Is Kratom Safe? Safety and Potential Side Effects

Illustration of Kratom leaves with a warning sign.
Written by Livvy Ashton | Last updated: December 3, 2022

Kratom (Mitragyna speciosa) is an herbal extract that grows on the leaves of an evergreen tree from Southeast Asia. Recently, it’s become tremendously popular worldwide, and some organizations have already branded it as dangerous without enough scientific evidence.

In this article, we’ll cover the traditional side effects of kratom and give you some tips and tricks to use your strains safely. We’ll also briefly explain why some federal entities believe it to be a substance of concern and what the World Health Organization has to say.

Is Kratom Dangerous?

Kratom can be dangerous if abused. Never mix kratom with painkillers, alcohol, or stimulant drugs. 

The DEA has listed kratom as a Drug and Chemical of Concern. This is mainly due to the herb’s recent surge in popularity in the Western hemisphere paired with a lack of studies on its long-term effects.

The FDA now harbors a strong negative opinion against the herb and even claims it might be dangerous. However, despite several attempts to ban kratom, the FDA has been unsuccessful in providing enough evidence to prove the herb poses any significant danger to the general public. Almost all cases of overdose involving kratom also had high concentrations of other dangerous drugs in the system [1]. It’s hard to pinpoint the cause of death towards kratom, specifically.

In 2019, Science Direct published a study reporting that opioid painkillers were 1000 times more likely to cause an overdose than kratom [2].

Interestingly, the World Health Organization reviewed kratom in 2021 and found it to be relatively safe and that scheduling it as a drug would cause more harm than good.

Side Effects of Kratom

Though kratom is relatively safe, there are some side effects to be aware of. These usually aren’t dangerous and don’t last long. New users can experience some discomfort, and larger doses tend to be more problematic than lower doses.

The most common side effects include the following:

  • Headaches
  • Nausea
  • Vomiting
  • Dizziness
  • Loss of appetite
  • Constipation
  • Diarrhea
  • Sweating
  • Abdominal pain

In some extreme cases, patients have experienced psychosis and hallucinations, but we suggest not to worry, as these tend to affect long-term users who abuse kratom. As long as you respect kratom and use it in moderation, you likely won’t feel any of these discomforts.

How Can Kratom Become Dangerous?

There are many different ways using kratom irresponsibly could make it a potential threat to your health.

1. Drug Interactions

First, as a pharmacologically-active substance, combining kratom with opiate alcohol, painkillers, or other drugs and substances could prolong their effects and lead to an overdose or adverse side effects.

Kratom has a high risk of interacting with many substances due to how it’s metabolized in the body [3]. It can inhibit the same enzymes that metabolize other medications, causing them to stay in the system longer than they should. This build-up leads to sometimes severe complications.

2. Long-Term or Heavy Use

Long-term abuse of kratom can deteriorate your body, and its potent effects can cause severe reactions if you have underlying health conditions, such as heart, liver, or kidney disease.

Kratom has caused liver disease in some individuals, though this is rare and seems to be reversible once the kratom use has stopped [4].

3. Unsafe Products

Adulteration of products is a rising problem within the kratom industry. Black market vendors may even mix opiate pain medications into their kratom, while others may add stimulants and other substances to boost its effects.

Other times, the kratom has been stored improperly and is tainted with bacteria or mold, causing people to get sick.

4. Addiction

Various studies have taken place in Thailand since 1973, concluding habitual kratom users are likely to start showing signs of dependency [5].

Even though the severity of kratom addiction isn’t similar to opioids, you can still experience withdrawal symptoms if you abuse kratom long-term. The risk of overdose is low, and kratom does not cause respiratory depression like opioids do [6].

Once you build up a tolerance, you might go through adverse symptoms such as muscle twitching, hormonal changes, runny nose, insomnia, and irritability.

Using Kratom Safely

Kratom dried and powdered leaf on a mini bowl and Kratom tea on a table

Kratom is safe when used in moderation. Next up, we’ve listed some tips and tricks to ensure you’re safe while enjoying your favorite strain.

1. Be Aware of Underlying Health Conditions

Doctors do not recommend kratom use for those struggling with liver, kidney, or heart complications, as it might interfere with treatment for these conditions.

We suggest contacting your primary healthcare provider before trying out the herb if you suffer any underlying ailments that might affect your health long-term.

2. Be Mindful When Dosing

You should start with a small daily dose — such as 2 grams — keeping close tabs on how your body responds before increasing it. If you start feeling nauseous, you’ve probably taken too much, and you should reduce the amount next time.

