Addiction treatment facilities nationwide are experiencing a significant surge in patients presenting with dependence on kratom-derived products, according to recent clinical reports. At Boulder Care, a telehealth addiction clinic, the proportion of new patients reporting kratom use rose from 3% in September 2025 to 14% in August 2026. Similarly, two inpatient clinics operated by the Recovery Centers of America in Massachusetts reported an increase from approximately one patient per week to between 10 and 20 patients weekly seeking treatment for kratom or 7-hydroxymitragynine dependence.
Kratom, a plant native to Southeast Asia traditionally sold as powder or tea, has been available in the U.S. for decades. Newer formulations contain highly concentrated levels of 7-hydroxymitragynine, a compound naturally present only in trace amounts in kratom leaves. This alkaloid acts directly on the brain’s opioid receptors, producing opioid-like effects including sedation and euphoria. Federal survey data indicates that lifetime kratom use among Americans increased from approximately 4 million people in 2019 to 5 million by 2023. Reports to U.S. poison centers regarding kratom exposure increased from 258 to 3,434 over the past decade, with a particularly sharp rise in 2025.
Clinicians report treating withdrawal symptoms that can be severe, with some medical professionals indicating they manage these cases similarly to opioid or heroin withdrawal. Common symptoms include agitation, sweating, anxiety, and gastrointestinal distress. Users frequently report rapid tolerance development and the need to increase doses quickly. Many patients begin using these products for pain relief, anxiety, or energy, unaware of the potential for physical dependence, particularly with newer concentrated formulations. Some individuals previously in remission from opioid use disorders have experienced relapse after using kratom products.
The Food and Drug Administration has identified 7-hydroxymitragynine products as an emerging opioid threat, and the Drug Enforcement Administration has proposed restrictions on these compounds. Several states have already enacted similar limitations. Clinicians suggest that regulatory actions may be prompting increased treatment-seeking behavior among dependent users. Early case reports indicate that medications used for opioid use disorder, including buprenorphine and methadone, show potential for managing kratom use disorders, though limited research exists on this treatment area.
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