Mitragyna speciosa is a tropical evergreen tree of the Rubiaceae family native to Southeast Asia. It is indigenous to Cambodia, Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where its dark green, glossy leaves, known as kratom, have been used in herbal medicine since at least the 19th century. They have also historically been consumed via chewing, smoking, and as a tea. Kratom contains multiple alkaloids (primarily mitragynine and to a lesser extent 7-hydroxymitragynine) that bind to opioid receptors, most notably as partial mu-opioid agonists. Kratom can also be subjectively stimulating to some, though this is likely not achieved through typical stimulant mechanisms (such as reuptake inhibition or release of monoamines), nor is this a universal effect.
It is the only plant other than Papaver somniferum (opium poppy) known to produce alkaloids that act as agonists at mu-opioid receptors.
The efficacy and safety of kratom are unclear. In 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition. Kratom has been used for managing chronic pain, for treating opioid withdrawal symptoms, or for recreational purposes. It is under preliminary research for possible antipsychotic and antidepressant properties. Kratom contains over fifty alkaloids, primarily mitragynine and 7-hydroxymitragynine, which act as partial agonists at mu-opioid receptors with complex, receptor-specific pharmacology that may explain its distinctive dose-dependent effects.
Kratom has become the subject of significant political and legal controversy, with active advocacy communities organizing to resist scheduling attempts at both federal and state levels. Proponents argue that kratom serves as a critical harm reduction tool for individuals managing chronic pain or transitioning away from more dangerous opioid dependence, while regulatory agencies have raised concerns about safety, quality control, and the potential for dependence.
What the Community Wants You to Know
Community Wisdom
The kratom community successfully fought off multiple state-level ban attempts through organized advocacy, including killing a scheduling bill in Mississippi, defeating bans in West Virginia, Tennessee, and New Jersey, and building congressional support through letter-writing campaigns.
671
Myth Busted
Kratom is often described as having coffee-like withdrawal, but long-term daily users report withdrawal symptoms that are real and uncomfortable, including insomnia, restless legs, irritability, and flu-like symptoms. The severity depends heavily on dose and duration of use.
455
Community Wisdom
Kratom has been a life-changing tool for people recovering from heroin and other opioid addiction. Multiple community members report years of sobriety from harder substances, restored family relationships, and renewed purpose directly attributed to kratom access.
396
Harm Reduction
Purchase kratom from reputable vendors who provide third-party laboratory testing results (certificates of analysis) showing alkaloid content and the absence of contaminants such as heavy metals, salm...
The effects of kratom vary dramatically with dose, producing stimulant-like effects at low doses and opioid-like sedation at higher ones. At lower doses, onset occurs within fifteen to twenty minutes of chewing leaves or swallowing powdered material. The first signs are a subtle brightening of mood and a gentle surge of physical energy, similar in character to a strong cup of coffee but warmer and more embodied. Motivation increases, fatigue recedes, and there is a mild but noticeable sense of well-being that settles over the mind like soft morning light. Social interaction feels easier, and physical labor becomes less burdensome.
At moderate doses the experience begins to shift along a spectrum toward opioid territory. The stimulant edge softens into a mellow, contented warmth. Pain relief becomes pronounced, and the body relaxes into a state of comfortable ease. The mind remains clear but adopts a rosy, optimistic cast, and emotional discomfort fades to a manageable background hum. There is a pleasant tactile quality to the experience, a feeling of being gently held or cushioned. Some people experience mild nausea at this threshold, particularly if the material was taken on an empty stomach.
At higher doses, kratom's opioid-receptor activity dominates. The experience becomes distinctly sedating: the eyelids grow heavy, the body sinks into whatever surface supports it, and a thick drowsiness descends. Pain relief is substantial, and the emotional landscape flattens into a tranquil, slightly dreamy plateau. Nausea becomes more likely, and some individuals experience what is colloquially called "the wobbles," a disorienting combination of dizziness, visual instability, and nausea that can make standing or walking difficult. The pupils may constrict, and appetite diminishes.
The duration of effects is typically three to five hours, with the peak occurring around the ninety-minute mark. The comedown is generally mild, characterized by a gradual return to baseline with some residual fatigue or irritability. With regular use, tolerance develops to both the stimulant and sedating effects, and a withdrawal syndrome can emerge that includes muscle aches, insomnia, irritability, and a runny nose. The experience is often described as gentler and less consuming than classical opioids, but the potential for dependence is real and should not be underestimated.
Subjective Effects
The effects listed below are based on the Subjective Effect Index (SEI), an open research literature based on anecdotal reports and personal analyses. They should be viewed with a healthy degree of skepticism. These effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects.
