Physicians and state health officials in Texas are warning residents against the use of kratom products following an increase in cases of harm linked to exposure to the opioid-like substance found in the plant. The Texas Medical Association (TMA) and the Texas Department of State Health Services (DSHS) have reported a rise in adverse health effects associated with kratom, particularly those products containing high concentrations of 7-hydroxymitragynine (7-OH), a psychoactive compound.
“Using kratom is like buying an opioid on the street, with the same risks – and harder to stop using,” said Michael P. Sprintz, DO, pain and addiction medicine specialist at TMA and member of the TMA Committee on Behavioral Health. “Just because something is ‘natural’ or legal does not mean that it is safe.”
Products with semi-synthetic or synthetic kratom can contain up to 98% 7-OH, significantly increasing potential health risks including dependence or abuse. By comparison, unsynthesized forms generally have less than 2% 7-OH content. Kratom is often sold as a natural remedy for pain, anxiety, or to ease opioid withdrawal symptoms but is available in various forms such as pills, gummies, candies, and imitation ice cream cones at gas stations, smoke shops, and online.
According to DSHS, symptoms related to concentrated 7-OH include high blood pressure, rapid heart rate, sweating, agitation, confusion, nausea or vomiting, and seizures.
In testimony before the Texas Legislature in 2025 supporting legislation to ban kratom and similar substances, TMA cited risks including liver toxicity, seizures, and substance use disorders. The association also noted that despite lacking approval or regulation by the U.S. Food and Drug Administration (FDA), about 1.7 million Americans aged 12 years or older used kratom in 2021. TMA stated: “Though the health effects of kratom still need to be further researched, studies so far have also shown risks of addiction and potential long-lasting cognitive and behavioral deficits among adolescents.”
Data from late August shows that the Texas Poison Center Network received 192 reports this year involving exposures to kratom or other products containing 7-OH—up from 107 reports in all of 2024 and 122 in all of 2023. Of those exposed to concentrated products this year alone (19 cases), more than half required medical treatment.
Dr. Sprintz emphasized that people seeking relief from pain should be aware of significant dangers tied to unregulated substances like kratom: “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. Withdrawal can resemble both opioid-type symptoms as well as those seen when discontinuing 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.”
