Kratom • Poison Control Data (NPDS) • MAHA

Kratom Poison Control Data (U.S. Poison Centers, 2019–2024)

Year	Total Cases (Case Mentions)	Single-Substance	Pediatric < 20 yrs (≤5 + 6–12 + 13–19)	Adults ≥ 20	Intentional	Treated in HCF	Outcome: None	Minor	Moderate	Major	Deaths
2019	1,357	885	102	733	540	713	63	203	275	78	3
2020	1,262	794	103	637	513	614	59	175	259	66	5
2021	1,524	948	139	741	588	712	69	213	305	67	4
2022	1,278	794	107	586	497	586	66	167	248	55	3
2023	1,489	880	106	723	519	671	60	184	305	70	5
2024	1,645	1027	149	820	608	803	92	233	332	76	7

Sources: America’s Poison Centers® NPDS Annual Reports, Appendix B (Table 22A/22B) 2019–2023. Pediatric counts are combined (≤5 + 6–12 + 13–19). HCF = treated/managed in a Health Care Facility.

total case mentions: 8,555 Single-substance totals: 5,328 Serious outcomes remain common

2023 “New & Emerging” Findings for Kratom

Severity: Among single-substance cases with known outcomes, 57.6% of kratom exposures produced a moderate/major/fatal effect (third-highest after tianeptine and phenibut).
Hospitalization: 34.3% of kratom exposures resulted in hospital admission.
Withdrawal: 4.76% of all kratom exposures were coded for withdrawal; of those seen in healthcare, 33.5% were admitted, and 13.5% of withdrawal calls originated from home.
Bottom line: Despite unregulated retail availability, kratom shows high rates of clinically significant toxicity and frequent healthcare utilization—be prepared for both acute overdose and withdrawal management.

Extracted from the 2023 NPDS Annual Report “Emerging Trends” analysis of kratom, phenibut, tianeptine, and nitrous oxide.

Pediatric Kratom Exposures (NPDS, 2019–2024)

Reported pediatric exposures to U.S. poison centers, categorized by age group. Data derived from NPDS Annual Reports (Appendix B, Table 22A/22B).

Year	<5 yrs	6–12 yrs	13–19 yrs	Total Pediatric
2019	60	3	39	102
2020	63	5	35	103
2021	91	5	43	139
2022	67	3	37	107
2023	71	3	32	106
2024	107	6	37	150

Source: America’s Poison Centers® NPDS Annual Reports, 2019–2024.

<5 yrs is dominant category 2024 highest on record Increase driven primarily by youngest children

Trend Interpretation

Children under five represent the largest pediatric exposure group each year. After relative stability in 2019–2020, exposures increased sharply in 2021, declined modestly in 2022–2023, and reached a new high in 2024 (107 cases).

Exposures among ages 6–12 remain low and relatively stable. Adolescent exposures (13–19) fluctuate moderately but do not show the same upward trajectory observed in the youngest age group.

Total pediatric exposures increased from 102 in 2019 to 150 in 2024. The majority of this increase is attributable to children under five.

Do <5 Exposures Include Neonates?

Poison center annual reports capture exposures reported directly to poison centers. Neonatal cases (including potential withdrawal) would only appear in the <5 category if a poison center call was made and coded as an exposure.

Many neonatal withdrawal cases are managed in hospital settings without poison center involvement. Those cases may appear in hospital discharge datasets or neonatal abstinence surveillance systems, but not necessarily in NPDS exposure totals.

Poison-Center & Toxicology Literature (PubMed)

Kratom exposures reported to United States poison control centers (2011–2017). Epidemiologic analysis of 1,807 exposures; ~52% serious outcomes; 11 deaths. PubMed
Kratom exposures among older adults reported to U.S. poison centers. 2014–2019 data; highlights higher adverse-reaction rates in ≥70. PubMed
Characteristics of deaths associated with kratom use. Fatal case characteristics; polysubstance risk emphasized. PubMed
A case of kratom overdose in a pediatric patient. 15-year-old with massive ingestion; serious cardiotoxicity noted. PMC
Legally lethal kratom: a herbal supplement with overdose potential. Case report of severe toxicity requiring intubation. PubMed

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