Kratom and kratom-based products are legal and accessible in some areas across the US. It may be sold as a remedy for pain, energy, and other uses based on its benefits in traditional Asian medicine. However, it’s not currently approved for any use by the FDA.
There’s not much research into the medicinal uses or side effects and risks of kratom, but some reports indicate that the drug may have potentially serious side effects
Kratom is an herbal substance derived from the leaves of the Mitragyna speciosa tree native to Southeast Asia. It’s grown in Thailand, Myanmar, Malaysia, and Southeast Asia as an herbal remedy. It has been used as a stimulant to help workers overcome exhaustion and muscle pain. Kratom has also been used as a substitute for opium if none is available.[1]
The active compounds in kratom are mitragynine and 7-hydroxymitragynine, which can produce similar effects to opioids like morphine or oxycodone.[2] With these effects, some people view kratom as a safer alternative to narcotic painkillers, but it can have side effects and risks of its own.
Kratom contains phytochemicals that can have different therapeutic effects and toxicological properties. The main components are mitragynine and 7-hydroxymitragynine, which are exclusive to the plant.[3]
The Kratom Act 2486 in Thailand made planting kratom trees illegal in 1943. Because of its uses, the Thai government enacted the Narcotics Act B.E. 2522 in 1979, making kratom Category V – the same as marijuana – but it was removed from the list in 2021.
Now, kratom is on the US market as a natural remedy and a recreational drug. It’s not currently listed in the Controlled Substances Act at the federal level, but some states have banned it.
Kratom is used in many ways. The extract may be sold in liquid form as a remedy for pain. There are also tablets, capsules, and loose leaves, which may be chewed, brewed into tea, or consumed.
As an Asian remedy, kratom is used as a substitute for opium. At low doses, kratom may act as a stimulant, though higher doses may cause euphoria and relieve pain. Kratom acts on the opioid receptors and may be used as a remedy for withdrawal from opioid drugs, but it can also lead to kratom dependence and abuse.
Kratom is also used recreationally, much like other substances. People may consume kratom to relieve social anxiety or achieve euphoria. While it’s considered natural and safe, kratom can have some risks and side effects.
People may use kratom to manage drug withdrawal symptoms and cravings, pain, fatigue, or mental health problems. The effects may begin 5-10 minutes after ingestion and can last several hours, but the substance isn’t regulated. It’s difficult to predict the effects without knowing the concentration of active ingredients in a kratom product.
Little research exists demonstrating kratom’s possible medicinal properties, but there are possible side effects, including:[5]
Though rare, kratom can contribute to serious health issues, including coma and death, often due to polydrug use or contaminated products. The challenge is that there’s no regulation for kratom dosage, so researchers can’t definitively determine the toxic dose of kratom. There are incidences of overdose and related death, but it’s often because of polydrug use (mixing multiple substances) or contaminated kratom products instead of a toxic dose of kratom itself.
The research is limited to the addictive potential of kratom and its long-term effects on the body. Its effects can vary significantly, as there’s no standardized dose, the potency of the active ingredients can vary, and how the substance is formulated and consumed can influence its effects. There are also individual differences in how the drug is metabolized.
Kratom is often seen as a safer alternative to opioids, but it may act on opioid receptors. People who use kratom regularly may experience withdrawal when they stop or dramatically reduce their dose – just like other drugs. The withdrawal symptoms may include:
Though kratom’s effects and kratom abuse aren’t as well understood as other substances, it’s possible that its effects on the opioid receptors and its opioid-like effects can cause dependence like other drugs. If you use kratom regularly, your body may become used to its presence. If you stop or reduce your dose, you can experience withdrawal symptoms that can include strong cravings for the substance. The risk of dependence and withdrawal is greater if you use kratom at higher doses or for longer periods.
The addictive potential of kratom isn’t well-researched or widely accepted. If it is addictive, it would have similar symptoms to any substance use disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which may include:[7]
Kratom use disorder may not be recognized as a substance use disorder on its own. However, some research shows that similar treatment options to opioid use disorders may be effective in managing cravings and setting the foundation for kratom rehab. A kratom detox center can play an important role in managing kratom withdrawal and preventing relapse before transitioning into a kratom addiction treatment program to address the emotional and psychological causes of addiction.
