Kratom is a tropical tree that grows naturally in areas of Southeast Asia including Thailand, Malaysia, Indonesia, Myanmar, and Papua New Guinea. The leaves of the tree contain two major psychoactive chemical compounds that can affect the body, producing both stimulant and sedative effects, depending on the dosage.
What Is Kratom?
Kratom leaf
Kratom has long been used in Southeast Asia as a multi-purpose remedy in traditional medicine to increase alertness and reduce fatigue and has become increasingly popular in the U.S. as both an alternative therapy and a drug of misuse. It’s marketed as a supplement to boost energy, enhance mood, and relieve pain. People also report using kratom products to ease drug withdrawal symptoms – especially for opioids – and alleviate symptoms relating to mental health conditions such as anxiety and depression. (1)
Currently, kratom is not a federally controlled substance, though many individual states/cities have regulations in place. Kratom is not approved by the U.S. Food and Drug Administration (FDA) for any medical use and the DEA has listed kratom as a Drug and Chemical of Concern. (2) According to the FDA, there is a concern “that kratom, which affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.” (3)
Kratom is not approved by the U.S. Food and Drug Administration (FDA) for any medical use and the DEA has listed kratom as a Drug and Chemical of Concern. (2)
How Is Kratom Taken
In the United States, kratom is available in many forms. Typically, the tree’s leaves are crushed and smoked, chewed raw, swallowed in capsule form, formed into powder to be mixed into food or drink, brewed as tea, or taken as a liquid extract. (2, 1)
Rise In Kratom Use
The use of kratom in the U.S. has increased in the last decade. The number of phone calls to U.S. poison control centers about kratom exposures increased from 13 in 2011 to 682 in 2017, including death reports.1 About half of these exposures resulted in serious adverse outcomes such as seizures and high blood pressure. (4)
Studies suggest that long-term kratom use may be associated with serious liver problems.
Effects of Kratom
Kratom typically takes effect after 5-10 minutes, with effects lasting 2-5 hours. The effects of kratom vary depending on dosing and potency. Because kratom products vary widely, the effects are difficult to predict and depend on various factors such as how kratom is taken, potency, dosing, underlying medical conditions, and the presence of other drugs in a person’s system. People experience both stimulant effects such as increased alertness and energy, as well as opioid- and sedative-like effects, such as relaxation and pain relief. (2, 1)
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People experience both stimulant effects such as increased alertness and energy, as well as opioid- and sedative-like effects, such as relaxation and pain relief. (2, 1)
Adverse Short-Term Effects
Dry mouth
Chills, nausea, and vomiting
Changes in urine and constipation
Muscle pain
Dizziness
Drowsiness
Confusion
Hallucinations and delusion
Depression
High blood pressure
Breathing suppression
In rare cases – seizures, coma, death (4)
Case studies suggest that individuals who experience the more severe adverse effects are using other substances in combination with kratom. (1)
Long-Term Effects
Because kratom research is relatively new, long-term health effects are not well understood. Studies suggest that long-term kratom use may be associated with serious liver problems. Researchers also are still learning how often and to what extent people who use kratom experience withdrawal or substance use disorder symptoms related to kratom use. (1)
Kratom capsules
On its own, kratom overdose is very rare but when combined with alcohol or other drugs (polysubstance use), dangerous side effects can occur such as liver problems.
Addiction, Overdose, and Risks
Research indicates that individuals who use kratom regularly may risk becoming dependent as the body adapts to regular exposure to kratom. When a person stops taking kratom, they may experience withdrawal symptoms similar to those that occur after opioid use:
Muscle spasms and pain
Difficulty sleeping
Watery eyes/nose
Hot flashes
Fever
Decreased appetite
Diarrhea
Restlessness
Mood swings
Agitation and nervousness (5)
On its own, kratom overdose is very rare but when combined with alcohol or other drugs (polysubstance use), dangerous side effects can occur such as liver problems. Additionally, contaminants such as heavy metals and bacteria have been found in kratom. As of April 2018, more than 130 people in 38 states became ill with Salmonella after taking kratom. Salmonella poisoning can be fatal, and the U.S. Food and Drug Administration has linked more than 35 deaths to Salmonella-tainted kratom. (4)
(1) National Institute of Health & National Institute on Drug Abuse. (2022, March). Kratom. https://nida.nih.gov/research-topics/kratom#scope
(2) Drug Enforcement Administration. (2023, March). Kratom. https://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf
(3) U.S. Food and Drug Administration. (2023, June 2). FDA and Kratom. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
(4) Mayo Clinic. (2022, June 3). Kratom: Unsafe and Ineffective. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/kratom/art-20402171
(5) Kaliszwski, M. (2023, April 13). How to Quit Kratom: What is the Best Way to Quit Kratom?American Addiction Centers. https://americanaddictioncenters.org/kratom/how-to-quit-kratom