Kratom is a mind-altering substance that is derived from the leaves of a tropical tree. Producing both stimulant and opioid-like qualities, kratom is used to boost energy, treat chronic pain, and as an aid for heroin withdrawal. While this highly debated substance is legal in the U.S., it is currently at risk of being labeled a controlled substance by the Drug Enforcement Agency (DEA) because of its addictive properties.

Due to its action on the body’s opioid system, kratom poses a risk for abuse and dependency. Not only are the effects potent and fast-acting, but chronic kratom use can lead to addiction and withdrawal symptoms.

While kratom is milder than synthetic opioids, treatment is often needed for people who become addicted to it. Luckily, there are numerous treatment options available, which means that individuals can restore their health and lead new lives free from addiction.

Before going into the treatment methods that are available for kratom addiction, this article will provide an outline of what kratom is and what the long-term effects are.

What is Kratom?

Kratom powder in bowl and capsules

Kratom is a psychoactive substance derived from Mitragyna speciosa, a tropical evergreen tree from Southeast Asia that hails from the same family as the coffee tree. Containing compounds that produce psychotropic (mind-altering) effects, the leaves of the tree can be chewed, ground into a powder, or taken as an extract or gum.

While its use is controversial, kratom is still legal in the U.S. and is easy to obtain on the internet. Low doses of kratom have a stimulant effect, much like coffee. Individuals report an increase in energy, talkativeness, and a reduced need for sleep. However, high doses of kratom produce an opioid-like effect that is similar to morphine. Kratom is often abused by mixing it with other substances such as caffeinated beverages or codeine cough syrups.

Due to kratom’s legal status and ease of availability, abuse of the drug is on the rise. In the U.S., it is often marketed as a nutritional or dietary supplement. However, the Drug Enforcement Administration (DEA) lists kratom as a drug of concern due to its risk of dependence and addiction.

On the street, kratom is also known as:

  • Biak
  • Ketum
  • Kakuam
  • Ithang
  • Thom
  • Nauclea speciosa
  • Biak-biak
  • Kakuam
  • Ketum
  • Mambog
  • Maeng da
  • Mitragynine extract
  • Red vein or white vein
  • Thang

How Does Kratom Work?

Kratom is a unique substance in that it produces both stimulating and sedative effects. This is caused by two active compounds in the leaves — mitragynine and 7-α-hydroxymitragynine. At low doses, these compounds act on receptors in the brain that produce stimulant effects such as increased energy, sociability, and alertness. High doses of kratom work on the body’s opioid receptors, producing effects such as sedation, pleasure, and decreased pain. However, kratom can also produce unwanted side effects if it is abused.

Why Do People Use Kratom?

Kratom has been used for hundreds of years by people in Southeast Asia to boost sexual energy and to treat conditions such as diarrhea, cough, and chronic pain. In the U.S., kratom is said to serve no medicinal benefits by agencies like the DEA; however, increasingly, more people have started to self-treat chronic pain or opiate withdrawal using this substance. This is supported by a growing community of people providing anecdotal evidence of its benefits, especially on social media.

Concerns About Kratom Use

Despite the growing support for kratom use, the DEA is threatening to make it a Schedule 1 controlled substance. This would put kratom in the same league as heroin or ecstasy, creating barriers to access. Like other drugs, making kratom illegal could make the supply more dangerous and subject to criminal activity.

Other concerns about kratom use stem from the lack of studies done on its safety and efficacy. Also, as kratom doesn’t show up on drug screening tests, there are concerns that people may take this as a means to replace other opioid drugs.

Is Kratom Addictive?

Kratom’s opioid-like effects have sparked concern about its high potential for abuse and addiction. Kratom is also fast-acting and potent, which means that it can quickly become habit-forming. Its opioid-like effects can also produce dependence and withdrawal symptoms if a person stops taking it.

Like most drugs, if kratom is abused or used in excess amounts, it can be physically and psychologically addictive. Long-term use — such as daily for a month — can result in cravings, which is why some countries in Southeast Asia have restricted its use. There are also some strains of kratom that are more potent and can lead to a quicker onset of dependence.