Currently, kratom products are not approved, but they’re legal and widely available. However, just because something is natural and can be purchased over the counter doesn’t mean it’s safe. Research is showing possible risks with kratom use, including addiction and possible overdose. If you believe you’re abusing or becoming dependent on kratom, seek help from a healthcare provider.
In Southeast Asia, kratom is used in traditional Asian medicine to relieve pain, boost energy, and improve sexual desire. It’s similar to other traditional substances like coca or khat. Topically, kratom extract may be used for wound healing and pain relief. There’s not much evidence supporting kratom’s efficacy as a natural remedy, however.
Many Southeast Asian countries grow kratom trees, and it’s legal, though Thailand made kratom a prohibited substance under the Narcotics Act 2564 in 1979. It was removed from the list of prohibited substances in 2021, however, and now kratom can be possessed and consumed in the country
The FDA is warning consumers about kratom use and its potential risks, including the risk of addiction.[9] The biggest concern for the organization is the potential for kratom to act on opioid receptors and cause abuse, dependence, and addiction like opioid drugs. There are currently no approved uses for kratom, though the FDA is reviewing reports about kratom’s safety and risks.
People who use kratom self-report benefits like pain relief, but there’s no research to prove its therapeutic effects. Several organizations are researching to evaluate kratom’s benefits and its active compounds, however.
Kratom use is controversial as the evidence hasn’t definitively proven its benefits or risks. It’s still legal on the federal level. The Kratom Consumer Protection Act is a movement that’s working to protect kratom’s legality and encourage regulators to develop requirements for its sale and use, such as transparent labeling, to protect consumers from potential risks.
[1] Kratom Mitragyna Speciosa Korth (street names: Thang, kakuam, thom … (n.d.). Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf on 2024, June 11.
[2] U.S. Department of Health and Human Services. (2023, April 24). Kratom. National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/kratom on 2024, June 11.
[3] Prozialeck, W. C., Edwards, J. R., Lamar, P. C., Plotkin, B. J., Sigar, I. M., Grundmann, O., & Veltri, C. A. (2020, July 30). Evaluation of the mitragynine content, levels of toxic metals and the presence of microbes in kratom products purchased in the western suburbs of Chicago. International journal of environmental research and public health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432033/#:~:text=Pharmacologic%20studies%20have%20shown%20that,hydroxymitragynine%20%5B7%2C8%5D on 2024, June 11.
[4] Kratom Mitragyna Speciosa Korth (street names: Thang, kakuam, thom … (n.d.). Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf on 2024, June 11.
[5] Mayo Foundation for Medical Education and Research. (2022, June 3). Kratom: Unsafe and ineffective. Mayo Clinic. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171 on 2024, June 11.
[6] Henningfield, J. E., Chawarski, M. C., Garcia-Romeu, A., Grundmann, O., Harun, N., Hassan, Z., McCurdy, C. R., McMahon, L. R., Sharma, A., Shoaib, M., Singh, D., Smith, K. E., Swogger, M. T., Vicknasingam, B., Walsh, Z., Wang, D. W., & Huestis, M. A. (2023). Kratom withdrawal: Discussions and conclusions of a scientific expert forum. Drug and alcohol dependence reports, 7, 100142. Retrieved from https://doi.org/10.1016/j.dadr.2023.100142 on 2024, June 11.
[7] Diagnostic and Statistical Manual of Mental Disorders | Psychiatry Online. (n.d.). DSM Library. Retrieved from https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787 on 2024, June 11.
[8] U.S. Department of Health and Human Services. (2023, April 24). Kratom. National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/kratom on 2024, June 11.
[9] Commissioner (n.d.). FDA and Kratom. U.S. Food and Drug Administration. Retrieved from https://www.fda.gov/news-events/public-health-focus/fda-and-kratom on 2024, June 11.
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