Three southwest Ohio coroners issued a joint warning on Monday, November 9, about kratom, an unregulated substance sold in stores across the region, saying there have been 14 suspected overdoses involving the drug in the past several months, according to reporting by The Cincinnati Enquirer.
Hamilton County Coroner Lakshmi Sammarco, Butler County Coroner Lisa Mannix and Warren County Coroner Russell Uptegrove told The Cincinnati Enquirer they are seeing overdose deaths involving drugs like fentanyl, methamphetamine and cocaine decrease in each of their counties — but kratom cases are rising. Kratom was found in 38 seizure cases in Hamilton County in 2026, up from three cases in 2024 and none in 2025, according to data Sammarco provided to the Enquirer.
There have been three overdose deaths involving kratom in Warren County and two in Butler County in 2026, according to the coroners’ figures reported by the Enquirer. Kratom is commonly used to boost energy or mood or to combat opioid addiction, and is concentrated and sold as pills, powders, drinks and gummies in convenience stores and vape shops, the Enquirer reported.
Sammarco told The Cincinnati Enquirer that only the leaf form of the substance is legal in Ohio, and that there are different, lethal substances mixed into kratom products that aren’t listed on the label. “Don’t believe what’s on the label. If it isn’t that powdered leaf form, be careful,” Sammarco told the Enquirer. “Know that it could be lethal.” Uptegrove’s warning to the Enquirer was shorter: “Buyer beware. Don’t do this.”
The warning comes as Ohio’s rules remain in motion. In December, Gov. Mike DeWine asked the Ohio Board of Pharmacy to designate kratom an illegal drug, calling the herbal extract an “imminent public health risk,” according to the Enquirer. In May, lawmakers approved a new rule to ban synthetic kratom, but the rule does not ban kratom in its vegetative form, including natural leaf and ground natural leaf, according to Ohio Board of Pharmacy documentation cited by the Enquirer.
The coroners’ warning lands against a longer decline the three counties have worked years to achieve. Overdose deaths in Hamilton County have fallen for four years straight, the Enquirer reported — 195 deaths in 2025, the lowest number since at least 2014 and a 66% reduction from the county’s peak of 567 deaths in 2017.
For southwest Ohio residents, the coroners’ message is practical: products sold openly in convenience stores and vape shops are not regulated the way pharmacy medicines are, and the label may not list everything inside. Anyone holding concentrated kratom pills, powders, drinks or gummies should treat the coroners’ November 9 warning as the latest word until the Board of Pharmacy and lawmakers settle the substance’s legal status in Ohio.