CDC Study Warns Against Consuming Kava-Kratom Drinks

By Pat Anson

For the second time in a week, the CDC has released a study warning of “serious medical outcomes” for people who consume kratom, a controversial supplement used by millions of Americans as a stimulant and pain reliever.

This time, the study focuses on the co-use of kratom with kava, a plant in the pepper family used to make a coffee-like drink that promotes relaxation and improves mood. 

Consumption of kava declined after the FDA warned in 2002 that it could cause severe liver injury. But consumption began rising about a decade ago, as drinks containing both kava and kratom rose in popularity among young people.

“These commercial products are commonly marketed as healthy alternatives to alcohol, sold near college campuses, and increasingly being combined with kratom, a psychoactive botanical with opioid-like effects, raising safety concerns,” wrote lead author Christopher Holstege, MD, Professor of Emergency Medicine and Pediatrics at the University of Virginia School of Medicine.

Holstege and his colleagues reported in the CDC’s Morbidity and Mortality Weekly Report (MMWR) that kava-related calls to U.S. poison control centers rose 383% from 2011 to 2025 (from 57 cases to 203). About a third of the kava calls in 2025 also involved kratom. 

“These data indicate a resurgence of overall kava exposure reports to poison centers, as well as an increase in kratom-related kava reports, which has coincided with higher rates of serious clinical outcomes. The findings in this report suggest the need for enhanced surveillance for, clinical awareness of, and public education regarding commercial products containing kava,” Holstege said.

Nearly half (43%) of the kava-related calls involve other substances, including ethanol (alcohol) and benziodiazepines. While most adverse effects were minor, such as nausea and dizziness, about a third resulted in hospitalizations or serious outcomes. Eight kava-related deaths were reported during the study period.

Last week the same group of researchers warned in another MMWR report that kratom-related calls to U.S. poison control centers rose by 1,200% over the past decade. While that appears to be a startling increase, it’s a misleading number that represents only a tiny fraction (0.28%) of the estimated 5 million kratom users.

A MMWR report in 2016 was used by the DEA to justify its efforts to have the kratom alkaloids 7-hydroxymitragynine (7-OH) and mitragynine listed as Schedule One controlled substances, a move that would have effectively banned kratom. That report was also based on calls to poison control centers.

The DEA dropped its proposal after a public outcry. A top federal health official in the first Trump administration later admitted the scheduling request was based on “embarrassingly poor evidence & data” from the FDA and could result in “substantial risk to public health” if kratom were made illegal.

The growing controversy over potent forms of 7-OH recently revived efforts by the FDA to have the DEA list 7-OH as a controlled substance, but not natural leaf kratom. The DEA has yet to act on that request. 

A controversial drink that contains kava and natural leaf kratom is Feel Free Classic, made by Oklahoma-based Botanic Gardens. Media stories claimed the drink is addictive, has “opioid-like effects” and is “hooking young people.”  

A class action lawsuit was filed against Botanic Gardens that alleged it used misleading advertisements to promote Feel Free as a healthy alternative to alcohol. The company settled the case for $8.75 million, and agreed to put stronger safety warnings on Feel Free bottles and limit sales to people 21 and older. 

In 2023, the FDA seized nearly 250,000 bottles of Feel Free, alleging the drink was an adulterated substance with inadequate safety information. Over a year later, the FDA quietly dropped the case.

A small short-term clinical study funded by Botanic Gardens found that Feel Free was “generally safe, with only mild to moderate AEs (adverse events) reported, which were all transient in nature.”

Moral Panic Over Herbal Drink Stirs Anti-Kratom Hysteria

By Crystal Lindell 

Last month, a TikTok influencer who goes by the name “YourBestieMisha” posted a video claiming that he was harassed at a Texas gas station by a teenager craving for a drink called “Feel Free.” 

The drink, which is sold in little blue bottles, is made by Oklahoma-based Botanic Tonics. It’s infused with kava root, natural leaf kratom, and other herbs. 

