Iowa officials have confirmed 45 kratom-associated deaths across 23 counties since 2024, including 16 in the first seven months of this year, and Gov. Kim Reynolds is now calling for a total statewide ban on a product still sold openly beside energy drinks and snacks.
The figures were released at a September 1 press conference and posted by the Iowa Department of Health and Human Services. Iowa Poison Control has fielded 68 kratom exposure calls so far this year, which the state describes as a 467 percent increase over two years.
For households, the practical issue is that the product involved is often not the leaf tea sold in health stores a decade ago. Officials are warning specifically about concentrated and synthetic versions built around 7-hydroxymitragynine, known as 7-OH, a compound that acts on the same brain receptors as opioids and can suppress breathing.
Gas Station Shelves and a Regulatory Gap
Kratom comes from a Southeast Asian tree, Mitragyna speciosa. Its leaves contain mitragynine and small amounts of 7-OH. At low doses the plant acts more like a stimulant; at higher doses the effects resemble opioids. What has changed is that manufacturers now sell tablets, gummies, drink mixes, and concentrated shots in which 7-OH levels far exceed anything found in the leaf.
"Kratom is not a supplement, it is not a medicine, and it is not safe," Reynolds said at the briefing, according to the Iowa Capital Dispatch. She added that the products are widely accessible and that many Iowans may not recognize the risks.
Robert Kruse, the state medical director at Iowa HHS, focused on the concentrated versions specifically, saying they can produce "powerful opioid-like effects and pose serious health risks." Being sold over the counter, he said, does not make them safe, and they can lead to dependence, severe illness, overdose, and death.
Iowa Department of Public Safety Commissioner Stephan Bayens framed the problem in terms of what is actually inside the package, calling a gas station product that can stop someone's breathing "a threat to every community in Iowa." He urged retailers to examine specific products on their shelves rather than rely on packaging claims, warning that doing so could mean selling controlled substances unlawfully.
The FDA has not approved kratom or 7-OH for any medical use.
Poison Center Calls Climb Across Twenty-Three Counties
The 45 confirmed deaths since 2024 are spread across 23 of Iowa's 99 counties, which means this is not a Des Moines or Cedar Rapids problem confined to one metro. Sixteen of those deaths occurred between January and July of this year.
The state has not published a year-by-year breakdown of the remaining deaths, and officials did not release one at the briefing.
On potency, the figure federal regulators have used publicly is not Iowa's. The FDA, citing published pharmacology, has described 7-OH as roughly 13 times more potent than morphine. That describes laboratory measurements of the isolated compound, not the strength of any particular retail product.
Iowa is not an outlier in raising the alarm. The FDA issued warning letters to seven companies in mid-2025 for illegally marketing concentrated 7-OH tablets, gummies, drink mixes, and shots, and later seized about 73,000 units of these products, worth roughly $1 million, from three firms in Missouri.
Families Checking Cabinets and Reading Labels
The most useful thing a parent or caregiver can do this week is learn what these products look like, because they are not labeled in a way that signals risk.
They appear as tablets, gummies, powdered drink mixes, capsules, and small concentrated liquid shots, often marketed with terms like plant alkaloids, enhanced, or super. Marketing language commonly references pain, anxiety, low mood, energy, or opioid withdrawal. Packaging may not disclose actual 7-OH concentration, and because these products are unregulated, the amount can vary between batches of the same brand.
That variability is the core hazard. A person who tolerated one bottle may take the same amount from a different lot and receive a substantially larger dose.
Signs of an opioid-type overdose apply here: unresponsiveness, slowed or stopped breathing, blue or gray lips or fingertips, and pinpoint pupils. Iowa officials advise calling 911 immediately. Naloxone, sold as Narcan and available without a prescription at pharmacies, reverses opioid effects, and state officials say it is safe to give even when the substance involved is unknown.
People who use kratom regularly should not stop abruptly without medical guidance, since withdrawal from opioid-acting substances can be physically difficult. Iowa directs residents with dependence or withdrawal concerns to Your Life Iowa at 855-581-8111 or YourLifeIowa.org, and to the 988 line for crisis support. Poison Help at 1-800-222-1222 handles non-emergency questions about adverse reactions.