Physical Effects
Physical(20)
Appetite suppression— A distinct decrease in hunger and desire to eat, ranging from reduced interest in food to complete d...
Constipation— A slowing or cessation of bowel movements resulting in difficulty passing stool, commonly caused by ...
Cough suppression— A decreased desire and need to cough, medically known as antitussive action, which can also allow in...
Dehydration— A state of insufficient bodily hydration manifesting as persistent thirst, dry mouth, and physical d...
Dizziness— A sensation of spinning, swaying, or lightheadedness that impairs balance and spatial orientation, o...
Headache— A painful sensation of pressure, throbbing, or aching in the head that can range from a dull backgro...
Increased heart rate— A noticeable acceleration of heartbeat that can range from a subtle awareness of one's pulse to a fo...
Insomnia— A persistent inability to fall asleep or maintain sleep despite physical tiredness, often characteri...
Itchiness— A persistent, diffuse urge to scratch the skin that arises without any external irritant, most commo...
Motor control loss— A distinct decrease in the ability to control one's physical body with precision, balance, and coord...
Nausea— An uncomfortable sensation of queasiness and stomach discomfort that may or may not lead to vomiting...
Nystagmus— Rapid, involuntary oscillating movements of the eyes that cause vision to vibrate and blur, often ma...
Pain relief— A suppression of negative physical sensations such as aches and pains, ranging from dulled awareness...
Physical euphoria— An intensely pleasurable bodily sensation that can manifest as waves of warmth, tingling electricity...
Pupil constriction— A visible narrowing of the pupil diameter (miosis) that reduces the size of the dark center of the e...
Respiratory depression— A dangerous slowing and shallowing of breathing that can progress from barely noticeable reductions ...
Runny nose— Excessive nasal discharge commonly occurring during opioid withdrawal or from nasal irritation cause...
Sedation— A state of deep physical and mental calming that manifests as a progressive desire to remain still, ...
Seizure— Uncontrolled brain electrical activity causing convulsions and loss of consciousness -- a life-threa...
Stimulation— A state of heightened physical and mental energy characterized by increased wakefulness, elevated mo...
Cognitive & Perceptual Effects
Visual(5)
Double vision— The visual experience of seeing a single object as two separate, overlapping images, similar to cros...
Drifting— The visual experience of perceiving stationary objects, textures, and surfaces as appearing to flow,...
Geometry— The experience of perceiving complex, ever-shifting geometric patterns superimposed over the visual ...
Internal hallucination— Vivid, detailed visual experiences perceived within an imagined mental landscape that can only be se...
Visual acuity suppression— Vision becomes blurred, indistinct, and out of focus, as though looking through a smudged lens. Fine...
Cognitive
Community Insights
Community Wisdom(8)
The kratom community successfully fought off multiple state-level ban attempts through organized advocacy, including killing a scheduling bill in Mississippi, defeating bans in West Virginia, Tennessee, and New Jersey, and building congressional support through letter-writing campaigns.
Based on 3 community posts · 671 combined upvotes
Kratom has been a life-changing tool for people recovering from heroin and other opioid addiction. Multiple community members report years of sobriety from harder substances, restored family relationships, and renewed purpose directly attributed to kratom access.
Based on 3 community posts · 396 combined upvotes
The FDA push to ban kratom is widely seen within the community as driven by pharmaceutical industry interests rather than genuine public health concerns. Kratom competes directly with expensive FDA-approved opioid addiction treatments like methadone and buprenorphine.
Based on 3 community posts · 353 combined upvotes
Kratom functions as an effective antidepressant for some users, alleviating persistent sadness and ruminative thought patterns that did not respond adequately to conventional psychiatric medications. Some users report it works symbiotically with prescribed medications like SSRIs and stimulants.
Based on 2 community posts · 200 combined upvotes
Tapering off kratom is significantly easier than tapering off traditional opioids. Users report cutting a 5g dose with minimal side effects beyond psychological unease. The primary withdrawal symptom at moderate doses is the habitual feeling that you should be doing something you are used to doing.
Based on 1 community posts · 187 combined upvotes
Common Misconceptions(4)
Kratom is often described as having coffee-like withdrawal, but long-term daily users report withdrawal symptoms that are real and uncomfortable, including insomnia, restless legs, irritability, and flu-like symptoms. The severity depends heavily on dose and duration of use.