In the video, Michael “Misha” Brown alleges that as he was going into the gas station, he was approached by a "child" who seemed to be about 14 years old.

In Texas, you have to be at least 18 to buy kratom, so when the teen asked Brown to help him get Feel Free, Brown said no. That’s when the teen lunged for his wallet, which Brown says he was able to pull away from the boy. 

Brown then went into the gas station and shared what happened with the clerk, who told him Feel Free is so addictive that people are coming in five or six times a day to purchase a bottle.

“So I get home and look into this and people are literally going to rehab over this drink that is legal in most states in the U.S. and is sold in gas stations,” Brown says in the video. “I don't think we talk enough about things that are legal but are sold next to gum and energy drinks.”

The video has amassed more than 23 million views. However, there does not appear to be any follow-up videos posted by Brown elaborating on his story, or providing any evidence that any of it actually happened. 

MICHAEL “MISHA” BROWN (TIKTOK VIDEO)

In fact, the video has all the classic hallmarks of a “moral panic” story, which is an exaggerated fear or anxiety about something that is fueled by media attention or a video going “viral” online. In this case, there’s the implied harm to a child, no way to verify any of it, and an incentive for the creator to embellish and exaggerate his claims. 

Brown, who is an aspiring actor and singer, has posted thousands of videos online and has over three million followers on TikTok. He also has a podcast and is working on a book. Like other social media influencers, Brown’s income comes from advertising revenue, which is based on the number of views his videos get.

Even if his gas station story actually happened, there’s still a lot to unpack. 

Aside from the fact that children can already purchase excessive amounts of caffeine all on their own, both cigarettes and alcohol are also “things that are legal,” and are sold right next to gum and energy drinks in gas stations across the country. 

The makers of Feel Free have already self-imposed an age restriction for customers to be 21 and older. So if the teen in Brown’s story was hooked on Feel Free, then an adult was helping him get it long before the run-in at the gas station. 

And yes, that is a problem, just like it would be a problem if an adult was buying vodka for a 14-year-old. However, most will agree that doesn’t mean vodka should be illegal for adults.

Videos like Brown’s are concerning because they have the potential to spark real policy debates and hysteria from people who know nothing about kratom, a dietary supplement used by millions for pain relief or as an energy booster. 

The safety of kratom became a hot topic again when the FDA recently announced plans to make the kratom alkaloid 7-hydroxymitragynine (7-OH) an illegal Schedule One controlled substance. 7-OH occurs naturally in kratom in trace amounts, but some kratom vendors sell a concentrated, synthetic version of 7-OH to boost its potency.

Although Feel Free contains very little 7-OH, many media stories have conflated the two, implying the drink has “opioid-like effects” and is “hooking young people.”

In 2023, a class action lawsuit was filed against Botanic Tonics, alleging that Feel Free was misleadingly advertised as a healthy alternative to alcohol. The company settled the case for $8.75 million and agreed to put stronger safety warnings on its products.

Botanic Tonics responded to this latest uproar by trying to differentiate Feel Free from 7-OH, and “applauding” the FDA for its move. 

"Our products contain trace amounts of 7-OH that occur naturally during the traditional drying process — levels that are dramatically different from the concentrated synthetic products now under FDA scrutiny," said Cameron Korehbandi, CEO of Botanic Tonics. "The difference between natural leaf kratom and synthetic 7-OH concentrates represents a night and day distinction in terms of safety and consumer protection."

In my opinion, this was a huge mistake for Botanic Tonics. While it’s tempting to think it can keep Feel Free legal by appeasing the FDA, it’s already become clear that the moral panic around 7-OH is spreading to all kratom products. 

As such, Botanic Tonics should unite with kratom users to ensure that 7-OH continues to be sold the same way nicotine, alcohol, caffeine, and kratom leaf already are: over the counter and with age restrictions. 

If the FDA succeeds in making 7-OH a Schedule One controlled substance, it won’t be long until they come after kratom leaf as well.