Three Southwest Ohio coroners issued a joint warning on Monday, November 9, about kratom, an unregulated substance sold in stores across the region, saying they have counted 14 suspected overdoses involving the drug in the past several months, according to The Cincinnati Enquirer.
Hamilton County Coroner Lakshmi Sammarco, Butler County Coroner Lisa Mannix and Warren County Coroner Russell Uptegrove said overdose deaths involving fentanyl, methamphetamine, cocaine and combinations of those drugs are trending down in each of their counties — but kratom cases are rising, The Cincinnati Enquirer reported. The Hamilton County Crime Lab found kratom in 38 seizure cases in 2026, after finding it in three cases in 2024 and none in 2025, according to data Sammarco provided to The Cincinnati Enquirer.
The coroners counted three overdose deaths involving kratom in Warren County and two in Butler County in 2026, according to The Cincinnati Enquirer. Kratom is commonly used to boost energy or mood or to combat opioid addiction, and concentrated forms are sold as pills, powders, drinks and gummies in convenience stores and vape shops.
“Buyer beware,” Uptegrove told The Cincinnati Enquirer. “Don’t do this.” Sammarco told The Cincinnati Enquirer that only the leaf form of the substance is legal in Ohio, and warned that lethal substances are being mixed into kratom products without being listed on the label: “Don’t believe what’s on the label. If it isn’t that powdered leaf form, be careful. Know that it could be lethal.”
The warning follows years of regulatory debate. The Ohio Board of Pharmacy considered regulating kratom in 2019 but delayed a decision after large numbers of supporters turned out for continued access. Ohio Gov. Mike DeWine later asked the board to designate kratom an illegal drug, calling it an “imminent public health risk,” and in May lawmakers approved a rule banning synthetic kratom — while leaving natural kratom leaf and ground natural leaf legal, according to Ohio Board of Pharmacy documentation cited by The Cincinnati Enquirer.
The coroners’ alert comes against a backdrop of real progress: overdose deaths in Hamilton County have fallen four years straight, to 195 in 2025 — the lowest since at least 2014 and a 66 percent drop from the county’s 2017 peak of 567, according to The Cincinnati Enquirer. The three coroners say the kratom trend is the exception they want residents to hear about before it grows.