Based on 3 community posts · 455 combined upvotes
After secret-shopping roughly 60 vendors and blind-testing around 200 so-called strains, experienced community members concluded that no strain is consistently better than another. Perceived differences between batches are largely driven by buyer expectation, marketing, and natural variation in alkaloid profiles rather than meaningful strain differences.
Based on 2 community posts · 364 combined upvotes
The color of your kratom powder does not reliably indicate vein color or effects. Most kratom is dried outdoors and the color changes based on drying conditions, rain exposure, and blending. Vendors routinely relabel and mix product to meet demand for popular color names.
Based on 2 community posts · 364 combined upvotes
All kratom sold in the US comes from Indonesia. Strain names like Thai, Bali, Malay, and Cambodian are complete marketing fabrications. The powerful suppliers in Southeast Asia invented these regional names to entice American buyers, but the leaf all grows on the same Indonesian island.
Based on 2 community posts · 364 combined upvotes
Combination Warnings(1)
Kratom combined with alcohol is widely discouraged. Many community members originally used kratom specifically to quit alcohol, and report that kratom is simply better in every way for relaxation and socializing. The combination can cause severe nausea.
Based on 2 community posts · 350 combined upvotes
Set & Setting(2)
Kratom works best as a daily functional tool rather than a recreational high. Users who approach it expecting strong euphoria tend to escalate doses, while those who use it for mood stability, pain management, or anxiety relief at consistent low doses report the best long-term outcomes.
Based on 3 community posts · 239 combined upvotes
Taking kratom on an empty stomach produces much stronger and faster effects. Many users report that eating within an hour before dosing significantly reduces or eliminates the effects entirely.
Based on 1 community posts · 6 combined upvotes
Harm Reduction(6)
Ask your vendor where the kratom was harvested and whether it is a blend. Vendors who can provide this information are more likely to be trustworthy. If they claim it comes from anywhere other than Indonesia, they are either uninformed or dishonest.
Based on 1 community posts · 227 combined upvotes
Be cautious buying kratom directly from small Indonesian Facebook suppliers unless you deeply understand the market. The supply chain involves powerful intermediaries who control pricing and quality, and uninformed buyers frequently end up with low-quality or adulterated product.
Based on 1 community posts · 227 combined upvotes
Excessive sun exposure during the drying process breaks down alkaloids in kratom leaf. If the leaf gets rained on after initial drying and has to be re-dried, alkaloid content drops further. This is one reason why batch quality varies so much, even from the same source.
Based on 1 community posts · 227 combined upvotes
The kratom supply chain is controlled by a small group of powerful multi-millionaires in Southeast Asia who bribe governments, control shipping, and enforce prices. Understanding this helps explain why product quality is inconsistent and why honest marketing remains rare in the industry.
Based on 1 community posts · 227 combined upvotes
Kratom is genuinely addictive with real physical dependence. After 8 years of daily use, one former user described withdrawal as uncomfortable but ultimately safe, with the worst acute effect being gastrointestinal distress. However, dismissing the addiction potential does the community a disservice and fuels opposition narratives.
Based on 2 community posts · 199 combined upvotes
Dosage Guidance(4)
For chronic pain management, splitting doses into smaller amounts throughout the day (such as 2g three times daily) provides more consistent relief than taking one large dose. The effects of a single dose typically last 3-5 hours.
Based on 2 community posts · 170 combined upvotes
Less is genuinely more with kratom. Even when you do not subjectively feel the effects, mood tracking shows that low doses still stabilize mood and improve day quality. Chasing a noticeable high by increasing dose leads to tolerance, wobbles, and dependence.
Based on 2 community posts · 154 combined upvotes
If you take too much kratom, you get the wobbles: a nauseating, dizzy feeling with eye oscillation that is extremely unpleasant. There is no way to speed recovery other than lying down and waiting it out. This is the plant telling you the dose was too high.
Based on 2 community posts · 154 combined upvotes
A widely recommended strategy is the 6-gram daily cap: give yourself a fixed daily amount like 6g and split it however you want (2g three times, 4g plus 2g, or 6g once for a special occasion), but never exceed it. Users following this approach report consistent effects over years without significant tolerance buildup.
Based on 1 community posts · 82 combined upvotes
Pharmacology
Mitragynine — the primary active alkaloid in kratom(Public domain)
Mitragynine, the primary alkaloid, is a partial agonist at mu-opioid receptors and a competitive antagonist at delta-opioid receptors, with negligible kappa-opioid activity. Its active metabolite 7-hydroxymitragynine (7-HMG) is approximately 46 times more potent than mitragynine and 13 times more potent than morphine at mu-opioid receptors. The low intrinsic efficacy of mitragynine at mu-receptors (partial agonism rather than full agonism) is thought to be responsible for its improved side effect profile relative to classical opioids, including less respiratory depression.
