What Is Kratom? A Comprehensive Guide to Its Uses, Effects, and Risks
Introduction
This guide explains what kratom is, its effects, uses, and risks. Kratom is a tropical tree (Mitragyna speciosa) that is native to Southeast Asia. The kratom plant contains several active alkaloids, including mitragynine and 7-hydroxymitragynine (7-OH), which are responsible for its opioid-like effects and have raised public health concerns.
Whether you are an individual considering kratom use, a healthcare professional, or a member of the general public seeking reliable information, this page provides a comprehensive overview of kratom’s properties, common uses, effects, and potential risks. An estimated 1.7 million Americans aged 12 and older used kratom in 2021, according to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, highlighting the significant number of kratom users in the U.S. Understanding kratom is important due to its increasing popularity, potential for self-treatment, and the serious health and regulatory concerns associated with its use.
Quick Summary: Kratom at a Glance
- What is Kratom?
Kratom is a tropical tree (Mitragyna speciosa) that is native to Southeast Asia. (Fact: 1) - Kratom is derived from the kratom plant, which contains alkaloids such as mitragynine and 7-hydroxymitragynine.
- Common Uses:
Kratom is often used to self-treat conditions such as pain, coughing, diarrhea, anxiety, and depression. (Fact: 2) - An estimated 1.7 million Americans aged 12 and older used kratom in 2021, according to the National Survey on Drug Use and Health, highlighting the number of kratom users in the U.S.
- Effects:
Kratom’s main alkaloid, mitragynine, and its psychoactive metabolite, 7-hydroxymitragynine (7-OH), act on μ- and k-opioid receptors. It is often marketed as having pain-relieving and mood-enhancing properties. (Facts: 5, 6) - Risks:
Kratom presents serious safety risks, including addiction, withdrawal symptoms, liver toxicity, seizures, high blood pressure, and potential death. It is not lawfully marketed as a drug, dietary supplement, or food additive in the United States, and the FDA warns consumers not to use kratom products due to the risk of serious adverse effects. (Facts: 3, 4, 7, 8, 9, 10) - Kratom is not approved as a dietary supplement or drug product in the U.S., and there are no lawfully marketed kratom drug products.
Key Insights on Kratom
Research suggests kratom, derived from a Southeast Asian tree, may offer benefits like pain relief, anxiety reduction, and aid in opioid withdrawal for some users, though evidence from clinical trials remains limited and mixed as of 2026. This guide explains what kratom is, its effects, uses, and risks. It seems likely that natural kratom leaf has a relatively low potential for severe harm compared to traditional opioids, with recent large-scale studies showing no significant organ toxicity in traditional users, but concentrated products like those high in 7-hydroxymitragynine (7OH) pose heightened risks of addiction and overdose. Notably, 7-hydroxymitragynine (7-OH) has been considered for scheduling under the Controlled Substances Act due to its opioid-like effects and associated health risks. The evidence leans toward kratom exhibiting opioid-like effects through receptor binding, yet it is not classified as a traditional opioid and typically causes less respiratory depression, sparking ongoing debates about regulation amid FDA efforts to restrict potent derivatives—especially in the context of the opioid epidemic. Importantly, kratom is not approved as a drug product and is not lawfully marketed as such in the United States. There are also ongoing debates about regulation, with the FDA maintaining that kratom is not approved or legally marketed as a dietary supplement, and warning of potential risks when it is added to food or marketed as a supplement. Ongoing research is also investigating kratom’s therapeutic potential, including possible benefits for mood, alertness, and pain relief.
What Is Kratom?
Kratom is a tropical tree (Mitragyna speciosa) that is native to Southeast Asia. Kratom refers to the leaves of the Mitragyna speciosa tropical tree, a member of the coffee family native to Southeast Asia, including countries like Thailand, Indonesia, and Malaysia. Traditionally, locals have chewed the leaves or brewed them into tea for centuries to boost energy during labor or treat minor ailments. Kratom’s leaves have also been used in traditional medicine to boost energy, alleviate pain, and treat opioid addiction. In modern contexts, particularly in the U.S., kratom is processed into powders, capsules, extracts, teas, or gummies, with an estimated 1.7 to 15 million Americans using it as of recent surveys.
Kratom contains more than 40 alkaloids, with mitragynine being the main chemical component noted in this plant. Kratom’s main alkaloid, mitragynine, and its psychoactive metabolite, 7-hydroxymitragynine (7-OH), act on μ- and k-opioid receptors. These alkaloids interact with brain receptors to produce varying effects. Alkaloids are naturally occurring chemical compounds that can have pronounced physiological actions on humans; in kratom, mitragynine and 7-hydroxymitragynine are especially important for their roles in pain relief and mood alteration.
