Written by Angi Allphin, LPC, NCC
Last reviewed: March 2026
In recent years, kratom has gained popularity as an herbal remedy for pain, anxiety, and even opioid withdrawal. Marketed as a natural supplement and widely available online and in smoke shops, it is often perceived as safe. However, this perception may be misleading. Beneath the surface, kratom carries significant risks especially for individuals in addiction recovery or those vulnerable to substance use disorders.
What Is Kratom?
Kratom comes from the leaves of the Mitragyna speciosa tree, native to Southeast Asia. Traditionally, it has been used in countries like Thailand and Indonesia for its stimulant and pain-relieving properties. In the United States, kratom is typically sold in powder, capsule, or liquid extract form.
Its primary active compounds mitragynine and 7-hydroxymitragynine interact with the brain’s opioid receptors. This interaction is where the danger begins.
A Drug with Dual Effects
One of the reasons kratom is so misunderstood is its dose-dependent effects:
- At low doses, it can act as a stimulant, increasing energy, alertness, and sociability.
- At higher doses, it produces opioid-like effects such as sedation, pain relief, and euphoria.
This dual nature can lead users to underestimate its potency and risk, often escalating use over time.
Important Facts about Kratom
It is important to understand the full scope about kratom beyond marketing and word of mouth. A few key facts from the CDC’s National Institute on Drug Abuse that point to the dangers of the drug include:
- There are no uses for kratom approved by the U.S. Food and Drug Administration (FDA), and the FDA has warned consumers not to use kratom products because of potential adverse effects.
- Kratom products may contain harmful contaminants. There are no uses for kratom approved by the FDA, and kratom products have been found to contain contaminants that produce effects not associated with kratom or kratom compounds alone, including heavy metals and harmful bacteria.
- In case reports, clinicians report seeing patients with a wide range of very rare but serious adverse effects associated with kratom exposure, including mental and neurological symptoms (confusion, tremors and seizures), heart and lung problems (high blood pressure and slow breathing), gastrointestinal problems (nausea and vomiting) and liver problems.
- Drug interactions may influence effects. Studies suggest many people who use kratom also use other drugs and have conditions for which medications are often prescribed, and case reports suggest polysubstance use (the use of multiple drugs) involving kratom has been associated with severe adverse effects, such as death and liver problems.
The Risk of Dependence and Withdrawal
Despite being marketed as a safer alternative to opioids, kratom can lead to physical dependence. Regular users may find themselves needing more of the substance to achieve the same or more intense effects, a hallmark of addiction.
When use is reduced or stopped, withdrawal symptoms can occur, including:
- Irritability and mood swings
- Muscle aches and insomnia
- Nausea and sweating
- Anxiety and restlessness
For individuals in recovery, this can be particularly dangerous, as kratom may serve as a substitute addiction or a gateway back to opioid use.
Serious Health Concerns
Kratom is not without medical risk. Reported adverse effects include:
- Liver toxicity: Cases of acute liver injury have been linked to kratom use.
- Cardiovascular issues: Increased heart rate and blood pressure.
- Seizures: Particularly when combined with other substances.
- Respiratory depression: Especially in high doses or when mixed with opioids, benzodiazepines, or alcohol.
There have also been reports of overdose deaths involving kratom, often in combination with other drugs.
Lack of Regulation and Contamination
One of the most concerning aspects of kratom is the lack of regulation. Products sold in the U.S. are not standardized, meaning:
- Potency can vary widely from batch to batch
- Products may be contaminated with heavy metals, bacteria, or other substances
- Labels may be inaccurate or misleading
Without oversight, users have no reliable way of knowing what they are consuming.
Misuse in Recovery Settings
In addiction treatment environments, kratom presents a unique challenge. Because it is often not included in standard drug screenings and is marketed as “legal” or “natural,” some individuals may attempt to use it while in treatment.
However, kratom’s action on opioid receptors can:
- Reinforce addictive pathways
- Undermine recovery progress
- Trigger cravings for stronger opioids
For treatment providers, addressing kratom use requires clear education and consistent clinical boundaries. It is critical to point out that just because it is currently legal, like alcohol and in some cases marijuana, does not mean that it is a health risk and addictive substance.
Are you concerned about kratom use? Take a simple self-test or speak confidentially with a clinical expert to determine if your use requires treatment.
Kratom Risks Are Real. Help Is Available.
Kratom may be marketed as “natural” but natural doesn’t always mean safe. It carries real risks for addiction, unpredictable side effects, and serious harm, particularly for anyone working to protect their recovery.
The good news? Knowledge is power. Understanding the risks and recognizing the warning signs early can make all the difference for yourself and for the people you love.
You Don’t Have to Navigate This Alone
If you or someone you care about is using kratom or struggling with substance use, help is available. Valley Hope’s licensed, expert clinical team provides confidential, compassionate addiction treatment with programs tailored to meet you exactly where you are in your recovery journey.
For 60 years, we’ve helped thousands of individuals and families find lasting recovery. We’re ready to help yours:
- Confidential conversations
- Voted Top in Patient Experience
- Insurance accepted: Verify your benefits today
- Personalized addiction treatment programs that meet your moment
Written by Angi Allphin, LPC, NCC
Angi is the Executive Director of Valley Hope of Missouri and North Central Regional Vice President for NAADAC, representing seven states across the Midwest. A Licensed Professional Counselor with a lifelong passion for addiction education, Angi began her career as a Nebraska Children’s Division investigator, where she witnessed the profound impact of addiction on families. She later earned her Master’s in Clinical Counseling from Central Methodist University and spent six years teaching Addiction Studies there, further solidifying her role as an educator and advocate. A former President of Missouri’s NAADAC affiliate, Angi is known for her engaging and accessible speaking style, with expertise in addiction as a disease, motivational communication, leadership in behavioral health, and strengthening professional standards across the region.
