Short answer: Kratom is a Southeast Asian tree whose leaves contain mitragynine and 7-hydroxymitragynine (7-OH), which act on opioid receptors. At low doses it is stimulating; at higher doses it is sedating and opioid-like. Kratom leaf is not federally controlled, but it is not approved for any medical use, several states ban it, and in 2026 the DEA moved to place concentrated 7-OH products in Schedule I.
Key takeaways
- What it is: Kratom is a plant with opioid-like alkaloids and not a federally controlled substance.
- Medical use: None approved.
- Timing: effects start in 10 to 30 minutes and last 2 to 6 hours.
- Most dangerous mix: Opioids, which can cause additive sedation and breathing suppression.
- Naloxone: it partly reverses an overdose.
- Dependence risk: Moderate to high.
- Legal route: kratom is not federally scheduled as of October 2026, but state bans, FDA restrictions, and pending federal action can apply; check current status.
What is kratom?
Kratom leaves have been used for centuries in Thailand, Malaysia, and Indonesia. In the US, kratom is sold in smoke shops, gas stations, and online as powder, capsules, and drinks, often marketed for pain, energy, mood, or opioid withdrawal.
At low doses kratom can cause alertness, energy, and sociability. At higher doses it causes pain relief, sedation, and euphoria, along with nausea, constipation, itching, sweating, and dizziness.
Quick facts
| Fact | Kratom |
|---|---|
| Botanical name | Mitragyna speciosa |
| Main alkaloids | Mitragynine; 7-hydroxymitragynine (7-OH) |
| Drug class | Plant product with partial opioid agonist and stimulant effects |
| US legal status | Leaf not federally controlled; three 7-OH-related compounds Schedule I since August 2026; concentrated 7-OH proposed for Schedule I |
| FDA status | Not approved for any use; import alerts and warnings |
| How it is used | Powder, capsules, teas, extracts, 7-OH tablets and shots |
| Onset | 10 to 30 minutes |
| Duration | 2 to 6 hours |
| Half-life | Mitragynine: about 24 hours (varies) |
How long does kratom last?
- Starts working: 10 to 30 minutes
- Effects last: 2 to 6 hours
- Half-life: Mitragynine: about 24 hours (varies)
Timing varies with the dose, the form, how it is taken, liver and kidney function, age, and other drugs taken at the same time.
What are the biggest risks of kratom?
Dependence: regular daily use, especially of extracts and 7-OH products, can cause opioid-like dependence and withdrawal.
Liver injury, seizures, and heart effects have been reported, along with weight loss, constipation, and, rarely, psychosis.
Contamination: kratom products have been recalled for salmonella and heavy metals such as lead and nickel. Labels often do not match contents.
What should you never mix with kratom?
| Combined with | What happens | Risk level |
|---|---|---|
| Opioids | Additive sedation and breathing suppression | High risk |
| Benzodiazepines, alcohol, sedatives | Additive sedation | High risk |
| Drugs metabolized by CYP2D6 and CYP3A4 | Kratom inhibits these enzymes, raising levels of many medicines | Check with a pharmacist |
| Stimulants | Heart strain, seizures | Use caution |
Check any combination with the DoseUses combination checker or ask a pharmacist.
What are the signs of a kratom overdose, and what should you do?
Kratom alone can cause agitation, fast heartbeat, high blood pressure, confusion, vomiting, and seizures. High doses, 7-OH products, or kratom mixed with sedatives or opioids can cause severe sedation and slowed breathing. Naloxone may help in these cases.
If someone may have overdosed
- Call 911 if the person is unresponsive, cannot be woken, has blue or gray lips, or is breathing slowly or not at all.
- Give naloxone (Narcan or a generic nasal spray, sold without a prescription) into one nostril. If there is no response after 2 to 3 minutes, give another dose.
- If you are trained, give rescue breaths. Otherwise place the person on their side so they do not choke.
- Stay with them. Naloxone can wear off before kratom does, so the overdose can return even after the person wakes up.
- Most states have Good Samaritan laws that protect people who call 911 for an overdose from some drug charges.
Is kratom addictive, and what is withdrawal like?
People who use kratom daily often develop dependence. Withdrawal resembles mild to moderate opioid withdrawal and is more severe after heavy use or 7-OH products.
- 12 to 24 hoursSymptoms beginCravings, restlessness, runny nose, muscle aches, irritability.
- Days 2 to 4PeakJerky movements, sweating, diarrhea, insomnia, anxiety, hot and cold flashes.
- 1 to 2 weeksResolvesPhysical symptoms ease; low mood and cravings can linger.
See the withdrawal timelines and the full kratom withdrawal guide.
Is kratom legal?
Federal law: kratom leaf is not a federally controlled substance. The FDA has not approved it for any use, has warned consumers not to use it, and blocks imports of kratom marketed as a dietary supplement or for medical use.
Outside the United States
| Country | Status |
|---|---|
| Thailand | Legalized in 2021 and regulated under a 2022 kratom act |
| Malaysia | Controlled under the Poisons Act |
| United Kingdom | Illegal to sell or supply under the Psychoactive Substances Act 2016 |
| Australia | Schedule 9 prohibited substance |
| International | Not under UN control |
Frequently asked questions about kratom
Is kratom an opioid?
It is not a classic opioid, but its alkaloids activate opioid receptors and it can cause opioid-like dependence and withdrawal.
Is kratom legal?
Kratom leaf is not federally controlled, but several states ban it, and the DEA began scheduling concentrated 7-OH and related compounds in 2026.
What is 7-OH?
7-hydroxymitragynine, a potent opioid alkaloid present in small amounts in kratom and concentrated in some products. It is much stronger than mitragynine.
Can kratom help with opioid withdrawal?
Some people use it that way, but it is not approved or proven, and it causes its own dependence. Buprenorphine and methadone are proven treatments.
Does kratom show on drug tests?
Standard opioid tests do not detect it, but specific kratom tests exist.
Sources
- Kratom, National Institute on Drug Abuse.
- DEA to temporarily schedule 7-OH and related substances to protect public safety, US Drug Enforcement Administration, July 2026.
- FDA and Kratom, US Food and Drug Administration.
- National Helpline, Substance Abuse and Mental Health Services Administration.
- FindTreatment.gov, Substance Abuse and Mental Health Services Administration.
- International drug control conventions, United Nations Office on Drugs and Crime.
This guide summarizes the sourced DoseUses Kratom profile, written from FDA labels, DEA rules, and federal health agencies. It is educational and is not medical advice. Last updated October 5, 2026.