Also, be patient when dosing and wait for the effects to manifest in your body. It is easy to take too much kratom because of the time it takes for its effects to set in, sometimes up to an hour.

3. Don’t Mix Kratom With Medications

Mixing kratom with pain medications is a dangerous and unnecessary risk. We recommend finishing the prescribed course and then waiting a few days for the drugs to fade away completely from your body.

Always speak to your doctor before starting kratom if you’re on other prescription substances.

4. Buy From Reputable Vendors

Perhaps the most harmful aspect of kratom is accidentally purchasing adulterated strains from shady vendors. Many companies try to enhance their kratom via dangerous means, such as mixing the herb with foreign prescription opiates.

We thoroughly recommend purchasing only from brands approved by the American Kratom Association (AKA) to ensure you’re getting top-notch, high-quality kratom. Always look for third-party testing since these can tell you exactly what you’re getting.

The Benefits of Using Kratom

Kratom can tackle many health conditions and disorders and is used by many as traditional medicine in Southeast Asian countries. In these countries, manual laborers turn to it to fight off fatigue and help them deal with physical aches.

In the last few years, the herb has been going through a sudden spike in popularity, and we estimate that around 10 to 15 million people use kratom in the US alone.

People use kratom to deal with:

Slowly but surely, society has started to value kratom’s therapeutic properties. Respected entities such as John Hopkins Medicine already advocate for it, and many scientists are now researching the plant to understand its potential benefits and help protect users.

How to Dose Kratom

Kratom powder and capsules with measuring spoons

The perfect dosage can vary from person to person, depending on various factors, including physical attributes, such as body weight and overall tolerance to the herb. However, an average adult’s standard dose is two to six grams. The kratom strain you use also plays a role.

Typically, small doses of kratom promote stimulating effects, while high doses mainly sedate you and are better for pain. White strains are used for energy, mood, and focus. Red strains are better for relaxation and pain. Green strains fall in the middle and provide a more balanced experience.

If you start feeling unpleasant effects, you likely took too much and should take a break and rest.

Only those who have experienced kratom’s effects and know how their bodies will react should experiment with higher doses.

Ways to Take Kratom

There are many ways of taking kratom traditionally in its native lands, including consuming dried and powdered strains, chewing on leaves, or brewing it into tea.

On the other hand, western society enjoys capsules or tinctures, but powdered kratom is still the most popular. Many people have also started adding kratom into their snacks by baking pastries with the herb or adding it to smoothies.

Still, most users will take kratom by mixing the dried powder into a cup of water or juice and gulping it down.

Conclusion: Is Kratom Dangerous?

Kratom is only dangerous when used irresponsibly. Many users across the globe turn to kratom as an alternative to opioids — or even to treat opioid addiction — and society can’t ignore its evergrowing list of benefits.

However, kratom is still relatively new to Western countries, and various drug agencies are wary of its potential for abuse and harm. The FDA, for example, wildly spreads misconceptions about kratom, arguing it has similar addictive properties as regular narcotics.

Luckily, scientists, the WHO, and pro-kratom organizations such as the AKA are making substantial progress in introducing the herb to our rightfully cautious society.

References Used

  1. Henningfield, J. E., Grundmann, O., Babin, J. K., Fant, R. V., Wang, D. W., & Cone, E. J. (2019). Risk of death associated with kratom use compared to opioids. Preventive medicine, 128, 105851 [1].
  2. Corkery, J. M., Streete, P., Claridge, H., Goodair, C., Papanti, D., Orsolini, L., … & Hendricks, A. (2019). Characteristics of deaths associated with kratom use. Journal of psychopharmacology, 33(9), 1102-1123 [2].
  3. Kamble, S. H., Sharma, A., King, T. I., Berthold, E. C., León, F., Meyer, P. K. L., … & Avery, B. A. (2020). Exploration of cytochrome P450 inhibition mediated drug-drug interaction potential of kratom alkaloids. Toxicology letters, 319, 148-154 [3].
  4. Schimmel, J., & Dart, R. C. (2020). Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review
  5. Mitragyna Speciosa) liver injury: a comprehensive review. Drugs, 80(3), 263-283 [].
  6. Kruegel, A. C., & Grundmann, O. (2018). The medicinal chemistry and neuropharmacology of kratom: a preliminary discussion of a promising medicinal plant and analysis of its potential for abuse. Neuropharmacology, 134, 108-120 [6].

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.