Maizie Hepner walked into a kava bar in Dubuque, Iowa last year expecting herbal tea. The 24-year-old bartender left hooked on kratom, a plant-derived substance with opioid-like properties that she consumed three to four times weekly before progressing to powder stirred into her own drinks.
When she asked the bar owner if it was addictive, she said he denied it flatly. Within months, her body told a different story. "I just didn't feel like myself without it," Hepner recalled. "I would start to get sweaty and irritable."
Her experience mirrors a growing public health concern. At least eight states have already moved to restrict or ban kratom entirely, and lawmakers across the country are weighing similar measures as emergency room visits and deaths spike. The substance, marketed as a benign herbal alternative, is increasingly sold at gas stations, convenience stores, and smoke shops under brand names that obscure what customers are actually consuming.
The numbers tell a stark story of escalation. In 2015, the United States recorded 43 hospitalizations tied solely to kratom, according to University of Virginia research. By 2025, that figure had climbed to 538. The jump coincides with the emergence of synthetic variants, particularly one called 7-OH, which manufacturers claim is vastly more potent than the plant powder itself.
Idaho reported that kratom appeared as a contributing factor in 47 deaths between 2021 and 2023, though toxicology reports in those cases also showed other substances, primarily opioids. In Bonneville County, the coroner documented four deaths in an eighteen-month span attributed solely to mitragynine, the primary active compound in kratom. That announcement, released in October 2025, prompted the largest city in the county, Idaho Falls, to ban sales effective July 1.
Lawmakers in Iowa have taken the most aggressive stance. The state house approved legislation in March that would criminalize possession of kratom. The bill has not yet been signed into law, but if enacted would make Iowa the ninth state with an outright prohibition. Seven other states already enforce bans: Alabama, Arkansas, Connecticut, Indiana, Louisiana, Tennessee, Vermont, and Wisconsin.
"It is increasing the prevalence of opioid use disorder," said Dr. Andrew Kolodny, director of the Opioid Policy Research Collaborative at Brandeis University. "Being able to buy an opioid at a convenience store is going to make the opioid crisis worse."
The kratom industry, however, disputes this framing. The American Kratom Association insists that only synthetic versions like 7-OH pose genuine danger, not the plant-based powder. Mac Haddow, a senior fellow on public policy for the association, argued that kratom itself is not addictive and that deaths attributed to it involve other substances. He claimed people with "addiction personality" may misuse kratom as they would any substance, suggesting a mental health issue rather than a physiological one.
The strategy has proven effective in some legislative battles. New York state assembly member Phil Steck co-sponsored bipartisan legislation that passed this month, which the governor must still approve, that would ban 7-OH specifically while leaving plant-based kratom products legal. The state previously required warning labels on natural kratom items after legislation Steck sponsored was approved last year.
"The two products are substantially different," Steck said, defending the distinction. "I would not go out and say that you can use the so-called natural product to an unlimited extent, but" the synthetic variant warrants separate treatment.
Kolodny views this argument as misleading. "Many policy makers seem to have fallen for" the claim "that all of the harms associated with kratom are limited to these 7-OH products and that the kratom leaf products are benign herbal supplements helping millions of Americans," he said.
In Idaho, the American Kratom Association's business arm has taken direct action. Happy Hippo and its parent company Animal Farm, along with affiliated entities, donated more than $34,000 to campaigns for state office seekers between 2024 and 2026, according to campaign finance records. The donations did not prevent Idaho Falls from moving forward with its ban.
John Radford, an Idaho Falls city council member who runs a nonprofit serving economically disadvantaged people, said he has spoken with hundreds of individuals attempting to quit drugs who switched to kratom believing it would not trigger a positive urinalysis. "They said it was harder for them to come off of kratom than it was some of their other drugs," he said.
Not all voices favor prohibition. Eric Schiesl, who works as a kavatender at the Kava Kava bar where Hepner first consumed kratom, credits the establishment with helping him achieve three years of sobriety. He said the social environment and kava and kratom offerings contributed to his recovery. "We definitely stress moderation," Schiesl said, and he has not heard customers report addiction from kratom use.
Schiesl opposes criminalization, invoking history. "Prohibition didn't work, and it led to more crimes," he said.
The Kava Kava bar itself has pushed back against Iowa's proposed legislation, posting on Facebook that the ban threatens the rights of "kava and sober communities to access natural plant-based alternatives." The bill does not address kava, and no jurisdiction has targeted it for restriction.
Hepner, the bartender who sparked this account, decided to quit kratom this month. She had read about its dangers and discovered a fundraising page from an Iowa family whose father had died from a kratom overdose. The withdrawal was brutal: a three-day fever, tremors, and difficulty eating solid food. But she is recovering without cravings.
"I think that it's unsafe, and I think there's not a lot of knowledge about it," Hepner said. "That is how people fall into it."
Author James Rodriguez: "The kratom fight exposes how industry money and incremental regulation can keep a dangerous substance on convenience store shelves while people suffer addiction and death, and Hepner's story proves ignorant marketing kills."
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