Kratom is a drug of emerging concern. The 2022 National Survey on Drug Use and Health (NSDUH) estimated that 1.9% of young adults aged 18-25 (nearly 700,000 people) reported past-year kratom use. The real concern is its growing use among young adults due to its widespread accessibility and low cost.
Kratom originates from a tree native to Southeast Asia. It is an herbal substance whose leaves contain a chemical called mitragynine, which has pain-relieving and stimulant effects like opioids such as morphine.
It is commonly taken for withdrawal symptoms and cravings from heroin, morphine, and other opioid drugs, as well as for pain, fatigue, cough, depression, anxiety, mood enhancement, and mental health conditions, among others.
Kratom and kratom-based products are currently legal in the US in many areas. However, the FDA has not approved any uses for the drug, and there is no good scientific evidence to support its use. It has the same safety concerns as other opioids, especially for young adults, particularly because it can be found in many forms in some gas stations and convenience stores.
What is Kratom?
Kratom contains the active alkaloids mitragynine and 7-hydroxymitragynine (7-OH). These bind to opioid receptors [1]. Although kratom has a different chemical structure than classic opioids like morphine or heroin, the active compounds interact with opioid receptors in the brain.
Low doses (1-5 grams) act as stimulants, boosting energy and alertness. Higher doses (5-15 grams) produce sedation, euphoria, and pain relief similar to opioids, and they may cause negative reactions.
Kratom is commonly consumed as:
- Powdered leaves (often mixed into drinks)
- Capsules
- Extracts or tinctures
- Chewed (fresh or dried leaves)
The Risks and Dangers
While some people advocate for kratom as a “natural” remedy, it is possibly unsafe and carries significant risks [1] [2] [3]:
Addiction and Dependence
- Regular use can lead to dependence, with withdrawal symptoms similar to opioid withdrawal (e.g., muscle aches, insomnia, irritability, nausea).
Side Effects
- Kratom can cause nausea, itching, sweating, dry mouth, constipation, increased urination, loss of appetite, and aggression.
- Sedation, dizziness, confusion, and hallucinations may be caused by high doses.
- If kratom is mixed with alcohol, benzodiazepines, opioids, or other central nervous system depressants, the risk of respiratory failure and death increases.
Risk of Poisoning
- Cases of poisoning have been linked to kratom products when adulterated with other potent substances.
Severe Adverse Effects
- Seizures, liver damage, respiratory depression (especially when mixed with other substances), psychiatric symptoms, and death are rare but serious side effects.
Lack of Regulation
- Kratom is unregulated in many countries. There may be contamination with heavy metals, bacteria, or other drugs. Dosage can vary widely between products.
- The FDA warns against kratom due to risks of addiction, abuse, and dependence. As well, it notes risks of contamination, adulteration with potent concentrates such as 7-OH (7‑Hydroxymitragynine), and over 3,400 poison control reports from 2014 to 2019. Research shows that 7‑OH binds opioid receptors with a strength that rivals morphine and may be as much as 30 times more potent than mitragynine [4].
- The FDA has not approved kratom for any medical use and has raised concerns about safety issues and the potential for abuse.
Addiction and Withdrawal
Kratom’s active alkaloids act as partial agonists at mu-opioid receptors in the brain, causing dependence. This is similar to opioids but with additional stimulant effects at lower doses [3].
Mechanism of Dependence
Regular use leads to rapid tolerance. Kratom reduces the production of natural endorphins and alters the sensitivity of receptors. Higher doses are required for the same effects, such as pain relief or euphoria [6]. When combined with frequent dosing, the risk of dependence increases. Over half of long-term users show moderate to severe symptoms.
Withdrawal Process
When you stop using kratom, the sudden lack of opioid receptor stimulation triggers rebound hyperactivity in the nervous system. This peaks 12–72 hours after the last dose and lasts 3–7 days or more. This causes acute physical symptoms, while psychological ones like anxiety arise from changes in mood-regulating pathways. Withdrawal can be managed safely in medical detox with buprenorphine/naloxone. Therapy is also recommended.
Common Symptoms
- Physical: Symptoms are similar to withdrawal from opioids, including cravings, muscle aches, insomnia, diarrhea, sweating, runny nose, fever, and tremors.
- Psychological: Symptoms include irritability, restlessness, anxiety, cravings, and depression.
Higher frequency of use, rather than dose amount alone, correlates more strongly with symptom severity.
How Engage Young Adult Transitions Can Help
At Engage, we are ready to support you in our welcoming community if you identify as LGBTQ+.
Engage Young Adult Transitions is a transitional living program and therapeutic community that assists young adults on their path to independence. Using attachment theory, we provide a foundation for forming connections, getting involved with the community, managing mental health, and building life skills for long-term success.
Engage offers structured autonomy and high support, without creating dependence. Our therapists and life coaches are here to honor the young adults’ need to gain independence and freely move to a more secure sense of self and their relationships.
Located just steps from Southern Utah University in Cedar City, we offer access to services seven days a week, including academic support, vocational training, career guidance, life skill coaching, mental health therapies, and recreational activities.
Our community offers high levels of therapeutic support that honor autonomy and independence while guiding young adults to a life of freedom, emotional wellness, and success.
Get involved with the Engage Transitions community today!
Sources
[1] National Institute on Drug Abuse. 2022. Kratom.
[2] WebMD. nd. Kratom – Uses, Side Effects, and More
[3] DrugAbuse.com. 2025. Kratom Short-Term, Long-Term, Side Effects, and Addiction Treatment.
[4] Van Law Firm. nd. FDA Cracks Down on Potent Kratom-Derived Products.
[5] Galan N. 2024. Kratom: Everything you need to know. MedicalNewsToday.
[6] Bin Abdullah MFIL. 2020. Kratom Dependence and Treatment Options: A Comprehensive Review of the Literature. Curr Drug Targets. 2020;21(15):1566-1579.