National Center for Complementary and Integrative Health (NCCIH)
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Kratom

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Kratom Mitragyna speciosa

Kratom (Mitragyna speciosa) is a tree in the coffee family, found in Thailand and other tropical countries. Traditionally, in Southeast Asia, people have chewed its leaves or made them into a tea that’s used to fight fatigue and improve work productivity. Kratom has also traditionally been used during religious ceremonies and to treat medical conditions such as pain and diarrhea, sometimes as a substitute for opium. 

Two compounds in kratom leaves, mitragynine and 7-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain when taken in high doses. Lower doses cause alertness instead of sedation.

Some people in Western countries use kratom to try to treat pain or manage opioid withdrawal symptoms. 

Bottom Line

  • There haven’t been any clinical trials (studies in people) to evaluate the health effects of kratom. There is currently no clinical research to determine if kratom is an effective or safe treatment for opioid addiction. 
  • Under the Federal Food, Drug, and Cosmetic Act, kratom is considered a new dietary ingredient since it was not marketed as a dietary ingredient in the United States before October 15, 1994; evidence of safety is required for new dietary ingredients. The U.S. Food and Drug Administration (FDA) has seized some shipments of kratom products. Some commercial forms of the drug are sometimes laced with other compounds that can be toxic and cause death.
  • In August 2016, the Drug Enforcement Administration (DEA) announced its intent to temporarily place the two main active ingredients in kratom in Schedule I. Substances in Schedule I are defined as drugs with no currently accepted medical use and a high potential for abuse; examples include heroin and lysergic acid diethylamide (LSD). In October 2016, the DEA withdrew this proposed action, citing numerous comments from the public. The DEA will consider public comments as well as a scientific and medical evaluation by the FDA before deciding whether to proceed with permanent or temporary action regarding kratom’s active ingredients. 

Safety

  • Although people may use kratom to try to overcome opioid addiction, kratom itself may be addictive. People may build up a tolerance to it (they may need higher doses to achieve the same effect), and long-term users may experience withdrawal symptoms if they stop using it. 
  • Studies in experimental animals suggest that high doses of kratom may be less likely than high doses of opioids to be fatal. However, some deaths in people have been linked to kratom. Typically, they have involved the use of kratom in combination with opioids or various prescription or over-the-counter drugs. 
  • A variety of side effects of kratom have been reported. They include anxiety, irritability, and increased aggression, which may be related to the drug’s stimulant effects; and sedation, nausea, constipation, and itching, which may be related to its opioid-like effects. Increased pigmentation of the cheeks, tremor, loss of appetite, weight loss, and psychosis have been seen in long-term kratom users. Seizures have been reported in users of high doses of kratom. 

This page last modified November 13, 2018