Legislative Session Ahead and Federal Scheduling Pending
Two tracks are moving at once, and neither is finished.
Federally, the Drug Enforcement Administration classified three synthetic kratom-derived compounds, mitragynine pseudoindoxyl, MGM-15, and MGM-16, as Schedule I controlled substances on August 26, 2026. Concentrated 7-OH itself remains under review for emergency scheduling and is not yet federally controlled.
At the state level, officials said the Iowa Board of Pharmacy is considering emergency rules to address synthetic kratom, but broader change would require legislation. The Iowa House passed House File 2133 by a 69 to 26 vote earlier this year, a bill that would have made kratom and its synthetic equivalents Schedule I substances. The Senate companion, Senate File 2192, never reached a floor vote, so kratom products other than the three newly scheduled compounds remain legal to sell and possess in Iowa. Reynolds said she supported the measure and wants a total ban, arguing that anything narrower is too easy to work around.
That approach has critics inside her own party. Rep. Ray Sorensen, a Creston Republican, proposed an amendment during the session that would have capped dosages and added age limits, labeling, and testing requirements rather than banning the products outright. "Prohibition removes safety controls," he argued, saying a legal market can be tested and regulated while a black market cannot. His amendment failed 44 to 51, which is also why Iowa still has no minimum purchase age for these products.
Iowa HHS said it will expand its statewide public health campaign to include new messaging about kratom and synthetic 7-OH.
Neither federal scheduling nor a state ban removes products already sitting in homes. Until then, the reasonable steps for households are to check whether these products are present, to avoid concentrated or synthetic 7-OH items, to avoid using them alone or alongside alcohol, and to keep naloxone available. Anyone considering kratom for pain, anxiety, or opioid withdrawal should raise it with a clinician, since approved treatments exist for all three and carry known dosing.
Key Questions Answered
What exactly did Iowa officials announce? At a September 1, 2026 press conference, Gov. Kim Reynolds and state health and public safety officials reported 45 kratom-associated deaths since 2024 across 23 counties, 16 of them in the first seven months of 2026, and 68 kratom exposure calls to Iowa Poison Control this year. Reynolds called for a total statewide ban.
Is kratom currently illegal in Iowa? No. Kratom remains legal to sell and possess in Iowa, and there is no statewide minimum purchase age. Three synthetic kratom-derived compounds became federally controlled on August 26, 2026, and the Iowa Board of Pharmacy is considering emergency rules on synthetic versions, but a full state ban would require legislation.
What is 7-OH and how is it different from regular kratom? 7-hydroxymitragynine is a compound that occurs in trace amounts in kratom leaves and produces much of the plant's opioid-like effect. Products marketed as concentrated, enhanced, or synthetic 7-OH contain far higher levels than the leaf and carry a greater risk of respiratory depression.
What should someone do if they find a kratom product at home? State officials advise avoiding concentrated or synthetic 7-OH products. Anyone who uses kratom regularly should speak with a clinician before stopping, because withdrawal can be difficult. Keeping naloxone on hand is a reasonable precaution in households where these products are present.
How would someone recognize an overdose? Warning signs match those of an opioid overdose: unresponsiveness, slowed or absent breathing, blue or gray lips or fingertips, and pinpoint pupils. Call 911 immediately and administer naloxone if it is available.
Does the FDA approve kratom for pain or anxiety? No. The FDA has not approved kratom or 7-OH for any medical use and has warned companies that marketing drugs containing 7-OH is unlawful. Products claiming to treat pain, anxiety, or opioid withdrawal have not been shown to be safe or effective for those purposes.
Where can Iowans get help for kratom dependence? Iowa officials point to Your Life Iowa at 855-581-8111, by text at 855-895-8398, or online at YourLifeIowa.org. The 988 line handles crisis support, and Poison Help at 1-800-222-1222 answers non-emergency questions about adverse reactions.
