What Is Kratom and Is It Safe To Use?

Kratom is a tropical tree whose leaves contain natural chemicals that can produce mind-altering effects. Some see a benefit in that psychoactive power, which explains kratom’s growing popularity for pain relief, mood boosts and energy.

But products made from the leaves of the kratom tree also come with plenty of health warnings.

So, is kratom safe to use? That’s a complicated question — but there are red flags that deserve your attention and caution, as integrative medicine specialist Yufang Lin, MD, explains.

What does kratom do?

Low doses of kratom can act as a stimulant and make you more alert. The use of its leaves to fight fatigue and treat various conditions dates back centuries in Southeast Asia, Africa and island nations in the Pacific Ocean.

But higher doses can be sedating — maybe even enough to offer relief from intense pain (much like opioid medications).

The effects are related to two specific compounds in kratom. These compounds — mitragynine and 7-hydroxymitragynine (7-OH) — interact with opioid receptors and other mood-altering parts of your brain, explains Dr. Lin.

How is kratom used?

In the past few decades, kratom has gained popularity as an herbal supplement. People who turn to kratom for self-treatment do so for a variety of reasons. Anecdotally, people say they use kratom for:

• Pain management: Because kratom interacts with the brain’s opioid receptors, some people use it to seek pain relief. Some advocates call it a natural alternative to opioid medications.
• Easing withdrawal symptoms from opioid medications: There’s a belief that chemicals in kratom can ease cravings for opioids such as oxycodone. However, researchers caution that kratom can also become addictive.
• Mental health issues: Some say that kratom’s effect on mood can help ease symptoms of anxiety or depression.
• Fatigue: Kratom is related to the coffee plant and can provide an energy jolt similar to a caffeine boost.

The U.S. National Institute on Drug Abuse (NIDA) reports that research is being done to explore possible benefits of kratom. But as of yet, NIDA says researchers HAVE NOT found kratom to be “safe and effective.”

But Kratom can easily be found at convenience stores, gas stations, vape shops and similar outlets. It’s available online, too. In 2022, it was estimated that more than 1.9 million people in the United States used kratom, according to a national survey.

Warnings about kratom

Debate and concern surround the use of kratom, which is NOT lawfully marketed in the U.S. as a medication, dietary supplement or food additive, according to the U.S. Food and Drug Administration (FDA).

The FDA also warns against using kratom given its potential for harm, including liver toxicity, seizures and substance use disorder. Products containing 7-OH have also drawn increased scrutiny.

Kratom is viewed as a “drug of concern” by the U.S. Drug Enforcement Administration (DEA). The agency started the process to criminalize possession of kratom in 2016 but withdrew the plan following public comment.

As of 2026, in the U.S., seven states ban kratom, while roughly two dozen others regulate it in some form, according to the Legislative Analysis and Public Policy Association (LAPPA). Some individual cities and counties have adopted kratom bans, too.

Globally, kratom is illegal or restricted in more than a dozen countries, including parts of Asia and Europe.

But on the flip side, there has been movement in the U.S. to protect access to kratom through several bills introduced in Congress. There are organizations dedicated to keeping kratom available as a wellness option.

Kratom side effects

Side effects from using kratom range from mild to severe and, in rare cases, even death, according to NIDA and other agencies.

Mild effects of kratom can include:

• Constipation
• Drowsiness and sedation
• Dry mouth
• Frequent urination
• Hypothyroidism
• Itching
• Lower libido
• Nausea and vomiting
• Sweating
• Weight loss

More serious side effects of kratom use can include:

• Addiction
• Anorexia
• Cardiac issues, such as heart attack, abnormal heart rhythms and high blood pressure
• Delusion and hallucination
• Liver damage and liver failure
• Seizures

In addition, neonatal opioid withdrawal syndrome has been documented in infants whose mothers regularly used kratom. It’s a condition that affects newborns who receive opioids or other addictive substances through their mother during pregnancy.

Bottom line: Kratom use calls for caution

Safer, evidence-based treatments exist for many of the conditions people try to manage with kratom, says Dr. Lin. Talk to your healthcare provider about what might work for you.

Self-treating with kratom isn’t worth the risk given associated health concerns. In addition, oversight of kratom supplements isn’t as stringent as prescription or over-the-counter medications. That makes it difficult to know exactly what you’re consuming.

“Just because kratom is considered natural doesn’t mean that it’s safe,” adds Dr. Lin. “When you consider everything, you’re better off not using kratom in any form.”