Kratom alkaloids also interact with kappa opioid receptors, contributing to its diverse pharmacological effects and differentiating it from traditional opioids. Unlike synthetic drugs, kratom is unregulated by the FDA for medical use, leading to variable product quality and contamination risks, such as heavy metals or bacteria like salmonella noted in past outbreaks. For more on its botanical background, see the National Institute on Drug Abuse overview.
A recent kratom report highlights the need for further research into kratom’s use patterns, medicinal potential, and adverse effects.
Now that we’ve covered what kratom is, let’s explore its common uses and why people turn to it.
History and Cultural Significance
Kratom, or Mitragyna speciosa, has deep roots in the cultural and medicinal traditions of Southeast Asia. For generations, this tropical tree has played a vital role in the daily lives of people in countries like Thailand, Malaysia, and Indonesia. Traditionally, kratom leaves were chewed or brewed into tea by laborers seeking increased energy and stamina during long hours of physical work. Beyond its practical uses, kratom has also held a place in social and spiritual gatherings, where it was consumed for its perceived medicinal and ritualistic properties.
In these communities, kratom use was often seen as a way to foster social bonds, mark important occasions, or provide relief from common ailments. The plant’s reputation for boosting endurance and alleviating discomfort contributed to its widespread acceptance and integration into local customs. However, as kratom has gained popularity outside its native region, particularly in Western countries, concerns have emerged about its health risks, abuse potential, and the possibility of withdrawal symptoms and substance abuse. The shift from traditional, controlled use to broader, unregulated consumption has brought increased attention to the adverse effects associated with kratom, highlighting the need for greater awareness and caution as its use continues to spread.
What Is Kratom Used For, Including Pain Relief?
Traditional Uses
In Southeast Asia, kratom has been used for centuries. Traditional applications include chewing the leaves or brewing them into tea to:
- Boost energy during physical labor
- Treat minor ailments such as diarrhea, cough, and fatigue
- Serve as a folk remedy for conditions like hypertension or diabetes
Modern Uses in the U.S.
In the United States, kratom is processed into powders, capsules, extracts, teas, or gummies. Surveys estimate that between 1.7 and 15 million Americans have used kratom. The most common reasons for use include:
- Self-management of chronic pain (such as back or joint issues)
- Seeking alternatives to prescription opioids
- Enhancing energy and focus
Mental Health and Pain Management
Many users view kratom as a pain reliever, seeking its analgesic effects for various pain conditions. Surveys indicate up to 91% of respondents cite pain relief as a primary reason for use. Other reported benefits include:
- Anxiety reduction (around 67% of users)
- Depression relief (65% of users)
- Mood enhancement
- Increased energy and focus, similar to caffeine
Opioid Withdrawal and Harm Reduction
Amid the opioid crisis, many report using kratom to ease withdrawal symptoms or reduce dependence on prescription opioids. Some studies suggest kratom may serve as a harm-reduction tool, though these uses lack FDA approval and efficacy varies by individual factors like dosage and strain (e.g., red vein for relaxation, white for stimulation). Recent 2025 research highlights its role in mitigating opioid harms, but experts emphasize consulting healthcare providers due to potential interactions. People use kratom for a variety of self-management purposes, including pain, mood, and energy. Check the Harvard Health blog for user-reported benefits.
With an understanding of kratom’s uses, let’s examine what effects it produces in the body.
What Does Kratom Do?
Kratom’s effects are dose-dependent: low doses (1-5 grams) typically provide stimulant effects, enhancing alertness, sociability, and energy, much like a mild coffee boost. At medium to high doses (5-15 grams or more), it shifts to sedative effects and analgesic properties, offering pain relief, relaxation, and euphoria by binding to mu-opioid receptors in the brain. At higher doses, kratom produces sedative effects, offering calmness and euphoria that could last up to 6 hours. Kratom’s main alkaloid, mitragynine, and its psychoactive metabolite, 7-hydroxymitragynine (7-OH), act on μ- and k-opioid receptors. Key alkaloids mitragynine and 7OH drive these outcomes, with mitragynine acting as a partial agonist to modulate mood and pain without severe respiratory suppression seen in full opioids. Kratom acts on multiple receptor types, including opioid, adrenergic, and serotonergic receptors, to produce its range of stimulant and sedative effects. Duration lasts 2-5 hours, influenced by factors like body weight, tolerance, and product form. Kratom is available in various forms, including powders, capsules, teas, and kratom extracts, which are concentrated preparations with distinct potency and safety considerations.
A dose of up to 5 grams of kratom powder taken up to three times per day is reported to be sufficient to feel effects.
Common side effects include:
- Nausea
- Dizziness
- Constipation
- Dry mouth
- Mild anxiety (especially at low doses)
- Vomiting (at higher doses)
- Drowsiness
- Weight loss (especially with chronic use)
- Potential tolerance buildup
Clinical effects observed in studies have included adverse cardiovascular outcomes such as cardiac arrest, hypertension, arrhythmias, and tachycardia, as well as neurological impacts. A 2026 study in Thailand found no significant hematological or liver toxicity in long-term traditional users, supporting a safer profile for natural forms. For detailed pharmacology, refer to the FDA’s kratom focus page.
