DES MOINES— Governor Kim Reynolds, Iowa Department of Health and Human Services (HHS), and the Iowa Department of Public Safety (DPS) are warning Iowans about the increasing dangers posed by kratom and newly emerging, highly concentrated synthetic kratom‑related products.

Although kratom is often marketed as a natural or herbal supplement for pain, anxiety, or opioid withdrawal, officials stressed that availability does not equal safety.

“Kratom is not a supplement, it is not a medicine, and it is not safe,” Governor Reynolds said. “These products are widely accessible, often sitting on shelves in gas stations and convenience stores, and many Iowans may not realize the serious risks they pose.”

Kratom contains psychoactive compounds, including mitragynine and 7‑hydroxymitragynine (7‑OH), that act on opioid receptors in the brain. Dr. Robert Kruse, State Medical Director at Iowa HHS, emphasized growing concerns about concentrated and synthetic 7‑OH products.  “Concentrated and synthetic 7-OH products can have powerful opioid-like effects and pose serious health risks,” Kruse said. “The fact that these products are sold over the counter does not mean they are safe. They can lead to dependence, severe illness, overdose and death.”

Rising Impact in Iowa 
Iowa data show a rapid increase in serious outcomes related to kratom: 

• 45 kratom‑associated deaths have been confirmed since 2024, across 23 counties.
• 16 deaths occurred in the first seven months of 2026. 
• Iowa Poison Control has received 68 kratom exposure calls so far this year, a 467% increase over two years.

Federal Scheduling and Retailer Responsibilities
On August 26, 2026, the Drug Enforcement Administration classified three synthetic kratom‑derived compounds, mitragynine pseudoindoxyl, MGM‑15, and MGM‑16, as Schedule I controlled substances, with 7‑OH currently under review for emergency scheduling.

“Our officers are seeing firsthand how quickly these substances can lead to severe medical emergencies,” said DPS Commissioner Stephan Bayens. “When a product sold at a gas station can stop someone’s breathing, that’s a threat to every community in Iowa.”

Retailers are urged to review their shelves closely, as reliance on packaging claims may not prevent the sale of controlled substances.

What Iowans Should Do
State officials urge Iowans to take the following steps: 

• Avoid concentrated or synthetic 7‑OH products.
• Know the signs of an opioid‑type overdose and call 911 immediately if someone is unresponsive or not breathing normally. 
• Use naloxone if available. Because 7‑OH acts on opioid receptors, naloxone can rapidly reverse its effects and is safe to administer when the substance is unknown.
• Seek help early for concerns about kratom dependence or withdrawal. 
• Call or text 988 for crisis support.
• Contact Your Life Iowa at 855‑581‑8111, text 855‑895‑8398, or visit YourLifeIowa.org. 
• For non‑emergency concerns about adverse reactions, call Poison Help at 1‑800‑222‑1222. 

“We need every parent, every caregiver, and every community member aware of these risks,” Governor Reynolds added. “Your Life Iowa offers confidential, 24/7 support so Iowans can get help when they need it.”

Iowa HHS will expand its statewide public health campaign to include new messaging alerting Iowans to the dangers of kratom and synthetic 7‑OH. 

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