices).

Inhalant

Nitrous Oxide

  • CDC reported a 4–5× rise (2019–2023) in recreational misuse in Michigan; multiple fatalities noted across EMS encounters.
  • Chronic use causes B12-linked neuropathy and spinal cord degeneration; acute risks include hypoxia, loss of consciousness, trauma.
  • CDC calls for targeted public education; clinicians should suspect N₂O in unexplained neuro deficits.

Status: Addressed by CDC (MMWR Notes from the Field).

Foodborne Toxin

Mad Honey (Grayanotoxin)

  • CDC travel medicine content describes poisoning from grayanotoxin-contaminated honey (Turkey, Nepal, etc.).
  • Symptoms: dizziness, sweating, hypersalivation, vomiting, visual changes; hallmark bradycardia and hypotension; often needs hospital care.
  • CDC advises avoiding honey of uncertain origin in endemic regions.

Status: Addressed by CDC (Yellow Book travel guidance).

References (CDC publications; no links)

  1. CDC. Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers — United States, 2010–2015. MMWR.
  2. CDC. Kratom-Related Deaths — Multi-state Analyses, 2016–2017. MMWR.
  3. CDC. Multistate Outbreak of Salmonella Infections Linked to Products Reported to Contain Kratom — 2018. CDC Outbreak Advisory/Update.
  4. CDC. Tianeptine Exposures Reported to Poison Centers — United States, 2000–2017. MMWR.
  5. CDC. Notes from the Field: Toxic Leukoencephalopathy Associated with Tianeptine Misuse — 2018. MMWR.
  6. CDC & Partners. 2024–2025 Notices on “Neptune’s Fix” and Tianeptine Poisonings — Health advisory/investigation summaries.
  7. CDC. Increasing Phenibut Exposures Reported to U.S. Poison Centers — 2009–2019. MMWR, 2020.
  8. CDC. Cannabis and Public Health: Health Effects and Risks of Concentrates/Vaping; EVALI Outbreak Summary, 2019.
  9. CDC Health Alert Network. Delta-8 Tetrahydrocannabinol (Δ8-THC) Products: Increasing Availability and Adverse Events — 2021 advisory.
  10. CDC. Yellow Book (Travel Health). Hallucinogens and plant/fungi-based intoxicants (e.g., ayahuasca, peyote, psilocybin, Salvia divinorum).
  11. CDC. Investigation of illnesses linked to “psychedelic” mushroom chocolates/gummies (Diamond Shruumz) — 2024 MMWR/recall coordination.
  12. CDC. Notes from the Field: Recreational Nitrous Oxide Misuse — Michigan, 2019–2023. MMWR, 2025.
  13. CDC. Yellow Book. Mad Honey (Grayanotoxin) poisoning — Food & environmental exposures section.

Compiled strictly from official CDC publications/pages. If CDC has not issued a dedicated bulletin for a substance (e.g., Salvia), that is noted above.