- Kratom is the common name for a plant called Mitragyna speciosa, which contains chemicals that have psychoactive properties similar to opioids.
- Some people claim kratom may help cure opioid addiction, but there’s very little evidence this is true and some evidence it may have dangerous side effects.
- Keep reading if you want to learn the side effects of kratom, whether or not it’s legal in 2020, and more.
Kratom is one of the most popular drugs in the U.S.
Although kratom was all but unknown to Western countries in the early 2000s, it’s since exploded into what will probably become a billion-dollar industry.
It’s supporters range from podcast extraordinaire Joe Rogan to democratic senator Bernie Sanders, and it’s being discussed everywhere from the dark corners of the Internet to the halls of the Capitol Building in Washington D.C.
One word: opioids.
Opioid use has skyrocketed nine-fold since 2013, with 400,000 Americans dying from opioid overdose since 1999. It’s gotten so bad that life expectancy dipped for American men for the first time in decades around 2015.
One of the chief reasons for kratom’s meteoric rise in popularity is the promise that it can help millions of people break the bonds of opioid addiction.
Users claim it’s a life-saving medication, but many scientists and government agencies counter that there’s no evidence kratom can help cure opioid addiction, and there’s good reason to believe the drug may be dangerous.
You’ll learn the answer to that question and many more in this article. Specifically, you’ll learn:
- What kratom is
- What kratom does to the body
- Why people take kratom and what the supposed benefits are
- What kratom’s side effects are
- Whether or not kratom is safe or addictive
- And more.
Let’s start with the most obvious question: what the heck is kratom?
Table of Contents
Kratom is the common name for a tropical tree known as Mitragyna speciosa, which grows in many countries in Southeast Asia and is a relative of the same plants that produce coffee beans.
When people say “kratom,” they’re generally talking about the dried leaves of the plant, which can be consumed as an herb.
Historically, kratom was consumed by manual laborers looking to boost their productivity and resilience, and was used as a natural medical remedy for many different conditions.
At low doses, these compounds cause mild stimulant effects, whereas at high doses they produce symptoms similar to opioids, such as euphoria, relaxation, sedation, and pain relief.
People consume kratom in a variety of ways, the main ones being:
- Drinking kratom tea, made by steeping kratom leaves in hot water
- Eating kratom powder, which is made of dried and crushed kratom leaves
- Consuming kratom capsules, which contain dried kratom powder
- Consuming kratom extract, which is a liquid with concentrated amounts of the psychoactive chemicals in kratom
- Chewing or swallowing kratom leaves, which releases the psychoactive chemicals
- Chewing kratom gum, which works in the same way
- Smoking kratom leaves, which are rolled into cigars
Summary: Kratom is a tropical tree native to Southeast Asia, the leaves of which contain powerful psychotropic chemicals that have similar effects to opioids in high doses.
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The chemicals in kratom leaves produce similar effects to opioids when consumed.
The two main psychoactive compounds kratom, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing feelings of pleasure, sedation, relaxation, and analgesia (pain reduction)—especially when consumed in large amounts.
In other words, although kratom isn’t an opioid it can mimic some of the effects of opioids.
At smaller doses, kratom typically causes a mild stimulant effect similar to caffeine, and many users report feeling more alert, sociable, and energetic.
Summary: In large doses, kratom produces feelings of pleasure, sedation, relaxation, and euphoria and can also reduce pain. In small doses, kratom produces mild stimulant effects.
The number one reason for the current hullabaloo surrounding kratom is that many believe it may help people stop taking opioid drugs like heroin, morphine, and oxycontin.
There is no cure for opioid abuse except to quit taking the drugs, but this causes debilitating withdrawal symptoms that often drive people back into the waiting arms of addiction. In most cases, quitting cold turkey simply doesn’t work and can even be dangerous.
The two most dangerous symptoms of opioid withdrawal are incessant vomiting and diarrhea, which can cause dehydration and depletion of the body’s sodium and potassium levels, which can lead to heart failure.
So, instead of forcing opioid addicts to quit completely, standard practice is to substitute the strong opioids they’re taking with milder opioids. These drugs, such as methadone and buprenorphine, mimic many of the same effects but cause less severe withdrawal symptoms and pose fewer health risks as stronger opioids. Once the addict is off of the hard drugs and accustomed to the softer drugs, they can wean themselves off of drugs altogether.
While this does help people quit opioid addiction, these drugs can cost hundreds of dollars per week and still have strong side effects.
