Kratom: Understanding the Risks and Safety Concerns

Kratom has gained popularity as a supplement marketed for energy, pain relief, and mood enhancement. However, despite its growing presence in vitamin stores and online marketplaces, serious safety concerns surround this substance. Understanding what kratom is, how it works, and the potential dangers it poses is essential before considering its use.

What Is Kratom?

Kratom is an herbal substance derived from the leaves of Mitragyna speciosa, an evergreen tree native to Southeast Asia, particularly Thailand, Malaysia, Indonesia, and Papua New Guinea. The leaves contain compounds that can produce mind-altering effects when consumed.

People consume kratom in various forms, including chewing fresh leaves, brewing dried leaves into tea, taking capsules or tablets, or mixing powdered extracts into beverages. The substance has traditionally been used in Southeast Asian countries but has recently gained attention in Western markets as an alternative remedy.

How Kratom Affects the Body

Kratom contains alkaloids, primarily mitragynine and 7-hydroxymitragynine, which interact with opioid receptors in the brain. The effects of kratom vary significantly based on the dose consumed:

At lower doses, kratom typically acts as a stimulant, producing effects such as increased alertness, enhanced energy, heightened sociability, and improved focus. Users report feeling more talkative and energetic within minutes of consumption.

At higher doses, kratom produces sedative effects similar to opioids, including pain reduction, feelings of calm and relaxation, decreased anxiety, and euphoria. These effects can last several hours depending on the amount consumed.

The onset of kratom effects typically occurs within 5-10 minutes of consumption, with peak effects happening within 1-2 hours. The duration of effects generally ranges from 2-5 hours, though this varies based on dosage and individual factors.

Why People Use Kratom

Despite limited scientific evidence supporting its effectiveness, people turn to kratom for various reasons:

• Pain management: Some individuals use kratom as an alternative to prescription pain medications
• Energy and focus: Users seek kratom for its stimulant properties to enhance productivity
• Mood enhancement: People consume kratom hoping to alleviate symptoms of depression or anxiety
• Opioid withdrawal: Some attempt to use kratom to ease withdrawal symptoms when stopping opioid use
• Social enhancement: Users report taking kratom to feel more confident and sociable

Many people assume that because kratom comes from a plant, it must be natural and safe. However, this assumption is dangerous and misleading. The natural origin of a substance does not guarantee its safety or effectiveness.

Significant Safety Concerns

Health authorities, including the U.S. Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA), have issued warnings about kratom. The FDA has explicitly cautioned consumers against using kratom due to serious safety concerns.

Between 2014 and 2019, U.S. poison control centers received thousands of reports related to kratom exposure, including cases resulting in death. These reports highlighted severe adverse reactions and the unpredictable nature of kratom products.

Inconsistent Product Quality

One major concern with kratom is the lack of standardization and regulation. The concentration of active compounds in kratom leaves varies dramatically depending on factors like growing conditions, harvesting time, and processing methods. This variability makes it impossible to predict the effects of any given dose accurately.

Additionally, testing has revealed that some kratom products contain higher concentrations of active alkaloids than naturally occurring levels, suggesting adulteration. Without clear labeling requirements or quality control standards, consumers cannot know exactly what they are taking or in what quantities.

Side Effects of Kratom

Kratom use has been associated with numerous adverse effects affecting multiple body systems:

Physical Side Effects

• Nausea and vomiting
• Constipation
• Dry mouth
• Increased urination
• Loss of appetite and weight loss
• Itching and sweating
• Muscle aches and pain
• Liver damage, including hepatotoxicity
• Elevated blood pressure
• Rapid heart rate
• Respiratory depression

Neurological and Psychological Effects

• Dizziness and drowsiness
• Confusion and brain fog
• Hallucinations (seeing, hearing, or feeling things that are not real)
• Delusions (false beliefs)
• Depression and mood changes
• Anxiety and agitation
• Tremors and loss of coordination
• Seizures

Addiction and Dependence Potential

Contrary to claims that kratom offers a safe alternative for managing opioid withdrawal, research indicates that kratom itself carries significant addiction potential. The substance interacts with the same brain receptors as opioids, leading to similar patterns of dependence.

People who use kratom regularly, especially for extended periods, often develop tolerance, requiring increasingly larger doses to achieve the same effects. When they attempt to stop using kratom, they experience withdrawal symptoms that can include:

• Muscle aches and tension
• Insomnia and sleep disturbances
• Irritability and mood swings
• Anxiety and restlessness
• Nausea and gastrointestinal distress
• Fever and chills
• Strong cravings for kratom

Studies have shown that individuals who use kratom for more than six months often report withdrawal symptoms comparable to those experienced with opioid cessation. Some people who become dependent on kratom require professional treatment for substance use disorders.

