How state regulations shape kratom exposure and harm with Grant Comstock and Ryan FeldmanHow state regulations shape kratom exposure and harm with Grant Comstock and Ryan Feldman
Addiction Audio
Conversation centres on kratom, examining how different US state regulations relate to poison centre-reported harms and healthcare use. The guests highlight that bans show the clearest link with reduced severe outcomes while stressing the limits of current data and the need for further research.
21:37•26 Jun 2026
Kratom, State Laws and Harm: What the Data Say
Episode Overview
- Kratom is a plant-derived alkaloid with stimulant effects at low doses and opioid-like effects at higher doses, used for energy, relaxation and managing withdrawal.
- Kratom remains unscheduled at the federal level in the US, leaving individual states to decide whether to ban, regulate or leave it unregulated.
- Using poison centre data, the researchers found that only states with kratom bans had fewer severe medical outcomes and less healthcare use related to kratom.
- States with kratom consumer protection acts, including age limits and purity or labelling rules, did not show a clear reduction in severe harms compared with unregulated states.
- The guests stress the limits of current data and call for more robust, forward-looking research before drawing firm conclusions about the best regulatory approach.
“The presence of a ban is the only thing that is associated with either decreased use in prior study, as well as now decreased harm in our study.”
How do people find strength in their journey to sobriety when new substances keep popping up on the market? This conversation on Addiction Audio takes on kratom, a plant-based substance with both stimulant and opioid-like effects, and asks some tough questions about how laws shape harm.
Host Dr Tsen Vei Lim chats with Dr Grant Comstock and Dr Ryan Feldman from the Medical College of Wisconsin, who have analysed poison centre data across the United States to see how different state regulations relate to serious kratom-related harms. Kratom, as they explain, can be used for energy, relaxation, or even to manage opioid withdrawal, but it also comes with risks like dependence, seizures, heart problems and respiratory depression.
The heart of the episode centres on one striking result: state-level bans are the only regulatory approach linked with fewer severe medical outcomes and less healthcare use.
As Comstock puts it, “the presence of a ban is the only thing that is associated with either decreased use in prior study, as well as now decreased harm in our study.” Age limits, labelling rules and product purity standards, grouped under “kratom consumer protection acts”, didn’t show a clear difference in poison centre calls or severe cases. Feldman and Comstock are refreshingly honest about the limits of their work.
Poison centre calls are a “surrogate outcome”, they point out, and they’re wary of anyone rushing to say every state should ban kratom based on this single dataset. They push for better, forward-looking research and more detailed tracking of different kratom products, especially highly concentrated shots now sold in places like petrol stations. For anyone interested in addiction, policy, or the fine line between harm reduction and unintended consequences, this episode offers data, caution and plenty to think about.
How should policymakers balance access, safety, and the realities of substance use in everyday life?
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