Thus, there’s been an ongoing search for alternatives to these drugs that might offer some of the same benefits with fewer risks and lower costs. People have also become more and more interested in “natural” alternatives to pills and injections for dealing with opioid abuse.
This brings us back to kratom.
Many people claim kratom has helped them wean themselves off of opioid drugs, and there’s enough anecdotal evidence that scientists have begun pushing for more research into how kratom could combat opioid addiction.
As you know, kratom interacts with the same receptors in the brain as opioids, and can also cause mild feelings of sedation, relaxation, and euphoria. What makes it unique, though, is that it doesn’t seem to come with the same health risks as traditional opioids.
One of the primary ways opioid drugs kill people is by causing respiratory depression—an involuntary decrease in breathing rate that can cut off oxygen to the brain.
While there’s still much debate over whether or not kratom also causes respiratory depression, research on animals shows it probably doesn’t, at least in the doses used so far in studies.
At the moment, though, there are still no long-term trials on how kratom could help fight opioid addiction, and most of the support for the idea is anecdotal.
Others claim kratom has helped them fight pain caused by other conditions such as Lyme disease and arthritis, and help reduce symptoms of anxiety and depression, although there’s more or less no research behind any of these claims.
And of course, many others take kratom because it makes them feel good.
In fact, it’s likely that one of the prime reasons for kratom’s sudden popularity is that people see it as a legal way to get high which, at the moment, it is (more on that in a moment).
One of the best review studies on the effects of kratom was conducted by scientists at the University of Rochester Medical Center. The scientists found that almost all of the “studies” on kratom were simply case reports of various incidents at hospitals involving kratom or surveys of kratom users, but there were no rigorous randomized controlled trials on the drug.
Lacking better data, they instead parsed through hundreds of anecdotal reports from Erowid, a website where drug users can share their experiences anonymously.
As you’d expect, their results showed that most people report both positive and negative effects from consuming kratom.
The main positive effects were (from most to least common):
- Enhanced sociability
- Increased energy
- Pain relief
- Sensory enhancement
- Feelings of warmth or pleasant tingling
And the main negative effects were (from most to least common):
- Withdrawal (after cessation)
- Chills and sweats
- Dizziness and unsteadiness
- Hangovers and headaches
Here’s a chart that shows you the exact breakdown of side effects from taking kratom:
Of course, like any new, mysterious, trendy drug or supplement, some companies are also making outlandish claims about kratom’s ability to cure cancer and a long list of other maladies. There’s no evidence this is true, and the FDA has already started going after companies for making unproven assertions about kratom’s benefits.
Summary: Many people believe kratom can help them quit taking opioids and reduce the symptoms of other health issues like Lyme disease, anxiety, and depression, but there’s still little to no scientific evidence proving this is true.
There aren’t enough studies on the effects of kratom to pinpoint a proper dosage, so anything you read or hear about online is more conjecture than fact.
What’s more, kratom comes in a variety of mediums (leaves, powder, liquid, etc.), there are different strains of kratom with different concentrations of psychoactive chemicals, and kratom products from different manufacturers can contain wildly different dosages of key ingredients.
There’s still no standardization of products in the kratom industry and very little regulation or oversight, so when you read the label of a kratom product, you’re trusting the company that made it to tell you the truth.
Summary: There’s no scientific consensus on what the proper kratom dosage is for different uses, and thus any recommendations you find online are speculative and unproven.
Right now this question is impossible to answer.
On the one hand, kratom users claim it’s safe if taken in small to moderate dosages.
On the other hand, most health authorities, government agencies, and researchers claim there’s not enough evidence to even decide what a “small to moderate dosage” is.
Well, poke around online and most of the information you’ll find about kratom’s safety and side effects comes from anecdotal accounts of users, which have to be taken with a large grain of salt.
For one thing, many of the people who take kratom do so hoping it will help them with some health condition, which makes it likely their perceptions are colored by the placebo effect. If they notice some benefit, they’re also likely to downplay or overlook any negative effects, too.
What’s more, many of these people are under the mistaken belief that because kratom is “natural,” it’s inherently safer than other drugs, which isn’t the case. There are plenty of poisonous and harmful plants and other substances found in nature (hemlock, arsenic, cyanide), and in some cases “natural” medicines pose even more health risks than synthetic drugs that have undergone rigorous scientific testing.
Even if someone says they haven’t noticed any immediate negative side effects of kratom, we have no idea of knowing how the drug will affect them long-term. While users point to people in Southeast Asia as evidence you can eat kratom for years without ill effects, there are no controlled long-term studies proving this is the case.