Mitragynine also acts on adrenergic, serotonergic, and dopaminergic systems, explaining the stimulant effects at low doses. At lower doses, mitragynine's activity at alpha-2 adrenergic receptors and 5-HT2A serotonin receptors appears to predominate, producing the stimulant-like and mood-elevating effects. At higher doses, the mu-opioid agonism becomes the dominant pharmacological action, producing analgesia, sedation, and euphoria characteristic of opioid compounds.
This dual pharmacology, stimulating at low doses and sedating at high doses, is one of kratom's most distinctive features and has no direct parallel among conventional opioids or stimulants. The partial agonist nature of the primary alkaloids also creates a ceiling effect for certain opioid responses, particularly respiratory depression, which may contribute to kratom's relatively wider therapeutic index compared to full mu-opioid agonists like morphine or fentanyl.
Detection Methods
Kratom alkaloids (mitragynine, 7-hydroxymitragynine) are not detected by standard drug panels (5-panel, 10-panel, 12-panel). Specialized testing using LC-MS/MS can identify kratom alkaloids and is available through some reference laboratories and used in some forensic investigations. A specific immunoassay for mitragynine has been developed but is not widely deployed.
Kratom does not cause false positives on standard immunoassay screens for opioids, benzodiazepines, amphetamines, or other common drug classes. Detection windows for mitragynine in urine are estimated at 5-7 days, though limited data is available. Blood detection windows are approximately 24 hours. Hair testing for kratom alkaloids has been reported in research settings but is not standard practice.
There are no widely available reagent tests for kratom in harm reduction settings. Laboratory testing of kratom products via HPLC or LC-MS/MS can determine alkaloid content and detect adulterants, and reputable vendors provide such testing results.
“Kratom combined with alcohol is widely discouraged. Many community members originally used kratom specifically to quit alcohol, and report that kratom is simply better in every way for relaxation and socializing. The combination can cause severe nausea.”
“Excessive sun exposure during the drying process breaks down alkaloids in kratom leaf. If the leaf gets rained on after initial drying and has to be re-dried, alkaloid content drops further. This is one reason why batch quality varies so much, even from the same source.”
Kratom (Mitragyna speciosa) is a tropical evergreen tree in the Rubiaceae (coffee) family native to Southeast Asia, indigenous to Thailand, Malaysia, Indonesia, Myanmar, and Papua New Guinea. The plant was first formally described by Dutch colonial botanist Pieter Korthals in 1839. The leaves have been used traditionally for centuries by farmers, laborers, and fishermen in Southeast Asia, who chewed fresh leaves or brewed them as tea to combat fatigue, increase work productivity, and relieve pain from hard physical labor.
The primary alkaloid mitragynine was first isolated in 1921 by Ellen Field at the University of Edinburgh. The more potent alkaloid 7-hydroxymitragynine was identified later. Western scientific interest in kratom grew in the mid-20th century, with several studies examining its pharmacology. Thailand banned kratom in 1943 under the Kratom Act, primarily because its use was cutting into government tax revenue from the opium trade. This ban remained in effect until Thailand decriminalized kratom in 2021.
Kratom gained significant popularity in Western countries beginning in the 2000s, initially through online vendors and ethnobotanical communities. It became widely used as an alternative to opioid painkillers and as a self-treatment for opioid withdrawal, with countless personal accounts describing successful transitions from heroin, oxycodone, or other opioid dependence to kratom use. The FDA has repeatedly warned against kratom use, and the DEA attempted to schedule kratom in 2016 but withdrew the proposal after unprecedented public backlash, including a campaign organized by the American Kratom Association and thousands of personal testimonials submitted during the public comment period. As of 2024, kratom remains legal at the federal level in the US but is banned or regulated in several states and municipalities, with ongoing legislative battles at the state level generating significant community organizing and advocacy efforts.
Harm Reduction
Purchase kratom from reputable vendors who provide third-party laboratory testing results (certificates of analysis) showing alkaloid content and the absence of contaminants such as heavy metals, salmonella, and adulterants. The kratom market is unregulated, and product quality varies enormously. Some products have been found contaminated with heavy metals, or adulterated with synthetic opioids or other drugs. Community experience from extensive vendor testing and comparison emphasizes that alkaloid content varies substantially between vendors, batches, and even within the same marketed strain, making it essential to find reliable sources.
