Treatment Centers Are Seeing a Kratom Wave the DEA's New Rule Won't Touch

Trace Swartzfager, the executive director of Laguna Treatment Center in Southern California, put a number on something his intake staff had been noticing anecdotally for months: in the first five months of 2026, 25 patients came in seeking help for kratom dependence. All of 2025 saw four. That’s a 525% jump at a single facility, in a single year, for a substance that’s still sold legally, on an open shelf, in most of the country.

The DEA is about to schedule kratom’s most concentrated form. The patients showing up at treatment centers this year were never buying the concentrated form — they were buying the supplement aisle.

Kratom — the ground leaf of a Southeast Asian tree, Mitragyna speciosa — has spent the last decade migrating from a niche import to a checkout-counter fixture, marketed on gas station shelves and supplement sites as a natural aid for energy, relaxation, and, pointedly, opioid withdrawal. At low doses it acts like a mild stimulant. At higher doses, or in its concentrated derivative form (7-hydroxymitragynine, or 7-OH), it acts on the same brain receptors as prescription opioids — which is exactly why it can treat withdrawal symptoms for some users, and exactly why Laguna’s Chief Operating Officer Chris Cummins is now watching people need treatment for the treatment: “Addiction to kratom can happen quickly, but recovery happens with the right help.” National surveillance data cited in Laguna’s release shows kratom-related exposure reports climbing 1,200% between 2015 and 2025 — a trajectory that outpaces almost every other substance this newsroom tracks.

The federal government tried this exact ban once before, and lost

The regulatory response arriving now has a direct ancestor, and it’s worth knowing the ending of that story before reading too much confidence into this one. In August 2016, the DEA announced its intent to place kratom’s core compounds into Schedule I on an emergency basis — the same legal tool used for heroin and LSD, requiring no public comment period first. It set off one of the more improbable grassroots reversals in modern drug policy: the American Kratom Association organized a demonstration outside the White House, a petition gathered more than 100,000 signatures, and dozens of members of Congress from both parties sent letters demanding the agency slow down. On October 12, 2016, the DEA withdrew the scheduling notice and opened a formal comment period instead — an almost unheard-of reversal for an agency that rarely un-announces a scheduling action.

Ten years later, the agency is trying a narrower version. Two notices filed July 1, 2026 would place concentrated 7-OH and three related synthesized compounds into Schedule I, at a specified concentration threshold — while explicitly exempting ordinary botanical kratom leaf below that threshold. DEA Administrator Terrance Cole framed it as targeting “highly concentrated, synthetic 7-OH products, which pose a growing threat to public safety.” HHS Secretary Robert F. Kennedy Jr. called the compounds “dangerous opioids that fuel addiction and put American lives at risk.” It’s a more surgical rule than 2016’s, built to survive the same backlash by leaving the leaf alone. But surgical bans have a blind spot: they regulate the product category, not the reason people bought it in the first place.

The reason people bought it in the first place is the actual story

Nobody at Laguna is describing patients who set out to buy an opioid-scheduled synthetic. Laguna’s own account of what’s driving admissions describes people who bought a bottle marketed as “natural” for pain, anxiety, or getting off something stronger — a description echoed by an ER physician writing in Forbes about the wider category of checkout-counter compounds now colloquially called “gas station heroin.” The 7-OH scheduling fight is about the extract at the dangerous end of the shelf. The patients arriving at treatment centers got there through the ordinary end of the same shelf, used exactly as the label suggested, for exactly the reason the label promised — and became physiologically dependent anyway, on a substance most of them never understood carried opioid-like risk at all.

Nobody at Laguna is describing patients who set out to buy an opioid-scheduled synthetic.

This is not a new story in American medicine, even if kratom is a new substance. For more than a century before the Harrison Narcotics Tax Act of 1914 brought opiates under federal control, Americans self-treated pain, cough, and — not infrequently — opioid withdrawal itself with over-the-counter “tonics” and “soothing syrups” that quietly contained morphine or opium, sold without a prescription because no framework existed yet to require one. The pattern has repeated with barbiturates, with early benzodiazepines marketed as harmless “mother’s little helper,” and now with a leaf sold next to the energy drinks. Each time, a substance fills a gap left by inaccessible or unaffordable medical care — and each time, regulation arrives only after a treatment population has already formed around the product regulators are now racing to catch up to.

What treatment programs need right now isn’t a schedule change

Treatment programs are the ones absorbing this shift in real time, and kratom withdrawal is its own clinical animal — it doesn’t map cleanly onto standard opioid-withdrawal protocols, and Cummins’s own framing (“recovery happens with the right help”) is a quiet admission that a lot of programs are still building that protocol as patients arrive. For the case manager or intake coordinator reading this: ask new clients directly and by name whether they’ve used kratom, 7-OH extract, or “gas station” energy/relaxation supplements in the last 90 days — it will not surface on a standard opioid panel, and a patient who doesn’t know kratom carries opioid-receptor activity has no reason to volunteer it. Treating it as an afterthought on an intake form is how a facility ends up managing an unrecognized opioid-type withdrawal as if it were simple anxiety.

Whatever happens to the DEA’s 7-OH rule in the coming weeks — and it will likely draw exactly the kind of organized pushback that killed the 2016 version, from a smaller and more concentrated set of manufacturers this time — it changes nothing for the person who’s already dependent on the version sold legally at the counter. The scheduling fight is about supply. The 25 people who walked into one treatment center this year are about demand that already exists, filled by a product nobody warned them carried a cost. That demand doesn’t wait for a Federal Register notice, and it isn’t going away when this one resolves either way.