This Week’s Focus: Kava + Kratom Tonics

This week’s NDEWS Weekly Briefing focuses on kava and kratom tonics such as "Feel Free". At a recent meeting with our NDEWS network, which consists of experts whose disciplines span toxicology, medicine, public health, and community engagement, we acquired new information about the use of kava and kratom tonics.

Kava and kratom tonics are marketed as natural wellness drinks but have recently become a popular topic of discussion due to growing concerns over their addictive potential and public health risks.

The briefing this week highlights our most recent NDEWS Special Report, NDEWS Web Monitoring report, and recent studies and news articles related to this theme. Additionally, we are sharing the NDEWS Rapid Street Report from Denver, Colorado.

We look to you, our reader, to inform us of any emerging trends or new information regarding drug use at the local or regional level that we can explore.

NDEWS evaluated biospatial data from January 2024 to August 2025 using the specified keywords* and found eight states (California, Colorado, New Mexico, Minnesota, Tennessee, North Carolina, South Carolina, Florida) with EMS encounters involving both kava and kratom-related overdoses. Data for each state was suppressed (under 10 encounters); it related to EMS encounters involving both kava and kratom-related overdoses. A total of 18 encounters was found during this time period. NDEWS will continue to monitor overdoses to this drug combination.

*Kava and Kratom-related EMS encounters were included if the chief complaint/narrative in the narrative text search contained US product names, trade names including (”kava” (”cava”, kavah”, “kawa”), “kava-kava”, “awa”, “ava” (“ava pepper”, “ava root”), “piper methysticum”, “yati” or “yaqona”) and ("kratom” or "kratum", "Cratom"), "Gratom", "kratom extract", "kratom shot", "kratom capsule", "Ketum", "Thang", "Thom", "Kakuam", "Biak”, "Katawn" or "Kedemba").

Limitations: Biospatial.io data reflect pre-hospital EMS encounters and do not include hospital outcomes, toxicology confirmation, medical history, or prescription information. Much of the data relies on clinical impressions, self report, or bystander accounts. Additionally, both kava and kratom-related overdoses may be underreported or misclassified.

75% of the data reported within 24 hours of event. Source: biospatial.io, 2025. NDEWS is funded by the National Institute on Drug Abuse to the University of Florida (MPI: Cottler (contact), Co-Is: Goldberger, Nixon, Striley), NYU Langone Health (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Recommended citation: National Drug Early Warning System
(NDEWS). (2025). Special Report (September 12, 2025). (NDEWS-2025-SR00039.5). Retrieved from https://ndews.org.

Click here to learn more about NDEWS Hotspot Alerts

Why are we reporting on this?
Kava and kratom tonics such as "Feel Free" are marketed as natural wellness drinks but have recently become a popular topic of discussion due to growing concerns over their addictive potential and public health risks. Reddit discussions reveal concerning patterns including reports of severe mood dysregulation from combined use, potential interactions with psychiatric medications, and the widespread availability of these combination products at gas stations, vape shops and specialty bars.

What is Kava + Kratom?
Kava and kratom are botanically-derived substances combined in commercial tinctures, drinks, and capsules. Commercial products containing both substances are readily available at gas stations, vape shops, specialty bars, and online retailers.

Public Health Impacts
Reddit discussants report significant adverse effects from kava-kratom combinations, including severe nausea, mood disturbances, and overwhelming anxiety. Commenters describe experiences where commercial mixtures containing both substances triggered melancholic and dreadful feelings, amplified social anxiety, and caused extreme irritability.

How is it Being Discussed?
Reddit commenters believe that kratom acts primarily on opioid receptors while kava affects GABA receptors, creating a combined sedative and euphoric effect. There is frequent discussion of kava-kratom combinations in the context of seeking alcohol alternatives or enhancing recreational experiences. Discussants share consistently negative experiences with pre-mixed commercial products like "Feel Free" bottles. Reddit users actively seek advice on making homemade kratom-kava teas to replicate effects experienced at specialty bars, believing bar preparations are more potent. The combination is discussed alongside other substances including phenibut, DMAA, benzodiazepines, and stimulants.

Click here to read more about NDEWS Online Monitoring.