The kratom community has widely noted that strain names (such as Maeng Da, Bali, Borneo, Red/Green/White vein) are often marketing designations rather than reliable indicators of alkaloid profile or effects. While vein color and regional origin may correlate loosely with certain effect tendencies, the variability between batches from the same vendor frequently exceeds the variability between named strains. A practical approach is to focus on finding effective batches from trusted vendors rather than pursuing specific strain names.
Start with a low dose (1-2 grams of dried leaf powder) to assess individual response, as potency varies between batches and individual sensitivity. Common doses range from 2-5 grams for stimulant effects and 5-8 grams for analgesic and sedative effects. Use a scale to measure doses accurately. Experienced community members frequently recommend a personal dosing ceiling, with many describing a self-imposed maximum of approximately 6 grams per dose as a practical limit that balances desired effects against diminishing returns and side effects.
Do not combine kratom with opioids, benzodiazepines, alcohol, or other CNS depressants, as this increases the risk of respiratory depression and represents the most common factor in kratom-associated fatalities.
Do not use kratom daily if possible. Regular daily use produces tolerance, physical dependence, and a withdrawal syndrome that, while generally less severe than classical opioid withdrawal, includes muscle aches, irritability, insomnia, runny nose, anxiety, and cravings. Community reports from long-term daily users consistently describe increasing tolerance to euphoric effects, a gradual narrowing of perceived benefits, and a withdrawal experience that, while manageable, can be physically and psychologically uncomfortable. Some individuals have found kratom useful for tapering off stronger opioids, but this should ideally be done under medical supervision. Be aware that using kratom for opioid withdrawal self-management may substitute one dependence for another.
Stay hydrated, as kratom commonly causes constipation and dehydration. Side effects at excessive doses include nausea, dizziness, and a characteristic visual instability known as wobbles (involving nystagmus-like eye movements and difficulty focusing), which is generally the body's signal that the dose was too high.
Toxicity & Safety
Kratom has a low toxicity relative to dose. Like most opioids, safe usage of kratom is not known to cause any dangerous long-term complications. Heavy dosages of kratom can result in increased respiratory depression, leading onto fatal or dangerous levels of anoxia (oxygen deprivation). This is significantly less powerful than the respiratory depression of heroin or morphine. This occurs because the breathing reflex is suppressed by agonism of µ-opioid receptors proportional to the dosage consumed.
It is likely impossible to achieve this using kratom in its standard leaf form as the nausea ceiling makes it difficult to consume high enough dosages without vomiting. A pure extract or tincture, however, may be potent enough to cause lethal respiratory depression at appropriate dosages, although oral administration of pure mitragynine to mice in dosages up to 920 mg/kg did not produce lethal respiratory depression. However, kratom can be fatal when it is combined with other depressants such as alcohol or benzodiazepines.
Side effects associated with chronic kratom use include loss of appetite and weight loss, constipation, decreased libido, apathy, and darkening of the skin color of the face. Chronic use has been associated with bowel obstruction.
It is strongly recommended that one use harm reduction practices when using this substance.
Lethal dosage
The lethal dosage of kratom is unknown but thought to be far above the active dosage. The precise dosage likely depends on a variety of factors including strain, potency, tolerance and method of consumption. It is unlikely that one could ingest a lethal dosage of kratom powder as the nausea will force one to vomit at around 8 - 9 grams; however, it could be possible to ingest a lethal dosage of a kratom if purer forms such as a resin or pure alkaloids are used.
Three case reports document deaths involving kratom. Other drugs were used in all cases, and in one, kratom was speculated to possibly be the primary cause of death. O-Desmethyltramadol (ODSMT) was present in the latter case, and has been found to be a frequent additive in certain commercial brands of kratom, there were nine cases of death reported in Sweden in 2010 and 2011 relating to use of Krypton, which was kratom mixed with O-Desmethyltramadol.
Dependence and abuse potential
As with other opioids, the kratom produces dependence with chronic use and has a high abuse potential. When dependence has developed, cravings and withdrawal symptoms may occur if a person suddenly stops their usage.
Tolerance to many of the effects of kratom develops with prolonged and repeated use. The rate at which this occurs develops at different rates for different effects, with tolerance to the constipation-inducing effects developing particularly slowly for instance. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption). Kratom presents cross-tolerance with all other opioids, meaning that after the consumption of kratom all opioids will have a reduced effect.
Chronic kratom use may lead to tolerance to the effects of serotonergic psychedelics due to kratom's antagonism of the 5-HT2A receptor and said receptor's paradoxical down-regulation in response to inhibitors.