Mixing kratom with alcohol or other sedatives increases the likelihood of severe, sometimes fatal, reactions.
| Dose Range | Main Effects | Duration | Common Side Effects |
|---|---|---|---|
| Low (1-5g) | Stimulant effects: increased energy, focus, mood elevation | 1-2 hours | Dry mouth, mild anxiety if sensitive |
| Medium (5-10g) | Pain relief, mild relaxation, anxiety reduction | 2-4 hours | Nausea, dizziness, constipation |
| High (10g+) | Sedative effects: sedation, strong analgesia, euphoria | 3-5 hours | Vomiting, drowsiness, potential tolerance buildup |
To better understand kratom’s unique properties, it’s important to look at its key alkaloids, especially 7-hydroxymitragynine.
What Is 7OH and Its Role Among Kratom Alkaloids?
7-Hydroxymitragynine (7OH) is a potent minor alkaloid in natural kratom leaves, comprising less than 2%, but formed as a metabolite of mitragynine in the body. It’s up to 13 times stronger than morphine, binding strongly to opioid receptors for enhanced analgesia but raising risks in semi-synthetic products (up to 98% purity) sold as gummies or shots. These concentrated forms have been linked to severe events like overdoses, seizures, and neonatal abstinence syndrome. The FDA’s 2025 push to schedule 7OH as Schedule I highlights its abuse potential, distinguishing it from natural kratom. 7-hydroxymitragynine is being considered for regulation under the Controlled Substances Act due to its potency and associated health risks. A 2026 PMC article warns of emerging challenges with unregulated 7OH drinks. The World Health Organization (WHO) has monitored kratom’s public health impact and, while it decided not to recommend an in-depth review in its latest assessment, continues ongoing surveillance of kratom globally. Learn more from the FDA press release.
Now that you know about kratom’s main active compounds, let’s discuss the risks, including addiction and withdrawal.
Is Kratom Addictive and What Are the Withdrawal Symptoms?
Kratom carries a risk of physical dependence, particularly with regular use, leading to tolerance and kratom withdrawal symptoms akin to mild opioid or caffeine cessation, such as irritability, muscle aches, insomnia, or cravings. Studies estimate about 12% of users may develop addiction-like issues, often mild to moderate, with lower overdose potential—over 1,000 times less than fentanyl—per population data. A 2025 Johns Hopkins review proposes decision-making algorithms for treating kratom use disorder (KUD), using buprenorphine, buprenorphine-naloxone, or behavioral therapies, with positive outcomes in small trials. Clinical protocols increasingly include buprenorphine-naloxone for managing kratom-associated withdrawal and dependence. Factors like frequency of use increase risks, but evidence suggests lower addictive potential than traditional opioids. The APA’s 2025 poll notes growing concerns, yet many users report manageable effects. Explore treatment insights at American Addiction Centers.
With the risks of addiction and withdrawal in mind, it’s also important to clarify kratom’s classification and how it compares to traditional opioids.
Is Kratom an Opioid?
Kratom is not derived from opium poppies and thus not classified as a traditional opioid, but its alkaloids bind to mu-opioid receptors, mimicking effects like pain relief and sedation without the same degree of respiratory depression. The FDA labels it a “drug of concern” due to abuse potential, especially in concentrated forms, while preclinical studies show similarities to morphine in animal models. It is important to understand the potential benefits and risks of kratom prior to use, including the possibility of dependency, withdrawal symptoms, and contamination. As of 2026, it’s unscheduled federally, though states vary in regulation. Experts view it as an atypical opioid agonist, potentially useful for harm reduction in opioid use disorder. Kratom’s use is also relevant in the context of broader drug use patterns, and healthcare providers should recognize possible interactions with other substances. For classification details, see the NIDA research page.
For personalized advice, consult a healthcare provider, especially if pregnant or using other substances, as interactions can be dangerous. Resources like the Virginia Poison Center offer guidance on risks.
Next, let’s look at how common kratom use is and what the legal landscape looks like.
Public Health Concerns
The growing use of kratom in the United States has sparked significant public health concerns. Reports from poison control centers indicate a sharp rise in kratom exposures, with many cases involving serious adverse effects such as liver toxicity, seizures, and even life-threatening complications. The Drug Enforcement Administration (DEA) has classified kratom as a drug and chemical of concern, while the Food and Drug Administration (FDA) has issued multiple warnings about the health risks associated with kratom use, including the potential for substance use disorder and dangerous drug interactions.
