Louisiana’s opioid deaths fell before kratom ban; law’s impact remains unproven

BATON ROUGE, La. — Louisiana’s opioid deaths were falling sharply before lawmakers criminalized kratom, leaving an unanswered question more than a year after the ban took effect: Did prohibiting the substance make residents safer?

State health figures show opioid-related deaths declined 59% between 2022 and 2025, compared with a 46.2% national decline. Louisiana also recorded a 52% reduction in opioid-related emergency department visits and a 10% decrease in opioid prescriptions per 100 residents. The 2025 figures remain preliminary.

Much of that improvement preceded the prohibition. A Louisiana Department of Health surveillance presentation documented a 45% decline in opioid overdose deaths from 2022 through 2024, alongside a 9% increase in buprenorphine prescriptions. Buprenorphine is used to treat opioid use disorder.

Kratom remained legal statewide during that period. The overlapping trends do not establish that kratom reduced deaths. They do establish that Louisiana’s progress began before the ban — and that the broader decline cannot, by itself, demonstrate the law’s effectiveness.

Act 41, sponsored by Sen. Jay Morris, passed the Senate 26-11 and the House 89-5. Gov. Jeff Landry signed it June 4, 2025, and it took effect Aug. 1. The law prohibits kratom possession and distribution and places its principal compounds, mitragynine and 7-hydroxymitragynine, on Louisiana’s Schedule I controlled-substance list.

Possession of 20 grams or less carries a maximum $100 fine. A first conviction involving more than 20 grams can bring six months in parish jail, a fine of up to $500, or both. Subsequent convictions involving that amount carry a maximum $1,000 fine and the same possible jail term.

Manufacturing, distributing or possessing kratom with intent to distribute carries substantially greater penalties: one to three years of imprisonment for less than 500 grams and one to five years for 500 grams or more, with fines of up to $50,000.

The prohibition covers traditional leaf products and concentrated derivatives alike. Federal regulators have taken a more targeted approach.

Kratom comes from a Southeast Asian tree whose leaves contain compounds that interact with opioid receptors. Natural leaves contain small amounts of 7-hydroxymitragynine, commonly called 7-OH. Commercial products with added or enhanced concentrations can deliver substantially different exposures.

The Food and Drug Administration’s July 2025 initiative targeted concentrated 7-OH products rather than natural kratom leaf. In July 2026, the Drug Enforcement Administration began a temporary scheduling process directed at certain concentrated and synthetic products, again distinguishing them from natural leaf containing trace amounts of 7-OH.

That distinction matters when interpreting national safety figures.

A March 2026 Centers for Disease Control and Prevention study identified 14,449 kratom exposure reports to poison centers from 2015 through 2025. Annual reports rose from 258 to 3,434, an increase of approximately 1,200%. Researchers recorded 233 associated deaths; 184, or 79%, involved multiple substances.

Those figures are poison-center reports, not a complete count of U.S. deaths involving kratom. Researchers could not distinguish traditional leaf from concentrated products or determine which substance contributed most to an individual outcome. The data therefore cannot establish a nationwide fatality rate or isolate the risks of each formulation.

An earlier CDC examination of 27,338 overdose deaths found kratom in 152 cases. Medical examiners or coroners identified it as a cause in 91. Seven had no other substance detected, although investigators cautioned that additional drugs could not be ruled out.

The National Institute on Drug Abuse says deaths attributed to kratom alone appear extremely rare, while acknowledging dependence, withdrawal and other health risks. Kratom has no FDA-approved medical use.

Evidence that some consumers use it to reduce opioid use is largely observational. A study published in 2020 surveyed 2,798 kratom users; 1,144 said they used it to reduce or stop prescription or illicit opioids, and 411 attributed more than a year of opioid abstinence to kratom. Because participants volunteered and reported their own experiences, the findings do not establish clinical effectiveness.

Critics of Louisiana’s ban argue that removing access could push some consumers toward alcohol, illicit opioids or unregulated sellers. Accounts cited in the debate include New Orleans residents who used kratom for alcohol cravings or persistent pain. Those experiences identify potential consequences worth examining, but they do not establish that prohibition caused relapses or deaths.

Maryland offers an example of a different policy and a way to monitor its consequences. The state regulated traditional kratom in 2024 and prohibited high-potency 7-OH sales in July 2026.

Its drug-checking program reported three samples containing 7-OH during the second quarter of 2026. One contained only 7-OH; two contained additional substances, including fentanyl, methamphetamine, medetomidine and anesthetics. Because the samples preceded the July prohibition, they cannot show that the ban caused contamination. Maryland officials nevertheless said they would monitor changes in the unregulated supply.

Louisiana faces its own evolving threats. On Aug. 25, the DEA warned St. Tammany, Tangipahoa and Washington parishes about nitazenes following a surge in fatal overdoses. These potent synthetic opioids can appear in counterfeit pills and other drugs without a buyer’s knowledge.

Another emerging opioid, cychlorphine, has appeared in Louisiana’s illicit supply. Medical toxicologists warn that routine hospital opioid and fentanyl screens may not detect it. Neither warning establishes a connection to former kratom consumers or proves that Louisiana’s statewide mortality decline has reversed.

The debate also intensified after University of Mississippi students Aidan Hamilton and Robert Strang died in separate incidents Sept. 21. Kratom products were found during the investigations, but subsequent accounts continued to describe the causes of death as under investigation. Finding a package or detecting a substance does not, by itself, establish what caused a death.

For Louisiana, evaluating the prohibition requires more than counting arrests or comparing annual death totals. Treatment entry, emergency visits, relapse patterns and changes in the drug supply would help determine what happened to people who previously used kratom.

The available figures establish a substantial improvement before prohibition. They leave the ban’s contribution — beneficial or harmful — unresolved.