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Kratom Use: Signs, Risks, & Getting Help

Kratom is a plant-derived substance with both stimulant effects and sedating, or opioid-like effects.1,2 Although kratom is currently not controlled under the United States Controlled Substances Act, some states have policies to regulate it.2 The Food and Drug Administration (FDA) has not approved kratom for any medical use, and the U.S. Drug Enforcement Administration (DEA) lists kratom as a drug of concern.2

In 2020, more than 2 million people in the U.S. reported using kratom within the last year.3 Although research into the health effects and safety profile of kratom is far from complete, several adverse effects associated with kratom use have been reported.1 Studies also suggest that people who use kratom regularly may experience mild to moderate withdrawal symptoms when they stop.1

This article explains the effects and risks of kratom and signs that someone may need to seek professional help for kratom use.

What Is Kratom?

The word kratom may refer to the Mitragyna speciosa tree native to Southeast Asia as well as the psychoactive substances extracted from the leaves of the tree.1 When ingested, kratom can produce stimulant-like effects (e.g., increased alertness and energy, rapid heart rate) at low doses and opioid-like effects (drowsiness, relaxation, and pain relief) at relatively higher doses.1, 2

Kratom is typically taken orally by ingesting the leaves or by grinding the leaves into a powder that is added to pill capsules or dissolved into a liquid.2 Kratom is not currently a scheduled controlled substance in the United States, so it remains legal to purchase and possess; however, it remains a DEA listed drug of concern.2 In 1979, Thailand placed kratom on a list of controlled narcotic substances.4 Since 2020, kratom has been under surveillance by the Expert Committee on Drug Dependence (ECDD) due to its potential for misuse, dependence, and harm to public health.5

Is Kratom Addictive?

In clinical settings, medical professionals diagnose a substance use disorder based on a person meeting specific diagnostic criteria from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).1 The DSM-5 does not currently include a specific diagnosis for kratom; however, some researchers suggest that people may develop problematic patterns and symptoms of kratom use that are similar to substance use disorders.1

Though some people use kratom to self-manage opioid withdrawal and cravings in the context of separate opioid use disorders, kratom itself may have addiction potential.1,8 Kratom contains 2 primary psychoactive compounds, mitragynine and 7-hydroxymitragynine, which can activate opioid receptors in a way that elicits somewhat similar effects to other opioid agonist drugs such as heroin and oxycodone (although relatively less robustly).1, 8 Though the mechanism of opioid receptor activation differs somewhat from that of other opioids, the FDA warns that these properties may similarly expose users to the risk of addiction development.8

Potential Risks of Kratom Use

While kratom may have potential medicinal uses, additional research is needed to better understand the effects of kratom use. For now, people who use kratom or are considering using kratom should know that there are no FDA-approved uses for the drug.8 The FDA warns against using kratom and any other products that contain mitragynine and 7-hydroxymitragynine.8

Kratom use can cause various cardiovascular, gastrointestinal, neuropsychiatric, and respiratory concerns, and has been linked to liver toxicity as well as a small number of deaths.1, 5 People have reported a variety of kratom side effects ranging from mild to severe.1

Mild effects of kratom may include:1, 9

  • Constipation.
  • Dizziness.
  • Drowsiness.
  • Dry mouth.
  • Increased urination.
  • Itching.
  • Hair loss (with daily use).
  • Nausea.
  • Sweating.

Although rare, people have reported experiencing serious adverse effects associated with kratom use, including:1, 9

  • Hypothyroidism.
  • Liver issues (e.g., cholestasis, which is a buildup of bile in the liver).
  • Heart issues (e.g., increased heart rate, high blood pressure).
  • Lung issues (e.g., respiratory depression or slowed breathing).
  • Confusion.
  • Tremors.
  • Seizures.

There is also concern about kratom use due to unregulated manufacturing and the risk of contamination.10 In 2018, there was a multistate outbreak of salmonella linked to kratom products.10

Signs of Kratom Misuse and Addiction

If you are concerned that someone you care about may be misusing or addicted to kratom, there are several signs that could indicate that their use of the drug is becoming problematic. They may exhibit certain behavioral changes such as a loss of interest in previously enjoyed hobbies or activities. You may notice that they are experiencing problems at home, school, or work due to their substance use. They may begin to compulsively use the drug to simply feel normal.11

You may also notice symptoms related to kratom withdrawal when the drug is not being used. While Kratom withdrawal has not been extensively researched, some studies suggest that kratom use is associated with cravings, dependency, and withdrawal symptoms if a person tries to cut back or stop using the drug.1, 9

Kratom withdrawal symptoms may be similar, though generally milder, than those associated with other opioid withdrawal syndromes, including: 9

  • Nervousness.
  • Restlessness.
  • Irritability.
  • Drug cravings.
  • Trouble sleeping.
  • Body aches.
  • Muscle spasms.
  • Decreased appetite.
  • Abdominal cramps.
  • Nausea and vomiting.
  • Diarrhea.
  • Fever.
  • Sweating.
  • Watering eyes.
  • Runny nose.

Getting Help for Kratom Use

If you believe that you or someone you love needs support for problematic kratom use, help is available. Several treatment options and settings may be helpful in cases of compulsive kratom use, including detox, inpatient rehab, and outpatient rehab programs.

American Addiction Centers (AAC) is a leading provider of addiction treatment across the U.S. Our admissions navigators are available 24 hours a day, 7 days a week when you contact . We can help you verify your insurance and answer questions about what kratom treatment programs are available.



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