Since kratom is classified as an herbal supplement and remains legal in many states, a subset of individuals mistakenly assume that it can be used regularly and eventually discontinued without any withdrawal symptoms. In reality, most individuals who use kratom on a regular basis will experience some withdrawal symptoms following cessation.
Dangerous interactions
Warning: Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous and even life-threatening when combined with certain other substances. The following list provides some known dangerous interactions (although it is not guaranteed to include all of them).
Always conduct independent research (e.g. Google, DuckDuckGo, PubMed) to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
Alcohol - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely
Stimulants - Stimulants increase respiration rate which allows for a higher dose of opiates than would otherwise be used. If the stimulant wears off first then the opiate may overcome the user and cause respiratory arrest.
Benzodiazepines - Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position blackouts/memory loss likely.
DXM - Generally considered to be toxic. CNS depression, difficulty breathing, heart issues, and liver toxicity have been observed. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.
GHB/GBL - The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position
Ketamine - Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
MAOIs - Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.
MXE - MXE can potentiate the effects of opioids but also increases the risk of respiratory depression and organ toxicity.
Nitrous - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are common.
PCP - PCP may reduce opioid tolerance, increasing the risk of overdose.
Tramadol - Increased risk of seizures. Tramadol itself is known to induce seizures and it may have additive effects on seizure threshold with other opioids. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.
Grapefruit - While grapefruit is not psychoactive, it may affect the metabolism of certain opioids. Tramadol, oxycodone, and fentanyl are all primarily metabolized by the enzyme CYP3A4, which is potently inhibited by grapefruit juice. This may cause the drug to take longer to clear from the body. it may increase toxicity with repeated doses. Methadone may also be affected. Codeine and hydrocodone are metabolized by CYP2D6. People who are on medicines that inhibit CYP2D6, or that lack the enzyme due to a genetic mutation will not respond to codeine as it can not be metabolized into its active product: morphine.
Addiction Potential
Moderately addictive. As a partial mu-opioid agonist, kratom produces dependence with regular use, though withdrawal symptoms are generally described as milder than classical opioid withdrawal. Cessation produces abstinence symptoms including irritability, muscle aches, insomnia, and nausea. Tolerance develops with chronic use. Kratom is increasingly used for opioid withdrawal self-management, though this creates risk of transferring dependence.
Overdose Information
Fatal overdose from kratom alone is debated and appears to be rare. The CDC has reported kratom-associated deaths, but the vast majority involved co-use of other substances (opioids, benzodiazepines, alcohol). Pure kratom overdose symptoms include severe nausea and vomiting, tachycardia, agitation, drowsiness, and in rare cases seizures. Respiratory depression from kratom alone is less likely than with traditional opioids due to mitragynine's partial agonist activity and the practical ceiling imposed by nausea at high doses.
Signs requiring medical attention include: extreme drowsiness or unresponsiveness, seizures, very rapid heartbeat, severe nausea and vomiting leading to dehydration, confusion, and difficulty breathing (particularly if other substances have been co-ingested).
Call emergency services (911) if any of these symptoms are severe or if other substances may be involved. Naloxone may partially reverse kratom's opioid effects, though evidence is limited and the response may be incomplete due to the atypical pharmacology of kratom alkaloids. Treatment is primarily supportive, with monitoring for respiratory depression, cardiac abnormalities, and seizures. If the person is conscious and nauseous, keep them hydrated and in a comfortable position. Good Samaritan laws apply.
Community harm reduction advice emphasizes that the primary overdose risk with kratom is not kratom itself but the combination with other depressants. If kratom is the only substance involved, most adverse reactions resolve with time, supportive care, and hydration.
Dangerous Interactions
The combinations listed below may be life-threatening. Independent research should always be conducted to ensure safety when combining substances.
Severe respiratory depression risk; leading cause of polydrug overdose
Tolerance
Full
develops with prolonged and repeated use
Half
3 - 7 days
Zero
1 - 2 weeks
Cross-tolerances
opioids
Legal Status
This map shows the legal status of kratom within each US state. It is currently a controlled substance within Wisconsin, Arkansas, Tennessee, Indiana, Rhode Island, and Vermont.
Australia: As of January 2015, kratom is a controlled and prohibited narcotic substance which requires a permit and license to import into the country.
Canada: As of October 2016, it is illegal to market kratom for any use in which it is ingested. However, kratom may be marketed for other uses, such as incense.
Europe: As of September 2011, kratom, mitragynine, and 7-hydroxymitragynine are controlled substances in a number of EU Member States such as Denmark, Latvia, Lithuania, Poland, Romania and Sweden.
