What you need to know
- Kratom is a tropical plant that some people use to ease pain, anxiety, or symptoms of opioid withdrawal.
- Many people describe it as a natural and safe remedy. But kratom is not FDA-approved, and its claimed health benefits haven’t been proven in clinical trials.
- One of kratom’s active ingredients, 7-OH, has been linked to serious health risks—especially when it’s highly concentrated or produced synthetically—prompting federal and state officials to consider regulations or bans.
In July, the Food and Drug Administration took the unusual step of recommending a nationwide ban on certain products made from kratom, a plant with opioid-like effects native to Southeast Asia. In the U.S., many people say it helps them manage pain, anxiety, or the difficult symptoms of opioid withdrawal. But researchers and regulators say kratom’s effects are still not well understood and that its risks may outweigh potential benefits. Here’s what you need to know.
What is kratom?
Kratom leaves can be chewed, smoked, or made into tea to extract their medicinal and intoxicating effects. The plant contains two main compounds, mitragynine and 7-OH, that bind to the same receptors in the brain that respond to opioids like morphine, oxycodone, and fentanyl.
In natural leaf form, 7-OH appears only in tiny amounts. But when it’s made synthetically, it can be highly concentrated and much more potent. Some research suggests that concentrated 7-OH is more than 13 times stronger than morphine.
Many people assume kratom is safe because it is plant-based. But experts warn that “natural” does not equal safe or healthy.
“People are really drawn to like these natural ways of overcoming everyday illness and problems because it feels like it’s a healthy option,” said Suzette Glasner, a clinical psychologist and professor of psychiatry at UCLA, on her podcast.
But she cautioned that “kratom in and of itself, unless you really know what you’re getting, is not inherently safe.”
Why do people use kratom?
Kratom’s popularity has surged over the last decade because it is far more accessible than similar drugs. In many states, anyone over the age of 18 can buy kratom products at gas stations, at smoke shops, or online—no prescription required.
A 2024 analysis of social media conversations found that people most often mentioned using kratom to help treat opioid withdrawal, anxiety, depression, and chronic pain.
Unlike opioids, kratom can also have stimulating effects, such as increased energy and focus.
But while these stories make kratom sound like a miracle drug, none of its alleged health benefits have been proven in clinical trials. Kratom is not approved by the FDA to treat any medical condition. As a supplement, it is not regulated or held to the same safety standards as prescription and over-the-counter medications.
What are the risks of kratom?
In August, America’s Poison Centers issued a health advisory after receiving reports of serious illnesses linked to 7-OH, including nausea, vomiting, rapid heartbeat, trouble breathing, loss of consciousness, and seizures. These concerns echo 2019 research suggesting kratom use is “associated with significant toxicities” and “poses a public health threat due to its availability as an herbal supplement.”
Reports of kratom overdoses, including overdose deaths, have also made headlines in recent years. A Tampa Bay Times investigation identified nearly 600 kratom-related deaths in Florida between 2013 and 2022. In Los Angeles County, health officials reported multiple fatal overdoses linked to kratom earlier this year.
Most of these deaths involved more than one substance. A 2019 study in the U.K. found that 87 percent of kratom-associated deaths involved other substances. Mixing substances can increase the risk of dangerous side effects, even if each substance is seemingly safe on its own.
How is kratom regulated?
Kratom products are not currently regulated at the federal level, though that could soon change. The FDA has recommended classifying 7-OH as a controlled substance—which would effectively ban its sale or use nationwide. FDA Commissioner Marty Makary emphasized that the ban would only apply to 7-OH, not kratom leaf products.
A patchwork of state laws already exists. Six states—Alabama, Arkansas, Indiana, Louisiana, Vermont, and Wisconsin—and Washington, D.C., ban the sale and possession of kratom. At least 22 others have rules that include age minimums, labeling standards, and restrictions on 7-OH. Rhode Island recently became the first state to overturn an existing ban on kratom products.
As political pressure to restrict kratom mounts, some advocates argue that banning kratom entirely could push people who rely on it to manage withdrawal symptoms toward more dangerous street drugs. Others say thoughtful regulation—such as product testing and clear labeling—would offer consumers better protection without criminalizing use.
For now, the FDA does not consider kratom “appropriate for use as a dietary supplement” and warns against using it as a medical treatment.