Is Kratom Safe To Use?

Leaves from the kratom tree have chemicals that deliver mind-altering effects. Some see a benefit in that ability, which explains kratom’s use for pain relief, mood boosts and energy. Others see potential danger.

So, are kratom-based products safe? 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 is kratom?

Kratom is a tropical tree related to the coffee plant. 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.

In the past few decades, kratom has gained popularity as an herbal supplement. Pills, powders and teas made from kratom can be found at convenience stores and online.

Low doses of kratom can act as a stimulant and make you more alert. Higher doses, on the other hand, can be sedating and possibly offer relief from intense pain (much like opioid medications).

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

In 2022, it was estimated that more than 1.9 million people in the United States used kratom, according to a national survey by a branch of the U.S. Department of Health and Human Services.

Warnings about kratom

Debate and concern surround the use of kratom, which is NOT lawfully marketed in the United States 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.

Six states in the U.S. ban kratom, while 16 other states have regulations restricting access, requiring warnings or limiting the strength of the compounds. 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 Europe, Japan and Russia.

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.)

On the flip side, there also has been movement in the U.S. to “protect access to kratom” through several bills introduced into Congress.

Why do people use kratom?

People who turn to kratom-based products for self-treatment do so for a variety of reasons, but — to be clear — the DEA emphasizes that “there is no legitimate medical use” for kratom in the U.S.

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

Anecdotally, people say they use kratom for:

• Pain management. Because kratom interacts with your brain’s opioid receptors, some people use it to seek pain relief. It’s often viewed as 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. But researchers caution that kratom can also become addictive.
• Anxiety.
• Depression.
• Fatigue.

Does kratom have 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 abstinence syndrome has been documented in infants birthed by people who regularly used kratom.

Bottom line: Kratom use calls for caution

Safer options that have been medically reviewed exist to address any of the conditions often connected to kratom use, states Dr. Lin. Talk to your healthcare provider about what might work for you.

Self-treating with kratom isn’t worth the risk given the associated health concerns, she emphasizes.

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 getting in quality and concentration.

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