Ironically, kratom is also being explored as a cure for heroin addiction as it is considered less toxic and potent. However, there is much controversy around kratom because it can also produce withdrawal symptoms and dependence. In some cases, kratom is also seen as a gateway drug to more dangerous opioids like heroin.

Kratom Addiction vs. Dependence

When it comes to kratom abuse, it’s also worth noting that there is a difference between dependence and addiction. Dependence, for example, is a state of adaptation in the body that develops after repeated use of the drug. In this state, a person isn’t mentally obsessed or attached to the drug. However, if the drug is discontinued abruptly, withdrawal symptoms can occur and may require medical assistance to taper off.

On the other hand, addiction is considered a chronic, primary disease that is marked by compulsive use, cravings, and continued use despite any negative consequences. Therefore, if a person is addicted to kratom, they will be obsessed with taking it and will usually take more of it than prescribed. People who have an addiction feel unable to function normally without the drug and will go to any lengths to keep taking it.

Statistical Overview of Prevalence of Abuse

  • According to a study by the Centers for Disease Control (CDC), kratom was found to be the cause of death in nearly 100 people over a 17-month period.
  • In that same study, 80% of those with kratom in their system also had a history of substance misuse.
  • The CDC also reports that approximately 7% of kratom exposure cases are classified as major and life-threatening.
  • According to the DEA, 15 deaths were known to be related to kratom between 2014-2016.
  • Most people who report using kratom are middle-aged, and many live with chronic pain.
  • Between 2011 – 2016, poison control hotlines reported a 50-fold increase in calls related to kratom overdose.
  • Most kratom overdoses have occurred when it is laced with other substances.

The History of Kratom

Kratom derives from Mitragyna speciosa, a tropical tree in Southeast Asia that is 4 to 16 meters high. For hundreds of years, the leaves have been chopped fresh, or dried into a tea, and then used as a supplement and medicinal aid. Native to Thailand, Malaysia, Papua New Guinea, and Indonesia, people in these areas have used kratom for pain relief, diarrhea, and to boost energy and sexual desire. It has also been used as an alternative to opium.

Similar to substances such as khat and coca, the kratom leaves and extracts have traditionally been used to heal wounds and as an intestinal deworming agent and local anesthetic. Kratom has also been used among laborers and other people in repetitive jobs to stave off exhaustion and hunger, and boost mood.

Dosage and Methods of Use

Most people in the West take kratom as a pill, capsule, or extract. In some cases, the leaves can be chewed whole, chopped, or brewed into a tea. Sometimes the leaves are smoked or eaten in food. As the leaves are quite bitter, it is also often mixed with a sweetener to make it more palatable.

In terms of dosage, a few grams of kratom are enough to produce stimulant effects. This can occur within 10 minutes of ingesting it and can last for up to 1.5 hours. Higher doses (between 10 and 25 grams) will produce opiate-like effects, and this can last for up to 6 hours.

Physical and Neurological Effects of Kratom

Kratom affects brain chemicals and receptors that are responsible for energy, pain, and mood. Some of the initial effects that a person may experience include:

  • Calmness
  • Sense of well-being
  • Euphoria
  • Talkativeness
  • Increased social behavior
  • Pain relief
  • Increased energy
  • Increased libido
  • Sleepiness
  • Constipation
  • Dry mouth
  • Increased urination
  • Itching
  • Loss of appetite
  • Nausea
  • Sweating
  • Sensitivity to sunburn
  • Increased motivation
  • Increased alertness
  • Psychosis

Potential Side Effects

Kratom can also cause uncomfortable side effects, especially if it’s abused or used in excess. These include:

  • Respiratory depression
  • Nervousness
  • Agitation
  • Aggression
  • Sleeplessness
  • Hallucinations
  • Delusions
  • Tremors
  • Loss of libido
  • Constipation
  • Skin hyperpigmentation
  • Nausea
  • Vomiting

