Kratom: What You Need to Know About the Fastest Growing “Legal” Opioid
Kratom has become one of the most talked-about substances in addiction medicine. Marketed as a natural supplement for pain relief, energy, and mood enhancement, it is widely available at gas stations, smoke shops, and convenience stores across the United States.
Unfortunately, many people have no idea that kratom acts on the same receptors in the brain as opioids—and for some individuals, it can lead to dependence, withdrawal, and opioid use disorder.
Below are answers to some of the most common questions about kratom.
What is kratom?
Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia. Its leaves have traditionally been used in countries such as Thailand and Malaysia for their stimulant and pain-relieving effects.
Today, kratom is sold in the United States as powders, capsules, teas, gummies, liquid extracts, and “energy shots.”
Although it is often marketed as a dietary supplement, its active compounds have opioid-like effects.
Is kratom an opioid?
While kratom does not contain morphine or fentanyl, its primary active compounds activate the same opioid receptors in the brain.
Because of this, many addiction specialists and the U.S. Food and Drug Administration consider kratom to have opioid properties.
Like other opioids, repeated use can lead to:
- Tolerance
- Physical dependence
- Withdrawal symptoms
- Opioid use disorder
Why are more people becoming addicted to kratom?
Twenty years ago, most people who developed opioid addiction began with prescription pain medications.
Today, clinicians are seeing increasing numbers of individuals whose opioid use disorder began with kratom.
Many users start taking it because they believe it is:
- Natural
- Safe
- Non-addictive
- A wellness supplement
- An energy booster
Unfortunately, these beliefs often delay recognition of a growing dependence.
If it’s legal, how dangerous can it be?
Legal does not necessarily mean safe.
Kratom remains legal in many states, despite reports linking it to:
- Liver injury
- Seizures
- Heart rhythm abnormalities
- Respiratory depression
- Substance use disorder
- Hospitalizations
- Poison center calls
The FDA has repeatedly warned consumers about these risks.
What is 7-OH?
Recently, the Drug Enforcement Administration announced plans to restrict products containing 7-hydroxymitragynine (7-OH), a highly concentrated and chemically enhanced kratom derivative.
These products are significantly more potent than traditional kratom leaf.
While this is an important step, many addiction professionals believe the larger concern remains the widespread availability of standard kratom products.
Isn’t ordinary kratom different from 7-OH?
Yes—but not in the way many people assume.
Traditional kratom is less potent than concentrated 7-OH products, but it still contains opioid-like compounds capable of producing dependence and withdrawal.
Many individuals who develop kratom addiction have never used enhanced products.
Can people experience withdrawal from kratom?
Yes.
Withdrawal symptoms can resemble those seen with other opioids and may include:
- Anxiety
- Muscle aches
- Sweating
- Nausea
- Vomiting
- Diarrhea
- Restlessness
- Insomnia
- Irritability
Some individuals require medication-assisted treatment similar to that used for other opioid addictions.
Why do some people think kratom helps anxiety or pain?
Initially, kratom may reduce discomfort, improve mood, or produce relaxation.
However, over time, many daily users experience withdrawal between doses.
The temporary relief they feel after taking kratom may actually represent relief from withdrawal rather than treatment of the original problem.
This cycle reinforces continued use and can make dependence difficult to recognize.
Can hospitals detect kratom?
Usually not.
Standard hospital drug screens typically do not detect kratom.
This can create confusion when patients develop opioid-like withdrawal symptoms during hospitalization despite testing negative for traditional opioids.
Specialized testing is required to identify kratom use.
Is there scientific evidence that kratom is safe for chronic pain?
At this time, high-quality scientific evidence remains limited.
While some users report meaningful pain relief, there is not enough research to conclude that kratom is both safe and effective for long-term treatment.
Clinicians must balance anecdotal reports of benefit against known risks of dependence, addiction, and other serious adverse effects.
Why is kratom becoming a public health concern?
Poison center calls and kratom-related hospitalizations have increased dramatically over the past decade.
Addiction specialists are increasingly concerned that widespread availability and marketing as a “natural wellness product” may expose more people to opioid dependence without them realizing the risks.
History has shown that when substances with opioid activity are perceived as safe or non-addictive, rates of misuse and addiction often increase.
Should kratom be banned?
This remains an active public policy debate.
Some experts argue that kratom should remain available because certain individuals report using it instead of prescription opioids for chronic pain.
Others—including many addiction physicians and the FDA—argue that its addictive potential and public health risks outweigh its unproven benefits and support stronger regulation or scheduling.
Regardless of where one stands on policy, there is broad agreement that consumers deserve accurate information about what kratom is, how it works, and the risks it may pose.
The Bottom Line
Kratom is often marketed as a natural supplement, but “natural” does not necessarily mean harmless.
For some individuals, kratom can lead to tolerance, dependence, withdrawal, and opioid use disorder. As addiction professionals continue to see more patients whose substance use began with kratom, awareness and education become increasingly important.
If you or someone you know is using kratom daily, experiencing withdrawal symptoms, or finding it difficult to stop, seeking an evaluation from a qualified addiction professional can be an important first step toward recovery.
At R&A Therapeutic Partners, Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention, and therapeutic/educational consulting services for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information, please visit Therapeutic-Partners.com or on Facebook.
At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.