Physicians and state health officials in Texas are warning residents about the dangers of kratom products following an increase in reported health incidents related to the substance. Kratom, a plant-derived product with opioid-like effects, has been linked to various health problems, prompting calls for caution.
Michael P. Sprintz, DO, a pain and addiction medicine specialist and member of the Texas Medical Association (TMA) Committee on Behavioral Health, stated: “Using kratom is like buying an opioid on the street, with the same risks – and harder to stop using. Just because something is ‘natural’ or legal does not mean that it is safe.”
The TMA reports that some kratom products—particularly semi-synthetic or synthetic varieties—can contain up to 98% of the psychoactive compound 7-hydroxymitragynine (7-OH), significantly higher than unsynthesized versions, which typically have less than 2%. This high concentration raises concerns about potential dependence and abuse.
Kratom products are often marketed as remedies for pain or anxiety and as aids for opioid withdrawal. They are sold in various forms at gas stations, smoke shops, and online. According to the Texas Department of State Health Services (DSHS), symptoms associated with concentrated 7-OH exposure include high blood pressure, rapid heart rate, sweating, agitation, confusion, nausea or vomiting, and seizures.
The TMA presented these risks to the Texas Legislature in 2025 while supporting a bill aimed at prohibiting kratom and other hallucinogenic substances. The association cited dangers such as liver toxicity, seizures, and substance use disorders.
Despite lacking approval or regulation from the U.S. Food and Drug Administration (FDA), an estimated 1.7 million Americans aged 12 years or older used kratom in 2021. The TMA noted: “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 the Texas Poison Center Network show a notable rise in cases involving kratom or similar products this year; there were 192 reports by late August compared with 107 in all of 2024 and 122 in all of 2023. Of those exposed to concentrated 7-OH products in 2025, more than half required treatment at a healthcare facility.
Dr. Sprintz cautioned against using kratom for pain management due to uncertainties about its production standards and potency: “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. He explained that users can experience both opioid-type withdrawal 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.”
