Kratom Use, Effects, and Risk of Addiction

Author: Hannah Sumpter

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Kratom is a newly popular substance in the United States, originating from the leaves of the Mitragyna speciosa tree and commonly found in Southeast Asia¹ and Africa.² In those cultures, kratom is frequently used for a wide variety of medical purposes,³ religious events and social engagements.⁴

Kratom can be consumed in tea, smoked in a pipe or used in powder form, making it a versatile and enticing, but extremely dangerous, opioid-like substance. ¹

What is Kratom Used For

Used for religious and social engagements in other cultures, Kratom is not FDA-approved for any medical uses in America.

In America, kratom is sometimes used as a natural remedy for opioid withdrawal and pain management, although this use is unregulated.

Although, as of 2026, studies have shown that there isn’t sufficient evidence that Kratom has any beneficial uses, in fact, the FDA warns against its use due to serious safety considerations.  Some people have claimed that Kratom has helped them with:

• Depression
• Anxiety
• Post-traumatic stress disorder (PTSD)
• Improving energy and focus

Recreationally, people use Kratom for its ability to cause a “high” or euphoria that is similar to opioids. In small doses, it can also increase alertness, physical energy and talkativeness.

Kratom Side Effects

Like all substances, kratom use comes with side effects.

Side effects of kratom use may include:¹¹

• Constipation
• Dry Mouth
• Muscle pain
• Dehydration
• Bladder spasms
• Weight loss
• Severe headache
• Muscle twitches
• Anorexia
• Loss of coordination, vertigo and dizziness
• Drowsiness
• Respiratory depression
• Kidney damage
• Hallucinations
• Grand delusions
•  Seizures
• Coma

Kratom has been shown to cause herb-drug interactions, most notably with other central nervous system substances. If you are considering kratom for yourself and are taking a medication that may affect your central nervous system, please speak with a medical professional.

Drug-induced liver injury (DILI) is a rare but possibly serious side effect of kratom. DILI is most often seen when taking higher kratom dosages for long periods.  This has been shown to happen in a relatively short time in some individuals.⁶

Lastly, safety concerns should be considered with kratom purchases in the United States, especially over the internet. The market for kratom is unregulated, and products may be adulterated or contaminated with dangerous substances, placing additional health risks on yourself or your loved ones.

When starting a new medication, speak with a medical professional to gauge your risk factors and make a final determination of the best treatment options for yourself and your condition.⁷

This advice becomes more significant with kratom, as studies have shown that kratom dependence, withdrawal and life-threatening toxicity are higher among people who began kratom therapy without oversight and guidance from a medical professional. As such, the unregulated use of kratom is not advised.¹²

Kratom Overdose

Overdose is a well-known risk for any medication and/or drug used with and without medical oversight. Since becoming popular in the United States, accidental overdose has been noted among kratom users, and most especially among those using kratom in combination with other medications and substances. Kratom overdose is most commonly observed in individuals who have been taking kratom for longer periods and at high doses.

Risk of Kratom Addiction

Most often, kratom is appealing for those looking to avoid narcotic and opioid use, possibly due to a past, present or fear of addiction to narcotics or opioids. If you are considering kratom use as a means to avoid addiction to narcotics and opioids, awareness should be raised about the potential risk of addiction to kratom itself.¹

Dependence on kratom is known to develop mostly among those taking kratom for prolonged periods (6 months or longer),¹⁵ and/or for managing opioid withdrawal symptoms.¹⁶ This dependence is strongly linked to your history of addiction, with the same pattern of increasing tolerance and dependence with kratom instead of your past drug of choice.¹⁷

Why is Kratom Addictive?

Kratom addiction seems likely due to its opioid-like effects. Its active compounds, mitragynine and 7-hydroxymitragynine, partially activate the same receptors that other opiates, including morphine, do. However, one specific addictive property of kratom has been found to be 10 times more potent than morphine and as addictive as heroin.

Although kratom has not been scheduled by the United States Drug Enforcement Administration, seven states have classified it, or its primary alkaloid, mitragyning/7-OH as a Schedule I substance. Furthermore, many states have enacted legislation regulating the sale to adults only and require that the products be clearly labeled.

Due to the limited information around kratom safety and concern with potentially severe kratom effects, personal awareness and caution is recommended before using kratom.