In other words, predicting how kratom will affect you is a crapshoot.
While kratom users tend to be overzealously in favor of the drug, government agencies have also stirred the pot by hinting they’re going to ban kratom.
For example, Food and Drug Administration (FDA) commissioner Scott Gottlieb has repeatedly lambasted kratom in the press, claiming “There’s clear data on the increasing harms associated with kratom.”
Gottlieb points to reports collected from U.S. poison control centers, which show a spike in kratom-related complaints from 2010 to 2015. The FDA also cites 44 cases in which someone has died after taking kratom as further evidence of its danger.
If you dig beneath the surface of these reports, though, you quickly see that it’s uncertain how much blame kratom deserves for these deaths.
The FDA admits that most of the people who died after consuming kratom had also consumed many other drugs, including opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications like cough syrup. In other cases, the kratom people consumed was found to have been adulterated with other drugs, and in other instances people had unwittingly consumed supplements that were laced with kratom and other drugs.
That said, the FDA does have grounds to be concerned about kratom.
To help elucidate kratom’s role in overdoses, scientists Northeast Ohio Medical University conducted a study where they analyzed 1,807 kratom-related reports from poison control centers across the U.S. from 2011 to 2017.
They found that in cases where kratom was the primary drug people consumed, 32% of these people wound up in the hospital and 52% were treated for some kind of serious medical problem. They also found that 11 people died after consuming kratom.
Nine of them consumed kratom along with a cocktail of other drugs such as alcohol, caffeine, cocaine, benzodiazepines (an antidepressant), fentanyl (an opioid), and diphenhydramine (an antihistamine), but two people died after only consuming kratom.
The researchers also found that among people who only consumed kratom and didn’t die, 86% still experienced some kind of negative clinical outcome (such as elevated heart rate, agitation, etc.).
Another study conducted by scientists at VCU Medical Center looked at the symptoms of 15 people who were admitted to poison control centers after consuming kratom, and found they suffered from impaired cognition, agitation, seizures, and rapid and irregular heart rate.
Now, while this sounds bad, it doesn’t tell the whole story. For one thing, almost everyone who calls a poison control center is suffering from some kind of negative symptom. Thus, if you look at this data as a whole, it’ll look like almost everyone who takes kratom suffers serious health problems.
The studies also involved small sample sizes—just under 2,000 reports of people who’d taken kratom—and it’s possible that the majority of the people who take the drug experience mild or no negative side effects.
And once again, many of the people included in this study were also found to have taken other drugs along with kratom before they experienced health issues.
So, circling back to our original question, is kratom safe?
Well, based on the available evidence, the answer is probably “no” until we have more research on how the drug affects people. Some people seem to be able to take it without any major negative effects, others run into severe symptoms, and a few people have died.
And while it’s impossible to say what role kratom played in many of these deaths, the FDA is probably right that it’s better to err on the side of safety until we know more.
So far, there isn’t any strong, scientific evidence that kratom can combat opioid addiction or help fight against anxiety, depression, or other ailments, and there is good reason to believe the drug could be potentially addictive and dangerous.
Perhaps the greatest danger posed by kratom is the lack of standardization of proper dosages.
Kratom products from different companies can have vastly different concentrations of psychoactive chemicals, which makes it difficult to know how much of the drug you’re really consuming.
For example, in one study conducted by Swedish scientists, the researchers looked at blood levels of the key ingredient in kratom in nine people who died after taking the drug. They found that blood levels ranged from 0.02 to 0.18 mcg per gram, a 9-fold difference.
Given all of the unknowns about how kratom affects people and the levels of psychoactive chemicals in different kratom products, taking kratom is a high-risk decision.
Summary: Multiple reports have shown kratom can have powerful negative side effects, and most health agencies recommend you don’t consume any kratom products until more research has been conducted.
Many kratom users insist the drug isn’t addictive, but given its ability to mimic the effects of opioids in the brain, it almost certainly has at least some addictive potential.
To help elucidate how addictive kratom really is, scientists from Syracuse University profiled the addictive potential of the compounds found in kratom, and looked at the real-world effects of kratom in regular users in Southeast Asia. They found that regular users—people who consumed about a third a cup of kratom tea per day—showed signs of “psychological and physical dependency on Kratom.”
“Cessation of Kratom use produced physical withdrawal symptoms similar to opiate addiction,” noted the authors of the study, “including pain, muscle spasms, sleep difficulty, watery eyes, runny nose, hot flashes, fever, decreased appetite, diarrhea, and Kratom craving.”