Kratom Contamination

Another unique issue with kratom is its potential for contamination. For example, the Food and Drug Administration (FDA) recently issued a warning about high amounts of salmonella and heavy metal contaminants in kratom, such as lead and nickel. This means long-term use of kratom can result in heavy metal poisoning, which can lead to conditions such as:

  • Anemia
  • High blood pressure
  • Kidney damage
  • Nervous system damage
  • Certain cancers

Common Kratom Combinations

Kratom and coffee beans

While Kratom is mainly used to boost energy and provide pain relief, some people abuse the drug to get high. It is also combined with other substances to maximize the effects. Some of the most frequent combinations are below.


Alcohol and kratom are both nervous system depressants. While kratom also produces stimulating effects, its opioid-like qualities mean that it will enhance the effects of alcohol and vice versa. Combining alcohol and kratom can lead to more pronounced effects such as heightened sedation and shallow breathing. This can result in low oxygen and the possibility of overdoses, coma, and seizures.

Some of the negative effects that can occur by combining alcohol and kratom include:


Since kratom is also a stimulant, there are risks associated with combining it with other stimulants like coffee, cocaine, or prescription Adderall. Depending on the dosage of kratom, its stimulant effects can be enhanced by another stimulating drug. This increased stimulation can lead to complications such as heart attack, stroke, impaired judgment, high blood pressure, and increased paranoia.

Other reported effects that can result from kratom and stimulant combinations are constipation, hallucinations, and aggression. If you are mixing these two substances, it’s advised that you do so in small doses to avoid over-stimulation.

Negative Health Consequences

Kratom is less toxic than other illicit drugs. However, long-term use can lead to damaging effects on a person’s health, such as:

  • Nausea
  • Itching
  • Sweating
  • Dry mouth
  • Constipation
  • Increased urination
  • Loss of appetite
  • Seizures
  • Hallucinations
  • Anorexia
  • Sleep problems


Although kratom is a natural substance, there is potential for overdose and/or death. However, most reported cases of kratom overdose have involved a combination of other substances. According to a report from the National Poison Data System, 11 deaths associated with kratom exposure involved other substances such as alcohol, caffeine, diphenhydramine, fentanyl, benzodiazepines, and cocaine. Other overdoses have occurred when kratom was labeled as a dietary supplement and then laced with unknown substances.

While kratom overdoses are rare, a few of the signs to watch out for include:

  • Hallucinations
  • Tremors
  • Aggression
  • Tachycardia or fast heart rate
  • Hypertension
  • Nausea
  • Agitation
  • Irritability
  • Drowsiness
  • Seizures
  • Coma

Signs & Symptoms of Kratom Addiction

Kratom can be physically and psychologically addicting, like any other drug. This is especially if it is used regularly and for extended periods. While there are fewer physical signs of kratom addiction compared with other drugs, there are a few general ones to watch out for:

  • Unexplained weight loss
  • Changes in eating or sleeping patterns
  • Mental confusion
  • Delusions
  • Hallucinations
  • Eating disorders
  • Weight loss
  • Insomnia
  • Mood swings
  • Hiding or lying about kratom use
  • Continuing to use kratom despite its negative side effects
  • Increased isolation from work, family, and friends
  • Loss of interest in activities or hobbies
  • Financial problems or job losses
  • Changes in performance at school or work
  • Acting suspicious or sneaking around
  • Frequent or unusual changes in behavior
  • Abusing other substances at the same time (poly-substance use)


If you or a loved one are struggling with kratom abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Grinspoon, P. (2019). Kratom: Fear-worthy foliage or beneficial botanical?. Harvard Health Publishing.

Mayo Clinic. (2019). Kratom for opioid withdrawal: Does it work?

National Institute on Drug Abuse (NIDA). (2019). What is kratom?.

O’Malley Olsen, E., O’Donnell, J., Mattson, C., Schier, J., Wilson, N. (2019). Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected — 27 States, July 2016–December 2017.

Medical Disclaimer

At, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on