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Kratom Side Effects

Kratom addiction

Kratom is a tree that grows in Southeast Asia, Mitragyna speciosa. Alternate names for kratom include:1

While many people will take kratom in the form of pill or extract, some people will chew the leaves, brew them into a tea, or cook them in food. Others will crush and smoke the leaves.1,2

The psychoactive effects of the plant may vary and, in a dose dependent manner, have both stimulant and opioid qualities. At lower doses, the effect is more stimulant-like (e.g., increased energy and sociability); at higher doses, sedative effects predominate.2

Is Kratom Legal?

While the Drug Enforcement Administration (DEA) has listed kratom as a Drug and Chemical of Concern, it is not currently a scheduled substance under the Federal Controlled Substances Act. Though not a federally controlled substance, some states (including Alabama, Wisconsin, and Vermont) have regulations that prohibit the sale, possession, and use of kratom.2,3

In the United States, kratom has achieved some degree of popularity and is often marketed for sale online, with dubious and untested claims that it is a safe alternative to opioid medications for the management of pain or for the relief of opioid withdrawal symptoms.4

Is Kratom Safe?

Despite these claims, there are no Food and Drug Administration (FDA) approved medical uses for kratom, and the FDA has expressed concerns about the drug’s potential for abuse, dependence, and addiction.5

Kratom may also be more dangerous than many people are led to believe, especially by online sellers and proponents of the substance. 1, 4

The pleasurable effects (increased energy and talkativeness at lower doses and sedating, euphoric, and pain-relieving effects at high doses) may be accompanied by adverse side effects that include:1,2,6

  • Drowsiness.
  • Confusion.
  • Anxiety.
  • Agitation.
  • Rapid heart rate.
  • Itchiness.
  • Sweating.
  • Dry mouth.
  • Nausea.
  • Vomiting.
  • Constipation.
  • Stupor.
  • Hallucinations.
  • Delirium.
  • Seizures.

What Are the Long-Term Effects of Kratom?

Individuals who abuse the substance for a significant length of time may experience: 1,2,4,6,7

  • Chronic insomnia.
  • Cognitive impairments (problems with visual learning and new learning).
  • Psychosis.
  • Anorexia/weight loss.
  • Darkening of the skin on the face.
  • Hair loss.
  • Urinary Changes (e.g., diuresis and increased urgency/frequency.
  • Liver toxicity.
  • Tremors.
  • Seizures.
  • Tolerance (as well as cross-tolerance to opioids).
  • Dependence.
  • Addiction.

One mustn’t discount the potential for serious, adverse drug interactions that could occur when used in combination with illicit and prescription drugs as well as other herbal substances.6 A number of deaths have been reported after users purchased kratom products containing high levels of O-desmethyltramadol—the primary active metabolite of tramadol, an opioid painkiller. Other reported deaths involving kratom include a 17-year-old boy who died as a result of taking kratom with benzodiazepines and over-the-counter cold medicine and an individual who died after using kratom in combination with propylhexedrine (used in nasal decongestants).4 In many instances, kratom users also consume other drugs such as alcohol, marijuana, and benzodiazepines,4 subjecting themselves to additional combined risks.

Kratom Withdrawal

Kratom use may lead to the development of physiological dependence. A person with a history of consistent kratom use and significant dependence may experience withdrawal symptoms that resemble those of opioid withdrawal when they quit or cut back.1,4

Symptoms of kratom withdrawal may include:1,4

  • Cravings for kratom.
  • Mood swings.
  • Irritable mood.
  • Difficulty sleeping.
  • Restlessness.
  • Aggressive behavior.
  • Lowered sexual drive.
  • Decreased appetite.
  • Diarrhea.
  • Runny nose.
  • Teary eyes.
  • Fever.
  • Body aches and pains.
  • Muscle spasms.
  • Jerky limb movements.

Addictive Potential of Kratom

Long-term abuse of kratom is not as risk-free as many online sources make it seem.

Despite the fact that kratom is not currently a DEA controlled substance and contrary to the claims of its supporters, evidence does indicate that kratom users are at risk of dependence and addiction to the drug. In Thailand, treatment admissions for kratom addiction tripled between 2007 and 2011. 4

If you suspect you or someone you love is addicted to kratom, help is available. Don’t wait. Long-term abuse of kratom is not as risk-free as many online sources make it seem. Regular use may result in problems such as cognitive impairments, psychotic symptoms, and liver injury.4,7

Common Related Questions

  • Is Kratom harmful?
    Kratom is more dangerous than many people believe.
  • What are the negative effects of Kratom?
    Mood swings, irritable mood, difficulty sleeping, restlessness, aggressive behavior, lowered sexual drive, and more.
  • What does kratom do?
    The psychoactive effects of the plant may vary and, in a dose dependent manner, have both stimulant and opioid qualities. At lower doses, the effect is more stimulant-like (e.g., increased energy and sociability); at higher doses, sedative effects predominate.


  1. National Institute on Drug Abuse. (2019). Kratom.
  2. Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide.
  3. Wing, Nick. (2018). Kratom Users In States That Ban It Discuss How Prohibition Has Made Life Worse. Huffington Post.
  4. Cinosi, E., Martinotti, G., Simonato, P., Singh, D., Demetrovics, Z., Roman-Urrestarazu, A., … Corazza, O. (2015). Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western CountriesBioMed research international2015,
  5. S. Food & Drug Administration. (2019). FDA and Kratom.
  6. Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects. The Journal of the American Osteopathic Association, 112, 792-799.
  7. Singh D Ph.D, Narayanan S Ph.D, Müller CP Ph.D, et. al. (2019). Long-Term Cognitive Effects of Kratom (Mitragyna speciosa Korth.) Use. J Psychoactive Drugs, 51(1), 19-27.