Germany: Kratom is not a controlled substance under the BtMG. It is legal, as long as it is not sold for human consumption, according to §2 AMG. This legal opinion was approved by court descision of the OLG Köln (Higher Regional Court Cologne), as of September 11, 2015.
Japan: Kratom and its active constituents mitragynine and 7-hydroxymitragynine are controlled substances in Japan effective March 9th, 2016.
Latvia: Kratom and its primary active constituent mitragynine are Schedule I controlled substances according to an amendment on August 16th, 2012.
Malaysia: The use of kratom leaves is prohibited in Malaysia under Section 30 (3) Poisons Act 1952, and the user may be, penalized with a maximum compound of MYR 10,000 (USD 3,150) or up to 4 years imprisonment.
New Zealand: Kratom and its primary active constituent mitragynine, after an amendment on August 6, 2015, are Schedule I controlled substances under Medicines Regulations 1984
Switzerland: Mitragynine and 7-Hydroxymitragynine are controlled substances specifically named under Verzeichnis A.
Thailand: Possession of kratom leaves is illegal in Thailand, despite the tree being native to the country. The Thai government passed the kratom Act 2486 which made planting the tree illegal and requires existing trees to be cut down. As of October 2, 2013, the justice ministry of Thailand suggested removal of kratom from the narcotic drug list relating to Category 5 of the Narcotic Drug Law of 1979, though still recommended regulating kratom in other ways.
Turkey: Kratom is a classed as drug and is illegal to possess, produce, supply, or import.
United Kingdom: It is illegal to produce, supply, or import this drug under the Psychoactive Substance Act, which came into effect on May 26th, 2016.
United States: On August 31, 2016, the DEA issued a statement indicating its intention to place kratom on Schedule I of the U.S. Controlled Substances Act in the temporary scheduling category. This ban would have come into effect on September 30th, 2016, but was withdrawn on October 13th, 2016. A public comment period, which closed on December 1st, 2016. Following the comment period, the DEA will have to issue a new statement of intent to place kratom in Schedule I. While there are states that have pledged to not pursue legislation to ban kratom, many others have passed or have pending legislation to ban kratom. It is currently prohibited in the states of Tennessee, Rhode Island, Vermont, Arkansas, Indiana, and Wisconsin.
Netherlands: Kratom is legal to possess, buy, and sell in the Netherlands according to the Opium Act of May 12th, 1928.
After secretly buying from about 60 vendors and analyzing roughly 200 'strains,' the reality is most kratom being labeled one thing or another is just a blend of the same thing repackaged and renamed. Don't chase strain names — what matters is finding a batch that works for you and buying more of that specific batch while it lasts.
hymnder · Mar 4
As a nurse who used kratom to get off 16 years of OxyContin and Percocet: the first 6 months are the hardest. The psychological addiction to your old medication is harder to beat than the physical part. Kratom gets you through the withdrawal, but you still have to do the mental work of not reaching for a pill every time you feel pain or stress.
SamIAm7997 · Mar 4
All of your kratom comes from Indonesia. ALL OF IT. Anyone telling you otherwise is uninformed or dishonest. Malay, Bali, Thai, Cambodian, Vietnam — these are complete fabrications, just marketing names. The actual variation comes from how the leaf is dried and processed, not where it supposedly grew.
BadgerSilver · Mar 4
Physical dependence develops faster than most people expect. Daily use for even 2-3 weeks can produce withdrawal symptoms (restless legs, insomnia, irritability, runny nose) similar to mild opioid withdrawal.
KratomDaily · Mar 4
Don't combine kratom with other depressants, especially opioids, benzodiazepines, or alcohol. Respiratory depression risk increases with combinations. Several deaths have been attributed to kratom combined with other CNS depressants.
KratomHonest · Mar 4
Even though kratom helped me get off harder substances and it works great for pain, being tied to it every single day is frustrating. No matter where I go or what I do, kratom has to always be a thought and in the plan. If you start using it, be mindful about keeping doses low and taking breaks so it doesn't become another thing you can't leave the house without.
A former 8-year daily kratom user who has been kratom-free for 2 years writes in support of keeping kratom accessible, arguing it is safe and that the FDA's financial motivations—not user safety—drive the push to ban it. They contrast kratom's safety record with legal substances like alcohol.
A detailed informational post summarizing New Jersey Assembly Bill A2865 which would criminalize possession, manufacture, and sale of kratom-containing substances. The post includes the bill's history (third iteration since 2014), committee status, and urges New Jersey residents to contact their Assembly representatives.