Contamination Risks

Laboratory testing of kratom products has revealed alarming contamination issues. Products have been found to contain:

• Heavy metals: Including lead, which can cause serious health problems
• Harmful bacteria: Such as Salmonella, which can cause severe food poisoning
• Other adulterants: Including synthetic compounds not listed on labels

Salmonella contamination is particularly concerning, as it can be life-threatening, especially for vulnerable populations such as children, elderly individuals, and those with compromised immune systems. The FDA has linked dozens of deaths to salmonella-contaminated kratom products.

Drug Interactions

Kratom can interact dangerously with other substances, including prescription medications, over-the-counter drugs, and alcohol. These interactions may lead to severe complications, including liver damage, respiratory depression, and death.

The risk of adverse interactions increases when kratom is combined with:

• Central nervous system depressants (such as alcohol, benzodiazepines, or sleep medications)
• Other opioids or pain medications
• Medications metabolized by the liver
• Antidepressants and psychiatric medications
• Stimulants

Most kratom-related deaths have involved the presence of other substances in addition to kratom, highlighting the danger of combining kratom with other drugs or medications.

Pregnancy and Kratom

Kratom use during pregnancy poses serious risks to developing babies. When pregnant individuals use kratom, the substance crosses the placental barrier, exposing the fetus to its effects. Babies born to mothers who used kratom during pregnancy may experience:

• Withdrawal symptoms at birth
• Low birth weight
• Developmental problems
• Need for medical treatment and monitoring

Pregnant or breastfeeding individuals should avoid kratom completely due to these serious risks to infant health and development.

Lack of Scientific Evidence

Despite marketing claims about kratom’s benefits, there is insufficient scientific evidence to support its use for any medical condition. The limited research available has focused primarily on safety concerns rather than therapeutic benefits.

Clinical trials examining kratom’s effectiveness for pain management, opioid withdrawal, or other conditions are lacking. The existing evidence consists mainly of anecdotal reports, animal studies, and small observational studies that cannot establish causation or confirm therapeutic value.

Without rigorous clinical trials, the medical community cannot determine appropriate dosing, identify who might benefit from kratom (if anyone), or fully understand its long-term effects on health.

Regulatory Status

Kratom occupies a complex legal landscape in the United States. While it remains legal at the federal level, the FDA has not approved kratom for any medical use and actively warns against its consumption. The DEA has listed kratom as a “drug of concern.”

Several states and municipalities have banned or regulated kratom sales and possession. The regulatory situation continues to evolve as more information about kratom’s risks emerges.

Federal agencies are taking action to combat false advertising and misleading health claims about kratom products. The FDA has issued warning letters to companies making unsubstantiated therapeutic claims about kratom.

Safer Alternatives

For individuals considering kratom for specific health concerns, safer and more effective alternatives exist:

For pain management: Consult with a healthcare provider about evidence-based treatments, which may include physical therapy, non-opioid pain medications, cognitive behavioral therapy, acupuncture, or other integrative approaches.

For energy and focus: Consider lifestyle modifications such as improving sleep quality, regular exercise, stress management techniques, and nutritional optimization. If concerns persist, discuss them with a healthcare professional to rule out underlying conditions.

For mood support: Speak with a mental health professional about evidence-based treatments for depression or anxiety, which may include therapy, lifestyle changes, or, if appropriate, medications prescribed and monitored by a qualified provider.

For opioid withdrawal: Seek professional medical help. Healthcare providers can offer medication-assisted treatment programs and comprehensive support for opioid use disorder. Your doctor can discuss appropriate treatment options based on your individual situation.

What to Do If You Are Using Kratom

If you currently use kratom and want to stop, do not attempt to quit suddenly on your own, especially if you have been using it regularly or in high doses. Consult with a healthcare provider who can:

• Assess your current health status
• Develop a safe tapering plan if needed
• Monitor for withdrawal symptoms
• Provide support and resources
• Address underlying health concerns that led to kratom use
• Discuss treatment options if you have developed dependence

Be honest with your healthcare provider about your kratom use, including how much you take, how often, and for how long you have been using it. This information is essential for providing you with appropriate care.

The Bottom Line

Despite marketing claims and anecdotal reports, kratom has not been proven safe or effective for treating any medical condition. The substance carries serious risks, including adverse effects, contamination, addiction potential, dangerous drug interactions, and even death.

Health authorities, including the FDA and DEA, warn against kratom use due to these safety concerns. The lack of regulation means that kratom products vary widely in quality, potency, and purity, making their use unpredictable and potentially dangerous.

Rather than experimenting with kratom, work with qualified healthcare professionals to address health concerns through evidence-based treatments. Many safer and more effective options exist for managing pain, improving energy, supporting mood, and treating substance use disorders.

Your health and safety are too important to risk on an unproven substance with documented dangers. If you are struggling with health issues that led you to consider kratom, reach out to a healthcare provider who can guide you toward appropriate, safe, and effective solutions.

Sources:

• Mayo Clinic
• U.S. Food and Drug Administration (FDA)
• U.S. Drug Enforcement Administration (DEA)
• National Center for Complementary and Integrative Health (NCCIH)
• Centers for Disease Control and Prevention (CDC)