Kolodny

Over the past century, new opioids have repeatedly been introduced with claims that they are fundamentally different from existing opioids and therefore safer or less addictive. Such claims have shaped clinical practice and regulatory policy, sometimes with profound negative public health consequences. One of the earliest examples followed Bayer’s introduction of heroin in the late 19th century, when company scientists claimed it was a safer, nonaddictive alternative to morphine.
Over the past decade, another opioid product has become widely available across the United States. Kratom, made from the leaves of a tree native to Southeast Asia, is now sold in the United States as dried powders, capsules, and concentrated liquid extracts and is widely available in gas stations and convenience stores. This growth in availability has been accompanied by a sharp rise in kratom-related harm. Between 2015 and 2025, US poison centers received 14,449 kratom exposure reports, rising from 258 in 2015 to a record 3434 in 2025—an increase of ~1200%