A 24-year-old celebrates two weeks of sobriety from heroin and subutex, crediting kratom and the community's guidance for their successful transition. They describe restored emotions, improved sleep, renewed joy in life, and a new goal of reaching 100 years old.
A frustrated community member questions why kratom users are arguing among themselves about strain names and regional origins at a time when the plant faces potential federal ban. They urge unity and perspective, emphasizing that the legal fight for kratom's survival should take priority over marketing disputes.
A community call-to-action post providing detailed information about multiple state legislative bills seeking to ban kratom, including New Jersey's Assembly Bill A2865, with contact information for relevant committee members. It urges kratom advocates to email their representatives to oppose the legislation.
A long-time community member and kratom insider definitively states that all kratom sold in the US originates from Indonesia, and that regional strain names like Thai, Bali, and Malay are fabrications used for marketing purposes. They argue that honest marketing is critical to the industry's legitimacy and to kratom's legal future.
A recovering addict and mental health author describes discovering kratom through a heroin-recovering client and becoming an advocate after personal positive experience with Green Bali. They propose using their social media platform to help keep kratom legal and educate people who could benefit most from it.
After extensive secret shopping across approximately 60 kratom vendors and analyzing around 200 'strains,' the poster concludes that most kratom on the US market is the same Indonesian product repackaged under different names and regional labels. Differences between strains are largely marketing fiction, though occasional genuine variance exists by chance.
A politically charged post reveals that a 24-year-old with no relevant experience and a falsified master's degree was appointed to a senior role in the White House's drug policy office. The poster shares concerns that someone who reportedly detests drug addicts is in charge of opioid crisis response.
A Dr. Oz article frames kratom companies as 'exploiting the opioid epidemic,' while the poster argues kratom is a superior and gentler alternative to FDA-approved treatments like methadone and buprenorphine, which carry worse withdrawal profiles and higher risks. The post advocates for access to kratom for those who cannot afford or do not want pharmaceutical MAT options.
Mitragynine — the primary active alkaloid in kratom(Public domain)
Frequently Asked Questions
What is Kratom?
Mitragyna speciosa is a tropical evergreen tree of the Rubiaceae family native to Southeast Asia. It is indigenous to Cambodia, Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where its dark green, glossy leaves, known as kratom, have been used in herbal medicine since at least the 19t
What are the effects of Kratom?
The effects of kratom vary dramatically with dose, producing stimulant-like effects at low doses and opioid-like sedation at higher ones. At lower doses, onset occurs within fifteen to twenty minutes of chewing leaves or swallowing powdered material. The first signs are a subtle brightening of mood
Is Kratom addictive?
Moderately addictive. As a partial mu-opioid agonist, kratom produces dependence with regular use, though withdrawal symptoms are generally described as milder than classical opioid withdrawal. Cessation produces abstinence symptoms including irritability, muscle aches, insomnia, and nausea. Toleran
What are the risks of Kratom?
Kratom has a low toxicity relative to dose. Like most opioids, safe usage of kratom is not known to cause any dangerous long-term complications. Heavy dosages of kratom can result in increased respiratory depression, leading onto fatal or dangerous levels of anoxia (oxygen deprivation). This is sign
How long does Kratom last?
The total duration of Kratom via oral is 2 hours to 4 hours. Onset typically occurs within 20 minutes to 40 minutes. Peak effects last 1 hour to 2 hours.
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Amnesia— A complete or partial inability to form new memories or recall existing ones during and after substa...
Anxiety— Intense feelings of apprehension, worry, and dread that can range from a subtle background unease to...
Anxiety suppression— A partial to complete suppression of anxiety and general unease, producing a calm, relaxed mental st...
Cognitive euphoria— A cognitive and emotional state of intense well-being, elation, happiness, and joy that manifests as...
Depression— A persistent state of low mood, emotional numbness, hopelessness, and diminished interest or pleasur...
Dream potentiation— Enhanced dream vividness, complexity, and recall, often occurring as REM rebound after discontinuing...
Focus enhancement— An enhanced ability to direct and sustain attention on a single task or stimulus with unusual clarit...
Motivation enhancement— A heightened sense of drive, ambition, and willingness to accomplish tasks, making productive effort...
Sleepiness— A progressive onset of drowsiness, heaviness, and the desire to sleep that pulls the individual towa...
Thought acceleration— The experience of thoughts occurring at a dramatically increased rate, as if the mind has been shift...
Thought deceleration— The experience of thoughts occurring at a markedly reduced pace, as if the mind has been placed into...
Time distortion— Subjective perception of time becomes dramatically altered — minutes may feel like hours, or hours p...
Dangerous
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
