What Is Kratom?
Kratom comes from the leaves of the Mitragyna speciosa, a tree that grows in Southeast Asia. For centuries, kratom was traditionally used by laborers in Thailand and Malaysia as both a stimulant to provide energy and a pain reliever.[1] Today, it has become increasingly more popular in the United States and is currently sold in gas stations, smoke shops, and online stores as an over-the-counter supplement in powder, capsules, and liquid extract form.
The two main components in kratom, mitragynine and 7-hydroxymitragynine, work by binding to opioid receptors in the brain. At smaller dosages, kratom works as a stimulant, providing increased energy levels, heightened alertness, and enhanced social interaction; however, at larger dosages, kratom acts as an opioid, providing sedative effects and euphoria.[2] This dose-dependent characteristic is central to understanding why kratom carries real addiction potential despite being sold legally in many states.
According to the Food and Drug Administration, kratom has no approved medical use in the United States, and the agency has raised serious concerns about its safety, including the risk of physical dependence, abuse, and serious health conditions, including liver damage.[3] The DEA has also designated kratom as a drug of concern and, at various points, has considered scheduling it as a controlled substance.
Understanding 7-Hydroxymitragynine (7-OH)
The increasing trend toward kratom products containing 7-hydroxymitragynine (commonly referred to as 7-OH) presents one of the largest emerging issues regarding kratom. Although 7-hydroxymitragynine is an alkaloid present in kratom plants, its presence occurs at very low levels in the kratom plant, usually under 2%.[4]
Due to a rising demand by consumers for new types of kratom products, manufacturers have developed products such as tablets, gummies, drink shots, powdered drinks, dissolvable strips, etc., designed to provide users with a greater concentration of 7-OH compared to traditional kratom leaf. Many of the commercially available 7-OH products are being marketed as if they were similar to natural kratom; however, there are substantial differences between how each type of product delivers 7-hydroxymitragynine into the body and what effects users will likely experience while consuming either type.
Federal regulators have expressed concern that many commercially available 7-OH products contain concentrations far exceeding those found naturally in the plant and may be manufactured through chemical or semi-synthetic processes rather than simple extraction.[5]
Why Are High-Strength 7-OH Products a Concern?
Compared to kratom leaf, almost all of the 7-OH tablet, gummy, drink shot, and extract-type kratom products currently available to consumers have been specifically created to deliver a far greater concentration of 7-hydroxymitragynine than can naturally occur in the kratom plant. Because 7-OH interacts strongly with the brain’s opioid receptors, these concentrated products may produce more intense opioid-like effects and increase the risk of tolerance, dependence, and withdrawal.[6]
As research continues to develop regarding 7-OH and kratom, public health professionals are increasingly concerned about the availability and strength of these products.
7-Hydroxymitragynine Treatment
For individuals seeking 7-OH rehab, the distinction between traditional kratom and newer high-potency 7-OH products can be clinically important. People using concentrated 7-OH products may experience more significant opioid-like effects, stronger cravings, and a more challenging withdrawal process than those using conventional kratom leaf. Regardless of which product a person has been using, professional assessment can help determine the most appropriate level of care and identify any co-occurring mental health or substance use disorders that should be addressed during treatment for 7-Hydroxymitragynine addiction.
Kratom Addiction and Abuse
One of the main reasons kratom is so addictive lies in the way it interacts with opioid receptors. Over time and with regular use, the brain will adapt to the drug’s presence in the same way it does with prescription opioids, downgrading its opioid receptors and reducing its natural production of dopamine.[7] This has the effect of making it increasingly more difficult to experience pleasure or relief without the drug. To compensate, people often start using kratom more frequently and in larger quantities, ultimately developing a tolerance.
It can happen faster than one might expect. Individuals consuming kratom regularly, even at moderate doses, can develop a physical dependency on it in as little as a few weeks. As tolerance grows, the initial amount of kratom no longer provides the desired effect, leading to even higher doses and more frequent consumption. This is a hallmark of substance use disorder, which is one reason why kratom dependency treatment is becoming clinically recognized in the same way as opioid use disorder by both medical professionals and addiction specialists.[8]
The road to kratom addiction often follows a pattern: kratom was initially used for a particular purpose, like pain management, managing withdrawal from opioids, or enhanced energy, and over time, usage starts becoming less about the desired effect and more about avoiding the discomfort of withdrawal.
