Proposals to ban or regulate kratom, a plant-based substance sold at gas stations, convenience stores and vape shops, are Making headlines in local newspapers Across the United States. But as Lawmakers debate whether to regulate or ban kratomPublic health problems associated with drugs continue to grow.
As of late March 2026, the Centers for Disease Control and Prevention reported that hospitalizations and poisonings involving kratom Over 1,200% growth in the past decade.
In legal hearings, families share Life’s tragic story summed up By kratom overdose and addiction.
On the opposition side, lawmakers are also hearing from lobbyists representing the kratom industry and kratom users who Emphasize that it is a safe, natural substance which boost mood and energy, relieve pain and even help people overcome opioid addiction.
As a physician who treats opioid addiction and Studies the opioid crisisI have followed this debate closely.
Scientific evidence shows that kratom carries real risk which are often underestimated or misunderstood. of Kratom Increasing use over the past decade Coincides with the opioid crisis, as people search for alternatives to prescription opioids. Because kratom comes from a plant and is marketed as “natural”, many people mistakenly assumed it was safe. That belief helped spur its use. Today, approx 1.7 million Americans report using kratom each year.
How does kratom work?
US Food and Drug Administration has warned consumers for more than a decade That kratom can cause serious problems, including liver disease, seizures, addiction and death.
According to the FDA, studies and adverse event reports clarify that “The compounds in kratom make it so it’s not just a plant—it’s an opioid“
Kratom comes from the plant Friendship is beautifulA tropical evergreen tree native to Southeast Asia.
People use kratom to experience opioid effects, including pain relief and improved mood. But with daily use, tolerance to these effects results in a need for higher doses, and users experience withdrawal symptoms when they try to stop.
Kratom’s effects come from compounds in its leaves, Including mitragynine and 7-hydroxymitragynine, often called 7OH. After consuming kratom, some mitragynine is converted to 7OH in the body. This is important because mitrazinine is a weak opioid, while 7OH is a much stronger opioid, which can increase the intensity of opioid effects and lead to overdose. Both compounds bind to opioid receptors in the brain, triggering chemical changes that can lead to dependence and withdrawal symptoms similar to oxycodone or heroin with regular use.
Some in the kratom industry argue that new products with only increased levels of 7OH are dangerous. But the evidence doesn’t support that claim. Link to death kratom has already increased before new 7OH products appear on the market by the end of 2023.
Kratom is not a treatment for opioid addiction
Another claim often made in legal hearings is that kratom can treat opioid addiction. The American Kratom Association, a lobby group that represents the kratom industry and its consumers, has even promoted kratom as a solution to the opioid crisis. One of the group’s videos claims that kratom can completely cure opioid addiction.
That false claim is based on a partial truth. If someone uses kratom for opioid withdrawal, their withdrawal symptoms may improve temporarily. But the same effect occurs with any opioid. A person addicted to heroin can relieve withdrawal by taking oxycodone and a person dependent on oxycodone can relieve withdrawal by taking heroin.
But relief of withdrawal symptoms does not make the drug a treatment for opioid use disorder; It simply shows that the drug is an opioid. Effective, evidence-based treatments already exist, including drugs Buprenorphine and methadoneWhich has been shown to reduce cravings, prevent withdrawal and reduce the risk of overdose. These drugs allow patients to feel and function normally.
When it comes to kratom, FDA cleared: It is not approved for any medical use and should not be used to treat opioid addiction.
Using kratom exposes people to risks that are not well understood. Some studies suggest that its primary compounds can cause dangerous heart problems, including sudden death. Kratom has also been High levels of lead are foundwhich can damage the brain and other organs. For women of childbearing age, kratom May be a risk to the fetus If pregnancy occurs. And using kratom during pregnancy can cause the baby to experience opioid withdrawal during birth.
Bold claims, limited evidence
Some advocates argue that keeping kratom available could help states reduce deaths from fentanyl and other opioids. But the available evidence does not support this idea.
If kratom fentanyl helps reduce overdose deaths, then it would be expected that banned kratom fentanyl would lead to higher death rates. That didn’t happen. For example, Vermont, one of the first states to ban kratom, did no worse than other states. In fact, Vermont has seen one of these Largest decline in opioid overdose deaths in nation.
Kratom advocates often point to personal stories from users who say it helped them. These experiences should not be dismissed, but personal stories are not the same as scientific evidence.
With opioids, when relief comes when a dose is taken after a withdrawal cycle, a drug may seem helpful, even when it causes harm. This is why controlled studies, which can reliably separate the true benefits from the relief of withdrawal symptoms, will be needed to prove that kratom’s benefits outweigh its risks. But those studies have not been done.
For now, the evidence shows that kratom is an opioid with real risks — not a harmful supplement.
Andrew KolodnyMedical Director of Opioid Policy Research, Brandeis University
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