OKLAHOMA CITY, Okla. — The Oklahoma Office of the Chief Medical Examiner has issued a public alert warning of a growing number of fatal overdoses involving kratom and related alkaloids across the state.

The alert, released by the agency's Forensic Toxicology Laboratory, is intended to inform public health officials, law enforcement agencies, legislators, healthcare providers and other stakeholders about increasing detections of mitragynine-related substances in overdose deaths.

Kratom, derived from the Southeast Asian tree Mitragyna speciosa, has historically been used for pain relief, mood enhancement and management of opioid withdrawal symptoms. The plant contains mitragynine, its primary active alkaloid, along with 7-hydroxymitragynine (7-OH) and dozens of other compounds.

According to the medical examiner's office, newer concentrated kratom products sold as powders, capsules and liquid extracts have raised significant concerns among health officials due to their potency and opioid-like effects.

The alert notes that some kratom-related compounds can be substantially more potent than morphine. Officials cited research indicating that 7-OH may be approximately 13 times more potent than morphine, while mitragynine pseudoindoxyl (MP) may be about 20 times more potent. Another compound, MGM-15, has been identified as potentially even more potent than 7-OH.

Reported adverse effects associated with kratom use include agitation, drowsiness, rapid heart rate, vomiting and confusion. More severe reactions can include seizures, hallucinations, respiratory depression, coma and cardiac arrest.

The Office of the Chief Medical Examiner reported that in 2025, its toxicology laboratory detected mitragynine in 35 fatal overdose cases. Investigators determined that mitragynine contributed to the cause of death in nine of those cases.

An additional nine cases involved mitragynine combined with at least one related alkaloid, with both substances contributing to death in three cases. Two other cases involved mitragynine-related alkaloids that were directly listed as causes of death.

Overall, 14 overdose deaths in Oklahoma during 2025 listed either mitragynine or a related alkaloid as a contributing cause of death, placing the substances among the state's 12 most commonly identified drugs in fatal overdoses.

The average age of individuals whose deaths involved mitragynine-related substances was 40 years old, with ages ranging from 22 to 70. Approximately 63 percent of those deaths involved males.

Since the beginning of 2026, toxicologists have observed a significant shift away from mitragynine alone and toward more potent kratom-related alkaloids. The majority of recent positive cases have involved MGM-15, according to the report.

Between January 2025 and May 2026, the laboratory identified at least one mitragynine-related substance in 58 death investigations spanning 24 Oklahoma counties. Tulsa County recorded the highest number of cases with 14, followed by Oklahoma County with nine.

Medical examiner officials said the findings highlight the growing presence of kratom-related substances in fatal overdoses and the increasing prevalence of highly concentrated products circulating in the marketplace.