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Is the Herbal Product Kratom Safe or Harmful?

A tropical plant that is part of the coffee family is growing in popularity in the U.S. It is a stimulant with opioid-like effects, but don’t expect to see it anytime soon in your local coffee shop or Starbucks.

You may have seen kratom if you visit a vitamin store, liquor store or smoke shop. Kratom is a natural product derived from Mitragyna speciosa, a tree native to Southeast Asia. Other street names for it are ketum, kakuam, ithang and thom.

“The kratom leaves contain many compounds, though the principal active ingredient is mitragynine,” said Bryan Kuhn, PharmD, a pharmacist and poison education specialist at Banner Health. “Mitragynine is responsible for the sedating or stimulating properties of kratom.”

Kratom is legal in most U.S. states and is marketed today as having “healing powers” or even as an alternative to opioids. However, most medical experts agree that the health risks make it unsafe. The supplement has numerous safety issues, adverse effects and risks – including fatal overdose.

Before considering the purchase of kratom, here are four things to consider.

1. Kratom is highly addictive

People take kratom for various reasons, but it appears to be commonly used as a treatment alternative for chronic pain and opioid withdrawal. It can also produce dose-dependent psychoactive effects, including euphoria, simultaneous stimulation and relaxation, analgesia (the inability to feel pain), vivid dreams and sedation. 

Based on the makeup of kratom, it’s believed that it has the potential for abuse and has withdrawal symptoms and cravings that are similar to what people experience with opioid withdrawal, including intense cravings, nausea, vomiting and muscle aches.

“If you recognize the signs of kratom withdrawal, it’s important to work with a health care provider who specializes in addiction,” Dr. Kuhn said. “They can guide you through an assisted detox to overcome your dependence and focus on tackling other underlying issues, such as opiod use disorder, addiction, chronic pain or depression.”

2. Kratom is legal but not regulated

In the United States, kratom is not regulated by the U.S. Food and Drug Administration (FDA). Unfortunately, this means there are no checks and balances or guarantees regarding the quality and safety of kratom products purchased in the U.S., including online. 

“The Drug Enforcement Administration (DEA) temporarily banned kratom in 2016, citing it necessary ‘to avoid an imminent hazard to public safety’ but reversed that decision a few months later,” Dr. Kuhn said. “Before this announcement, kratom was regulated as an herbal product under FDA and DEA policies and, as such, was considered a legal substance in most of the U.S.”

As of April 2023, kratom is currently illegal to buy, sell, possess or use in:

  • Alabama
  • Arkansas
  • Indiana
  • Rhode Island
  • Vermont 
  • Wisconsin

Kratom is now banned from use in Australia, Malaysia, Indonesia and many European Union countries, although Indonesia is still involved in the raw export of the product.

3. High risk of overdose

Contrary to what you may have heard, it is possible to overdose on kratom. The terms “all-natural” or “herbal” mask the nature of the active ingredients that can vary widely by plant, making its effects unpredictable. This leads to a risk of overdose and serious side effects.

“Since kratom is an unregulated product, it’s often found to contain various impurities that can result in further psychoactive effects,” Dr. Kuhn said.

Symptoms of an acute kratom overdose can include liver injury, psychosis, seizures, insomnia, tachycardia (heart rate more than 100 beats per minute), poor concentration and hallucinations. 

4. Dangerous drug interactions

The negative effects can be even more severe when kratom is combined with other drugs and prescription medications. The possible consequences of many drug interactions range from seizures, liver damage and respiratory failure leading to death.

Because there is little research currently available on how kratom interacts with other substances, the severity of its effects is yet unknown. This uncertainty adds to the dangers of using kratom.


Although kratom is sometimes touted as a “safe” substance to help overcome opioid addiction or treat chronic pain, regular, long term use and higher doses may lead to addiction, negative side effects and potentially deadly interactions.

If you have questions regarding kratom use, misuse or abuse, please contact the Banner Poison & Drug Information Center at 800-222-1222. 

Are you concerned that you or a loved one may suffer from addiction? Unfortunately, this disease is more powerful than you may realize. But, strengthened by your professional and social advocates, you will have the support you need to work to regain your control. To find help and begin your journey toward recovery, there are several resources available if you or a loved one are struggling with addiction:

To find a doctor or behavioral health specialist, visit bannerhealth.com.

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