In some areas in Southeast Asia, kratom addiction is so common that researchers have already developed a way of measuring kratom dependance, a rating system known as the Kratom Dependence Scale (KDS).
Soooo, yeah, it’s probably addictive.
That said, there’s still very little research on how much kratom people need to consume and for how long before they show strong signs of addiction. There’s also little research on how addictive kratom is versus opioid drugs, such as heroin, oxycodone, and methadone.
Summary: Kratom is almost certainly addictive and can produce withdrawal symptoms similar to heroin, although not quite as severe. It’s still unclear how much kratom you need to take and for how long before you experience withdrawal symptoms.
Yes, for now.
There’s an ongoing debate about whether or not kratom should be banned for public consumption, with many scientists and users fighting to keep it legal and many government agencies angling to ban it.
In 2016, the Drug Enforcement Administration (DEA) declared kratom was “an imminent hazard to the public safety,” and took steps to add kratom to its list of Schedule 1 drugs—compounds that have no approved medical uses and/or a high potential for addiction—such as heroin, LSD, and ecstasy. This would have also banned the production, importation, and sale of kratom in the U.S.
This boomeranged on the DEA when they faced a massive public backlash, with both users and scientists urging the DEA to wait until more research was done. Many people who’ve been using kratom to combat opioid addiction would have been turned into criminals by the ban, and scientists would have been significantly limited in their ability to study the new drug.
Finally, members of Congress urged the DEA to pigeonhole their proposed kratom ban until the public had a chance to comment.
The DEA obliged them, and asked the FDA to quicken the pace of new research into kratom. This was an unusual move, considering the DEA’s history of aggressive action against new, untested, and potentially dangerous drugs, and they could renew their efforts to ban kratom at any time.
So, for now, kratom is in a kind of legal limbo.
On the one hand, the DEA could still move to ban it (and there are many in the agency who probably want to), and most of the reports coming from the FDA only seem to vindicate the DEA’s concerns.
On the other hand, the potential of kratom to help curb opioid addiction has likely stayed their hand for the moment.
So, kratom is currently legal at the federal level, but it’s a different story at the state level.
Kratom is legal in most states, but some have passed major restrictions on the drug.
For example, kratom is illegal to own, use, or buy in Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin.
In other states, kratom is only legal outside of certain areas and for people above a certain age.
Kratom is legal in California but banned in San Diego.
It’s legal in Florida, but banned in Sarasota County.
It’s legal in Colorado, but banned for human consumption in Denver.
It’s legal in New Hampshire, but only for people over 18.
It’s legal in Tennessee, but only for people over 21.
And it’s legal in Illinois to people over 18, but banned in Jerseyville.
Aside from those states, kratom is legal to own, buy, or sell in every other state without age or area restrictions.
Summary: Kratom is currently legal at the federal level and in 38 states, although it’s banned completely in 6 states and restricted to people in certain areas and above a certain age in 6 others.
Kratom is an herb that contains psychoactive chemicals that mimic some of the same effects of opioids in the brain.
Kratom isn’t technically an opioid, but in large enough doses it can induce feelings of pleasure, sedation, relaxation, and euphoria and reduce pain. In small doses, kratom produces mild stimulant effects.
Many people believe kratom can help them wean themselves off of opioids, but there’s still little to no scientific evidence this is true.
Many others take kratom recreationally because they think it’s a safe, legal way to get high, but most evidence shows it can still cause serious side effects.
There’s no scientific consensus on what the proper kratom dosage is for different uses, and thus any recommendations you find online are speculative and unproven.
Multiple reports have shown kratom can have powerful negative effects, and most health agencies recommend you don’t consume any kratom products until more research has been conducted.
Although many users claim kratom isn’t addictive, the best available scientific evidence shows it can produce dependency and withdrawal symptoms similar to heroin, although not quite as severe.
Kratom is still legal for now, but it’s possible the FDA and DEA will ban it soon.
It’s legal in most states, but banned in six states and restricted to certain areas and age groups in another six states.
In the final analysis, the best you can say about kratom is that it’s a high-risk, potentially low-reward drug, and until more research is conducted, it’s probably best to steer clear of it.
What are your thoughts on kratom? Anything else you’d like to share? Let me know in the comments section below!