Kratom Withdrawal

Withdrawal is also a risk associated with kratom use, most especially if kratom has been taken for longer than a month. Withdrawal symptoms may include:¹⁵

• Muscle spasms
• Pain
• Sleeping difficulty
• Watery eyes and nose
• Hot flashes
• Fever
• Decreased appetite
• Diarrhea
• Restlessness
• Tension
• Anger
• Sadness
• Nervousness
• Anxiety
• Depression

Self-reports from those kratom users who experienced withdrawal indicate that cessation from chronic kratom tea consumption was associated with unpleasant psychological symptoms, including the new onset of anxiety and depressive symptoms. The level of withdrawal symptoms depended on the amount of kratom consumed, with higher levels of use being associated with higher levels of anxiety and depression.³

If you or someone you love has developed a problem with your kratom use, help is available. There are treatment programs around the country that can help you get control over your kratom addiction and live a healthier, happier life. Reach out today.

References

1. Cole, M.A., Pillitterri, J.L., Sembower, M.A., Gerlach, K.K., & Henningfield, J.E. (2019). Kratom as a substitute for opioids: Results from an online survey. Drug and Alcohol Dependence, 202, 24-32.
2. Warner, M., Kaufman, N., & Grundmann, O. (2016). The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. International Journal of Legal Medications, 30(1): 127-38.
3. Singh, D., Muller, C.P., Murugaiyah, V., Hamid, S.B.S., Vicknasingam, B.K., Avery, B., Chear, N.J.Y., & Mansor, S.M. (2018). Evaluating the hematological and clinical- chemistry parameters of kratom (Mitragyna speciosa) users in Malaysia. Journal of Ethnopharmacology, 3(25): 197-206
4. Singh, D., Narayanan, S., Vicknasingam, B., Corazzo, O., Santacroce, R., & Roman- Urrestarazu, A. (2017). Changing trends in the use of kratom (Mitragyna speciosa) in Southeast Asia. Hum Psychopharmacology. 32(3). doi: 10.1002/hup.2582
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6. Fernandes, C., Iqbal, U., Tighe, S., & Ahmed, A. (2019). Kratom-induced cholestatic liver injury and its conservative management. Journal of Investigative Medicine High Impact Case Reports, 12(7).
7. Prozialeck, WC., Avery, BA., Boyer, EW., Grundmann, O., Henningfield, JE., Kruegel, AC., McMahon, LR., McCurdy, CR., Swogger, MT., Veltri, CA., & Singh, D. (2019). Kratom policy: the challenge of balancing therapeutic potential with public safety. International Journal of Drug Policy, 8(70) 70-77.
8. Singh, D., Narayanan, S., Muller, C.P., Vicknasingam, B., Yucel, M., Ho, E.T.W., Hassan, Z., & Mansor, S.M. (2019). Long-term cognitive effects of kratom (Mitragyna speciosa korth) use. Journal of Psychoactive Drugs, 51(1)19-27.
9. Singh, D., Murugaiyah, V., Hamid, SBS, Kasinather, V., Chan, MSA, Ho, ETW, Grundmann, O., Chear, N.J.Y., & Mansor, S.M. (2018). Assessment of gonadotropins and testosterone hormone levels in regular Mitragyna speciosa (korth.) users. Journal of Ethnopharmocology. 15(221), 30-36.
10. Singh, D., Muller, C.P., Vicknasingam, B.K., & Mansor, S.M. (2015). Social functioning of kratom (Mitragyna speciosa) users in Malaysia. Journal of Psychoactive Drugs, 47(2): 125-31.
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12. Sethi, R., Hoang, N., Ravishankar, DA., McCracken, M., & Manzardo, A.M. (2020). Kratom (Mitragyna speciosa): Friend or foe? Primary Care Companion CNS Disorders, 30(22), 1.
13. Palasamudrum, S., Rojas, E.E., D’Angelo, C.C., Gillenwater, S.R., & Martinez, G. (2019). Legally lethal kratom: A herbal supplement with overdose potential. Journal of Psychoactive Drugs, 51(1), 28-30.
14. Galbis-Reig, D. (2016). A case report of kratom addiction and withdrawal. WMJ, 115(1), 49-52.
15. Singh, D., Muller, C., & VIcknasingam, B. (2014). Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug and Alcohol Dependence, 1(139), 132-7.
16. Singh, D., Chear, Y., Narayanan, S., Leon, F., Sharma, A., McCurdy, CR, Avery, B.A., & Balasingam, V. (2020). Patterns and reasons for kratom (Mitragyna speciosa) use among current and former opioid poly-drug users. Journal of Ethnopharmacology, 1(249), 112462.
17. Goldin, D., Salani, D., & McKay, M. (2019). Kratom: implications for health care providers. J Psychosoc Nurs Ment Health Serv. 57(12):15-20.
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