Signs of Kratom Addiction
Although kratom is legal in many parts of the U.S. and perceived by many users as a dietary supplement, it does have addiction potential, with signs that mirror addiction to other substances.
Some of the most common are:
Behavioral
- Using kratom in greater quantities or more frequently than originally planned
- Spending considerable amounts of time acquiring, preparing, or recovering from kratom use
- Continued kratom use despite negative impacts on health, relationships, or employment
- Failed attempts to reduce or stop kratom use
- Reduced participation in recreational or social activities in favor of using kratom
- Concealment of kratom use from family members or doctors
Physical
- Sedation and sleepiness at high doses
- Constipation and gastrointestinal discomfort
- Reduced appetite and weight loss
- Nausea, particularly at high doses
- Possible liver damage from long-term excessive kratom use
- Potential withdrawal symptoms if kratom use is reduced or stopped
Psychological
- Strong cravings for kratom between doses
- Using kratom for mood or emotional stability and to manage anxiety or depression symptoms
- Feeling irritable or agitated when unable to access kratom
- Feeling incapable of functioning normally without kratom
If you believe a loved one displays some or all of the above signs of kratom dependency, consulting with a medical professional or addiction specialist is recommended.
Kratom Withdrawal Symptoms
Because kratom binds to opioid receptors, its withdrawal is similar to opioid withdrawal, with symptoms that can include muscle aches, insomnia, nausea, sweating, anxiety, irritability, and depression. These symptoms are uncomfortable enough that many people find it very difficult to stop without professional support, which is one reason kratom dependency is increasingly treated as a clinical condition rather than a simple habit.
The timeline for kratom withdrawal symptoms depends on how long the person has been using, how much they’ve been taking, and the form of kratom consumed. Symptoms typically begin within 12 to 24 hours of the last dose and peak within the first two to three days.[9] Psychological symptoms like depression and cravings can sometimes linger for weeks or months, which is why professional support during and after detox is so important.
What States Is Kratom Banned In?
Kratom is currently legal in the United States at the federal level. However, as of 2025, several states have banned or restricted its sale and possession, including:
- Alabama
- Arkansas
- Indiana
- Rhode Island
- Vermont
- Wisconsin
Many cities and counties have also put local ordinances in place. Both the FDA and DEA have raised concerns about kratom’s safety and abuse potential, and the regulatory landscape continues to change.[10] Anyone using or purchasing kratom should verify the current laws in their specific state.
The variance in state laws governing kratom reflects disagreement over its safety. Proponents of kratom claim it serves legitimate purposes and that prohibition causes consumers to seek out other, more hazardous substances. Researchers and healthcare workers have countered that due to a lack of regulation regarding kratom products, varying levels of product quality, and mounting evidence of adverse effects, which include liver injury, dependency, and death from overdose, stricter regulations are necessary.[11]
How Does Kratom Affect Your Behavior?
The impact of kratom on behavior varies based on the amount consumed. Small amounts cause stimulant-like effects such as enhanced energy, motivation, and sociability, while large amounts cause sedative effects, including pain relief, diminished inhibitions, and euphoria.
Prolonged use of kratom produces additional changes to behavior that may appear unrelated to kratom’s primary effects at first. Impulsiveness and poor decision-making are common among those who chronically use kratom, as are social isolation and withdrawal, neglecting personal and family obligations, mood swings, and, in many instances, the emergence or worsening of co-occurring mental health disorders.[12]
It is important to recognize the effect of kratom on behavior, both for the individual using kratom and those around them. The first indicators a family may notice are typically changes in personality, mood, and reliability, often before any observable physical signs of kratom use appear.
Long-Term Effects of Kratom
There is a growing body of research exploring the long-term effects of kratom use, and most of what currently exists indicates a cause for considerable concern.
Prolonged kratom use can result in acute liver failure and chronic liver damage, cardiovascular stress, excessive weight loss and nutritional deficiency, impaired cognition affecting memory and concentration, worsening mental health issues such as anxiety and depression, and dependency requiring professional treatment.[13]
Because kratom is not regulated by the FDA, product quality and dosage can vary considerably, even in different batches from a single manufacturer. This creates a considerable risk for unintended overdose or exposure to unknown contaminants. Many healthcare practitioners now suggest that patients with a history of kratom use undergo comprehensive medical evaluations and liver function tests.
