Kratom
Mitragyna speciosa · Botanical opioid-receptor agonist
What it is
A Southeast Asian leaf whose alkaloids (mitragynine, 7-OH-mitragynine) act on opioid receptors — stimulating at low intakes, opioid-like at higher. Millions of US users take it for energy, pain or to self-taper off opioids, mostly without knowing the receptor pharmacology.
What human evidence shows
Human trial evidence is thin; the user-report literature is enormous. Real analgesia and real withdrawal-bridging capacity are plausible from mechanism and surveys. Nothing about its common "energy supplement" framing survives contact with the fact that it is an opioid-receptor agonist.
Risks
Dependence and a genuine opioid-type withdrawal syndrome with daily use — the single most under-communicated fact about it. Tolerance escalation, nausea, constipation; liver injury reports; deaths almost always involve co-ingestants but exist. Concentrated 7-OH extract products sold at gas stations are a different, sharper drug than leaf powder. Unregulated supply, salmonella recalls on record.
Legal status
US: federally unscheduled but FDA-hostile; banned in several states. Sold openly elsewhere.
Evidence base
established literature
Real human evidence: randomised trial reports, or review-level evidence backed by at least one human trial report.
- phase 3/4
- 0
- randomised
- 4
- reviews
- 17
- human trials
- 5
Counts are of published papers, not distinct trials, and measure how much research exists — not whether this works or is safe for you.
Research (12)
- Kratom (Mitragyna speciosa): Friend or Foe?Prim Care Companion CNS Disord · 2020
- Kratom2012
- Kratom Dependence and Treatment Options: A Comprehensive Review of the LiteratureCurr Drug Targets · 2020
- An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerationsExpert Rev Clin Pharmacol · 2024
- Kratom (Mitragyna speciosa): worldwide issuesCurr Opin Psychiatry · 2020
- Controversies in Assessment, Diagnosis, and Treatment of Kratom Use DisorderCurr Psychiatry Rep · 2024
- Treatment of Kratom Withdrawal and Dependence With Buprenorphine/Naloxone: A Case Series and Systematic Literature ReviewJ Addict Med · 2021
- Kratom: a primer for pain physiciansCurr Opin Anaesthesiol · 2024
- Kratom: Substance of Abuse or Therapeutic Plant?Psychiatr Clin North Am · 2022
- Kratom: A Narrative Review of the Possible Clinical Uses and Dangers of This Opioid-Like PlantCureus · 2024
- The pharmacology and toxicology of kratom: from traditional herb to drug of abuseInt J Legal Med · 2016
- Kratom: A Bibliometric Analysis of Scientific PublicationsJ Psychoactive Drugs · 2024
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