Gas-station kratom products associated with 45 Iowa deaths as poison calls soar

DES MOINES — A psychoactive substance sold openly at Iowa gas stations and convenience stores has been associated with 45 deaths since 2024 as poison-control calls involving the products continue to soar.

Gov. Kim Reynolds, the Iowa Department of Health and Human Services and the Iowa Department of Public Safety issued a statewide warning Tuesday about kratom and newly emerging products containing highly concentrated or synthetic 7-hydroxymitragynine, commonly called 7-OH.

“Kratom is not a supplement, it is not a medicine, and it is not safe,” Reynolds said.

Kratom is frequently marketed as a natural or herbal product capable of relieving pain and anxiety or easing opioid withdrawal. State officials warned that its presence on store shelves should not be mistaken for government approval or proof that the products are safe.

Kratom contains psychoactive compounds, including mitragynine and 7-OH, that interact with the same brain receptors affected by opioids. Concentrated and synthetic 7-OH products can produce powerful opioid-like effects capable of causing dependence, severe illness, overdose and death.

Iowa’s numbers show the problem escalating rapidly:

• 45 kratom-associated deaths have been confirmed since 2024 across 23 Iowa counties.
• 16 deaths were recorded during the first seven months of 2026.
• 68 kratom exposure calls were received by Iowa Poison Control during that period.
• Exposure calls have increased 467 percent in two years.

Iowa State Medical Director Dr. Robert Kruse said concentrated and synthetic 7-OH products carry serious health risks despite being available without a prescription.

DPS Commissioner Stephan Bayens said officers have witnessed how quickly the substances can produce severe medical emergencies. A product capable of stopping a person’s breathing, he warned, poses a threat regardless of whether it was purchased from a dealer or a convenience-store shelf.

The federal Drug Enforcement Administration placed three synthetic kratom-related compounds — mitragynine pseudoindoxyl, MGM-15 and MGM-16 — into Schedule I of the Controlled Substances Act effective August 26.

Possession, sale or distribution of those compounds outside limited federally authorized circumstances is now illegal. Highly concentrated 7-OH remains under federal review for emergency scheduling.

The federal action targets synthesized products and substances containing elevated concentrations of 7-OH. It does not apply to ordinary botanical kratom containing only naturally occurring trace levels below the federal threshold.

Retailers are being urged to inspect their merchandise closely. State officials warned that trusting labels or packaging may not protect a business from selling a product containing an illegal controlled substance.

The kratom warning adds another front to Iowa’s struggle with opioid-like substances. State officials previously warned Iowans about deadly fentanyl and counterfeit pills capable of killing unsuspecting users.

Iowa has also directed millions of dollars toward treatment and recovery programs. More than $10 million was awarded to opioid recovery and treatment projects, including programs serving Mason City and other Iowa communities.

Officials urged Iowans to avoid concentrated and synthetic 7-OH products and learn the warning signs of an opioid-type overdose. Anyone who is unresponsive or not breathing normally requires immediate emergency assistance.

Call 911 and administer naloxone if it is available. Because 7-OH acts on opioid receptors, naloxone may rapidly reverse its effects and is considered safe to administer even when the substance involved is unknown.

People concerned about kratom dependence or withdrawal should seek assistance before the situation becomes an emergency. Crisis support is available by calling or texting 988.

Confidential help is also available through Your Life Iowa by calling 855-581-8111 or texting 855-895-8398. Non-emergency questions about possible adverse reactions may be directed to Poison Help at 1-800-222-1222.

Iowa HHS plans to expand its statewide public-health campaign with new warnings about kratom and synthetic 7-OH products.