The Mental Health Services Administration has also noted an increase in emergency department visits related to kratom, underscoring the urgent need for public education about the risks of kratom alkaloids and the dangers associated with unregulated products. Adverse effects linked to kratom use can range from high blood pressure and respiratory depression to severe withdrawal symptoms, especially when used in combination with other drugs. These public health challenges highlight the importance of monitoring kratom exposures, improving poison control resources, and ensuring that individuals are informed about the potential health risks and serious adverse effects associated with kratom. As the use of kratom continues to rise, coordinated efforts among healthcare providers, regulatory agencies, and public health organizations are essential to address the complex issues associated with this substance.
Prevalence of Use and Legality
Prevalence of Use
Kratom use has seen a notable rise across the United States, with recent national surveys estimating that approximately 1.9 million Americans reported using kratom in the past year. This surge is reflected in the widespread availability of kratom products, which are now commonly found in vape shops, specialty stores, and through online retailers.
Legal Status
Kratom is not lawfully marketed as a drug, dietary supplement, or food additive, due to ongoing concerns about its safety, abuse potential, and lack of regulatory oversight. The Drug Enforcement Administration (DEA) has classified kratom as a drug and chemical of concern, while the Food and Drug Administration (FDA) has issued multiple warnings about the health risks associated with kratom use.
Key Legal Status by State (as of 2026):
| State | Legal Status |
|---|---|
| Alabama | Banned |
| Arkansas | Banned |
| Indiana | Banned |
| Rhode Island | Banned |
| Vermont | Banned |
| Wisconsin | Banned |
| Other States | Legal or regulated |
Regulatory Considerations
- FDA: Warns consumers not to use kratom products due to the risk of serious adverse effects, including toxicity and seizures. Kratom is not approved as a drug, dietary supplement, or food additive. (Facts: 9, 10)
- DEA: Lists kratom as a drug and chemical of concern and continues to review its status for possible scheduling.
- SAMHSA: Reports an uptick in kratom-related emergency department visits.
- Poison Control Centers: Document a growing number of kratom exposures, with cases involving adverse reactions such as high blood pressure, respiratory depression, and, in severe instances, life-threatening toxicity.
Given the increasing prevalence of kratom use and the associated health effects, there is a growing call for regulatory measures to address these concerns. Potential actions include:
- Establishing quality standards for kratom products
- Implementing educational campaigns to inform the public about health risks and withdrawal symptoms
- Expanding access to mental health services and substance abuse treatment for those affected by kratom use
Healthcare providers should remain vigilant for signs of kratom use, substance use disorder, and adverse effects, and be prepared to offer guidance and support to patients navigating the risks associated with kratom and other substances. As the landscape continues to evolve, ongoing monitoring and research will be essential to protect public health and inform effective policy.
Research and Studies
Scientific research on kratom is still evolving, with ongoing studies exploring both its potential therapeutic benefits and its risks. A systematic review of available research suggests that kratom may offer some promise as a pain reliever and as a tool for managing opioid dependence, but the evidence remains limited and often inconclusive. The National Institute on Drug Abuse (NIDA) has supported several studies to better understand kratom’s effects, including its possible role in treating opioid use disorder and the associated health effects of regular kratom use.
Despite these efforts, significant gaps remain in our understanding of kratom’s safety profile, particularly regarding its potential for drug abuse, addiction, and adverse reactions—especially among older adults and those with pre-existing medical conditions. The World Health Organization (WHO) has also reviewed kratom, calling for more comprehensive research to clarify its health effects and guide policy decisions. Additionally, laboratory analyses have revealed that some kratom products purchased online may contain toxic metals or other contaminants, raising further concerns about product safety and the need for stricter regulation. As research continues, it is crucial to balance the investigation of kratom’s potential benefits with a clear-eyed assessment of its risks, ensuring that public health remains a top priority.
Conclusion and Future Directions Associated with Kratom
In summary, kratom is a multifaceted substance with a long history and cultural significance, but its rapid rise in popularity has brought significant public health challenges. While preliminary research points to potential benefits such as pain relief and support for opioid dependence, the risks—including withdrawal symptoms, substance abuse, adverse effects, and liver toxicity—cannot be overlooked. The presence of unregulated kratom products on the market further complicates the landscape, increasing the likelihood of adverse reactions and substance use disorder.
To protect public health, it is essential for regulatory agencies like the FDA and DEA to collaborate on establishing clear guidelines and quality standards for kratom products. Healthcare providers must also be equipped to recognize and address the health risks associated with kratom use, offering support and treatment for those experiencing negative effects. Looking ahead, future research should focus on clarifying the potential benefits and risks of kratom, developing effective interventions for kratom-related disorders, and ensuring that consumers are fully informed about the possible consequences of use. By taking a comprehensive and evidence-based approach, we can better navigate the complexities associated with kratom and safeguard the well-being of individuals and communities.