The Rapid Street Reporting (RSR) team visited Denver, Colorado between August 15th and 17th, 2025 and surveyed 232 individuals. After alcohol and marijuana for recreational use, the next most commonly reported substances used in the past 12 months were psilocybin (32.8%), powder cocaine (12.9%), ecstasy/MDMA/molly (11.6%), ketamine (9.1%) and LSD (9.1%) .
Click here to read the full report.

Click here to read more about NDEWS Rapid Street Reporting.

A recently published article by CNN investigates the growing concerns surrounding the "Feel Free" tonic. The article focuses on the experiences of people who have used the tonic, and retail vendors who sell the tonic. It also discusses the history of the "Feel Free" tonic. Read the full article here.

A recently published case report in The American Journal of Emergency Medicine by Bleifuss et al. described an incident involving a 45-year-old male who presented to the emergency department after days of heavy usage of a beverage containing kava and kratom. The individual was consuming 8 to 10 two-ounce bottles daily, which led to severe withdrawal symptoms when stopping. The case report highlights the potential for severe withdrawal symptoms from herbal supplements like kava and kratom, emphasizing the need for clinicians to be aware of their potential for misuse. Read the full case report here.

A recently published article by NBC News shared testimonies from two individuals who have had experiences with the "Feel Free" tonic. The first individual described his experience outside of a gas station involving a teen asking him to buy the herbal drink, which is restricted for those 21 years of age and over. This went viral on social media. Another testimony involved an individual who previously struggled with heroin and meth use. After eight years of abstinence from heroin and meth, the individual blamed the tonic for a new addiction. Read the full article here.

A recently published article in USA Today focused on people who have used the "Feel Free" tonic in addition to other products that contain kratom. USA Today spoke with more than 20 people who say they became severely addicted to kratom products. Medical experts who spoke with USA Today said that all kratom products carry a risk for addiction. Read the full article here.

Are you committed to advancing the science of substance use and public health? The University of Florida’s NIDA-funded T32 Training Program offers predoctoral and postdoctoral scholars an exceptional opportunity to launch impactful research careers focused on NDEWS!

What We Offer:
- Interdisciplinary training at the intersection of addiction science, epidemiology, and surveillance
- Mentorship from leading UF faculty in epidemiology, public health, psychology, medicine, and more
- Hands-on research with landmark and important NIH-funded projects and access to rich data
- Career development support, including grant writing, publishing, and professional networking
- A collaborative, inclusive research community committed to reducing the burden of substance use

Eligibility:
- US citizens or permanent residents
- Interested in a PhD in Epidemiology, or early-stage postdoctoral fellows
- Demonstrated interest in substance use, addiction, or public health research

Location: Gainesville, Florida — a dynamic hub for scientific innovation with high quality of life and low cost of living.

📅 Date: Monday, September 29, 2025

🕑 Time: 3:00 pm - 4:00 pm ET

📍 Location: Online 

The NDEWS Weekly Briefing curates emerging data and findings from across the Early Warning Network, which includes three core components: our Scientific Advisory Group (SAG), comprised of national experts and federal partners; our Sentinel Site Directors (SSDs), who lead local surveillance in key geographic regions; and our Community-Based Health Experts, who provide on-the-ground insights from populations most impacted by drug trends. Together, these contributors generate timely, multidisciplinary and impactful information, ranging from peer-reviewed research findings to local surveillance data. These contributions inform public health and research communities.

More about The NDEWS Early Warning Network
- Issue 230: Early Warning in Action — Insights from the NDEWS Early Warning Network
- Issue 234: Early Warning in Action — Insights from the NDEWS Early Warning Network

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If you miss or want to learn more about NDEWS Original Content, you can find our archived content on the NDEWS website:

     • NDEWS Hotspot Alerts using substance-related EMS data
     • NDEWS Rapid Street Reporting (RSR) survey data reports
     • NDEWS Web Monitoring Team Reddit Alerts
     • NDEWS Sentinel Site Reports
     • Previous issues of the NDEWS Weekly Briefings

The Weekly Briefing is a newsletter published each week by the National Drug Early Warning System (NDEWS) Coordinating Center, which is funded by the National Institute on Drug Abuse (U01DA051126) to the University of Florida (MPI: Cottler (contact), Co-Is: Goldberger, Nixon, Striley), NYU Langone Health (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.