+ Scientific References
- Federal Register :: Schedules of Controlled Substances: Temporary Placement of Mitragynine and 7-Hydroxymitragynine Into Schedule I. https://www.federalregister.gov/documents/2016/08/31/2016-20803/schedules-of-controlled-substances-temporary-placement-of-mitragynine-and-7-hydroxymitragynine-into?utm_campaign=pi+subscription+mailing+list&utm_medium=email&utm_source=federalregister.gov. Accessed March 16, 2020.
- Bergen-Cico D, MacClurg K. Kratom (Mitragyna speciosa) Use, Addiction Potential, and Legal Status. In: Neuropathology of Drug Addictions and Substance Misuse. Vol 3. Elsevier Inc.; 2016:903-911. doi:10.1016/B978-0-12-800634-4.00089-5
- Bäckstrom BG, Classon G, Löwenhielm P, Thelander G. [Krypton--new, deadly Internet drug. Since October 2009 have nine young persons died in Sweden]. Lakartidningen. 107(50):3196-3197. http://www.ncbi.nlm.nih.gov/pubmed/21294331. Accessed March 16, 2020.
- Cumpston KL, Carter M, Wills BK. Clinical outcomes after Kratom exposures: A poison center case series. Am J Emerg Med. 2018;36(1):166-168. doi:10.1016/j.ajem.2017.07.051
- Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011–2017. Clin Toxicol. 2019;57(10):847-854. doi:10.1080/15563650.2019.1569236
- Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom | FDA. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-fda-advisory-about-deadly-risks-associated-kratom. Accessed March 16, 2020.
- FDA warns companies selling illegal, unapproved kratom products marketed for opioid cessation, pain treatment and other medical uses | FDA. https://www.fda.gov/news-events/press-announcements/fda-warns-companies-selling-illegal-unapproved-kratom-products-marketed-opioid-cessation-pain. Accessed March 16, 2020.
- Swogger MT, Hart E, Erowid F, et al. Experiences of Kratom Users: A Qualitative Analysis. J Psychoactive Drugs. 2015;47(5):360-367. doi:10.1080/02791072.2015.1096434
- White CM. Pharmacologic and clinical assessment of kratom. Am J Heal Pharm. 2018;75(5):261-267. doi:10.2146/ajhp161035
- Boom M, Niesters M, Sarton E, Aarts L, W. Smith T, Dahan A. Non-Analgesic Effects of Opioids: Opioid-induced Respiratory Depression. Curr Pharm Des. 2012;18(37):5994-6004. doi:10.2174/138161212803582469
- Darke S, Larney S, Farrell M. Yes, people can die from opiate withdrawal. Addiction. 2017;112(2):199-200. doi:10.1111/add.13512
- Kosten TR, Baxter LE. Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. Am J Addict. 2019;28(2):55-62. doi:10.1111/ajad.12862
- Hassan Z, Muzaimi M, Navaratnam V, et al. From Kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev. 2013;37(2):138-151. doi:10.1016/j.neubiorev.2012.11.012
- Yamamoto LT, Horie S, Takayama H, et al. Opioid receptor agonistic characteristics of mitragynine pseudoindoxyl in comparison with mitragynine derived from Thai medicinal plant Mitragyna speciosa. Gen Pharmacol. 1999;33(1):73-81. doi:10.1016/s0306-3623(98)00265-1
- Suhaimi FW, Yusoff NHM, Hassan R, et al. Neurobiology of Kratom and its main alkaloid mitragynine. Brain Res Bull. 2016;126(Pt 1):29-40. doi:10.1016/j.brainresbull.2016.03.015
- E. Adkins J, W. Boyer E, R. McCurdy C. Mitragyna speciosa, A Psychoactive Tree from Southeast Asia with Opioid Activity. Curr Top Med Chem. 2011;11(9):1165-1175. doi:10.2174/156802611795371305
- Gibbons S, Arunotayanun W. Natural Product (Fungal and Herbal) Novel Psychoactive Substances. In: Novel Psychoactive Substances: Classification, Pharmacology and Toxicology. Elsevier Inc.; 2013:345-362. doi:10.1016/B978-0-12-415816-0.00014-6
- Warner ML, Kaufman NC, Grundmann O. The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. Int J Legal Med. 2016;130(1):127-138. doi:10.1007/s00414-015-1279-y
- Veltri C, Grundmann O. Current perspectives on the impact of Kratom use. Subst Abuse Rehabil. 2019;Volume 10:23-31. doi:10.2147/sar.s164261
- Ho JY, Hendi AS. Recent trends in life expectancy across high income countries: Retrospective observational study. BMJ. 2018;362. doi:10.1136/bmj.k2562