For centuries, people in Southeast Asia have chewed the leaves of the kratom tree, which belongs to the coffee family, to relieve pain and boost energy and mood.
In the United States, as kratom has become more accessible and popular in recent years, it has sparked an ongoing debate and regulatory challenges. While proponents claim that kratom can help manage various issues, from anxiety to opioid withdrawal symptoms, research supporting these assertions is limited, and US regulators continue to caution against potential health risks associated with kratom.
Despite these warnings, Americans are buying kratom and kratom-infused products in such large quantities—available through online retailers, gas stations, convenience stores, smoke shops, and bars—that it has developed into a $1 billion industry.
What is kratom?
Typically, the leaves of the kratom tree are dried and ground into a powder, resembling traditional usage by Thai and Malaysian farmworkers. In the US, kratom is commonly consumed in various forms, including capsules, drinks, teas, gummies, or as shots.
At low doses, kratom acts as a stimulant, while higher doses have sedative effects and carry addictive properties similar to opioids, according to the National Institutes of Health and the Mayo Clinic. The plant’s effects are primarily due to its two main compounds, mitragynine and 7-hydroxymitragynine, which provide stimulant and pain-relieving qualities. The effects of kratom are typically felt within minutes and can last for a few hours.
How dangerous is kratom?
Currently, there isn’t enough data to definitively assess kratom’s safety, and researchers emphasize the need for further studies. Generally, consuming the raw kratom leaf is less likely to cause adverse effects; however, more concentrated forms present additional risks.
“The danger occurs when we have foreseeable harm, and at the moment, we lack the data to definitively say that kratom is hazardous,” stated Kirsten Smith, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University.
Nonetheless, kratom products can be harmful and even potentially toxic in high doses, particularly kratom-based beverages, which often contain elevated levels of the active compounds. For example, the US Food and Drug Administration (FDA) issued a warning against Black Liquid Kratom, highlighting side effects such as aggressive behavior, increased anxiety, and even a reported death linked to its use.
“It’s akin to comparing coffee and caffeine pills—they are not the same,” remarked Abhisheak Sharma, assistant professor of Pharmaceutics and co-director of the Translational Drug Development Core at the University of Florida.
What risks are associated with kratom?
The FDA cautions that kratom can cause issues such as liver damage, seizures, and substance use disorders. While deaths associated with kratom use have been reported, they often involve other substances, making kratom’s contribution ambiguous.
Multiple lawsuits have been filed against kratom-selling companies, with plaintiffs claiming that misleading marketing and inadequate safety labeling have left consumers unaware of how kratom might interact with other drugs.
Kratom is frequently advertised as a safe alternative to opioids or a self-medication solution for opioid withdrawal, but these claims lack medical validation, according to Matthew Rossheim, a professor at the University of North Texas who conducted a 2024 survey on kratom’s prevalence in US tobacco and vape shops.
Is kratom classified as a drug?
In 2016, the US Drug Enforcement Administration (DEA) sought to classify kratom as a controlled substance, similar to heroin and ecstasy, which would have made its possession and distribution illegal. However, public backlash from pro-kratom advocacy groups halted those efforts. The DEA continues to regard kratom as a “drug of concern.”
Is kratom legal?
Kratom’s legality varies across states. Six states—Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin—have enacted complete bans on kratom due to health and safety concerns. Other states, including Tennessee and Ohio, have considered bills to regulate kratom recently.
Thirteen states have adopted versions of the Kratom Consumer Protection Act (KCPA), which the American Kratom Association supports at both federal and state levels. This legislation legalizes kratom while prohibiting adulterated products and establishing regulations for content and labeling.
In states where kratom remains legal, there may still be age restrictions or local regulations, such as city-specific bans. For instance, while kratom is legal in California, its manufacture, sale, distribution, and possession are prohibited in San Diego.
Is the FDA investigating kratom?
While kratom may not be widely recognized in the US, it has drawn the attention of the FDA, which advises against its medical use until it thoroughly assesses its safety. Over the years, the FDA has issued warning letters and seized products from certain kratom manufacturers following reports of adverse events, including fatalities.
Kratom has not received FDA approval for any medical application, and the agency maintains that it cannot be marketed as a dietary supplement
