Kratom is a plant-based substance derived from the Mitragyna speciosa tree, native to Southeast Asia, whose leaves contain compounds that act on opioid receptors in the brain. It is sometimes marketed as a natural supplement, herbal remedy, or alternative to opioids, but kratom can produce both stimulant-like and opioid-like effects and may carry real risks of dependence, withdrawal, overdose, and other health consequences.
Many people who search what kratom is are trying to understand something they or a loved one have already started using. Others may be trying to stop kratom and wondering why withdrawal feels so difficult. This guide explains what kratom is, what it may do in the body, common kratom effects and side effects, whether kratom is addictive, and when treatment support may help.
Table of Contents
What is kratom used for?
People may use kratom for many different reasons. Some people report using it for chronic pain, low energy, anxiety, low mood, or to reduce symptoms of opioid withdrawal. Others may use kratom recreationally because it can produce mild euphoria, relaxation, or a sense of increased energy depending on the dose and product.1
It is important to talk about reported kratom benefits honestly. Some people feel that kratom helps them function, manage discomfort, or avoid returning to other substances. Those experiences may be real for the person using kratom. At the same time, kratom is not approved by the U.S. Food and Drug Administration to treat pain, opioid withdrawal, anxiety, depression, or any other medical condition.2
Because kratom products are not standardized, the effects can vary widely. The same amount may feel different depending on the product, alkaloid concentration, preparation method, tolerance, and whether other substances are involved. What starts as occasional use may become more difficult to control over time, especially when someone begins using kratom to avoid withdrawal rather than for its original intended effect.
How does kratom work in the brain and body?
Kratom contains active alkaloids, including mitragynine and 7-hydroxymitragynine, often called 7-OH. These compounds interact with opioid receptors in the brain and body, which helps explain why kratom can produce pain-relieving, sedating, euphoric, and dependence-forming effects.
Kratom effects may change by dose. At lower doses, some people report stimulant-like effects, such as increased energy, alertness, or reduced fatigue. At higher doses, kratom may produce opioid-like effects, including sedation, pain relief, calmness, and euphoria.
7-OH is especially concerning because it may be much more potent at mu-opioid receptors than mitragynine and has been described by the FDA as having substantially greater mu-opioid receptor potency than morphine.3 This does not mean every kratom product has the same risk level. However, concentrated extracts, enhanced products, and 7-OH products may carry a higher risk of intoxication, dependence, overdose, and dangerous interactions with other substances.
A “kratom high” can vary from person to person. Some people may feel energized or social, while others may feel sedated, detached, euphoric, or physically slowed down. Because kratom products are not consistently regulated for dose, purity, or alkaloid strength, it can be difficult for people to know exactly what they are taking.
Types of kratom strains
Kratom products are often marketed by strain or vein color. The most common categories are red, white, and green vein kratom. These categories are usually based on the color of the leaf vein and how the product is marketed rather than on reliable clinical evidence.
Common user-reported strain claims include:
- Red vein kratom: Often described as more relaxing, calming, or sedating
- White vein kratom: Often described as more stimulating or energizing
- Green vein kratom: Often described as a middle-ground or “balanced” option
These claims are largely anecdotal. Effects may vary based on growing conditions, harvesting, processing, product strength, individual biology, tolerance, and other substances a person may be using. Because of this, kratom strains should not be treated like predictable medications or clinically validated treatment options.
Kratom side effects
Kratom side effects can range from mild discomfort to serious medical concerns. Short-term side effects may include nausea, constipation, dry mouth, dizziness, drowsiness, itching, appetite changes, sweating, muscle pain, rapid heart rate, or sedation at higher doses.4
With regular or long-term use, some people may experience more serious kratom risks, including physical dependence, withdrawal symptoms, liver problems, cognitive changes, mood changes, weight loss, and worsening anxiety or depression.
There are also risks related to the products themselves. Because kratom is often sold as an unregulated supplement, products may vary widely in strength and purity. The FDA has warned about kratom products contaminated with Salmonella and concerning levels of heavy metals, which can create health risks beyond the effects of kratom itself. A CDC-linked investigation also described a multistate Salmonella outbreak associated with contaminated kratom products.5
Some kratom products may also contain concentrated alkaloids or adulterants that make the effects stronger or less predictable. This is one reason people may experience a very different reaction from one product to another, even if both products are labeled as kratom.
Is kratom addictive?
Yes, kratom can be addictive. Regular or high-dose kratom use may lead to tolerance, physical dependence, withdrawal symptoms, cravings, and compulsive use despite consequences.
The addiction cycle often begins with tolerance. Over time, a person may need more kratom to feel the same effect. As the body adapts, stopping or reducing use may cause withdrawal symptoms. This can lead someone to keep using kratom not because it feels good anymore, but because they are trying to avoid feeling sick, anxious, restless, or unable to sleep.
Signs of kratom addiction may include:
- Using more kratom than intended
- Taking kratom more often over time
- Trying to cut back but being unable to stop
- Feeling intense cravings
- Using kratom to avoid withdrawal
- Spending increasing time or money obtaining kratom
- Neglecting work, school, family, or personal responsibilities
- Continuing to use despite physical, emotional, financial, or relationship problems
Kratom addiction is not a character flaw. Many people begin using kratom because they are trying to manage pain, stress, fatigue, trauma, opioid withdrawal, or another unmet need. If kratom use has become difficult to control, professional support through substance abuse treatment programs may help.
Kratom overdose: Signs and risks
Kratom overdose is possible, especially with high doses, concentrated extracts, 7-OH products, or kratom combined with other substances such as opioids, alcohol, benzodiazepines, sleep medications, or other sedatives. Reports to poison centers involving kratom have increased in recent years, and public health agencies have raised concern about high-risk patterns of use and polysubstance exposure.
Possible signs of kratom overdose or severe toxicity may include:
- Extreme drowsiness
- Loss of consciousness or unresponsiveness
- Agitation or confusion
- Rapid or irregular heart rate
- High blood pressure
- Severe nausea or vomiting
- Seizures
- Trouble breathing
- Respiratory depression
- Coma in severe cases
Anyone suspected of a kratom overdose should receive emergency medical attention immediately. Call 911 right away if someone is unresponsive, having trouble breathing, having a seizure, or showing signs of a severe reaction.
Is kratom legal in North Carolina?
Kratom is currently legal in North Carolina and is not federally scheduled as a controlled substance. However, legality can change, and kratom legislation moves quickly. The DEA has listed kratom as a “drug and chemical of concern,” and North Carolina lawmakers have considered legislation to regulate kratom products.7,8
Several states have banned kratom or specific kratom alkaloids, including Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. Local rules may also vary by municipality. Because of this, people should verify current kratom legal status before purchasing, possessing, or using kratom in any state.
Legal does not mean safe. Kratom products may still lack standardized dosing, purity testing, labeling consistency, and quality controls. This can make it difficult for consumers to know how much mitragynine, 7-OH, or other compounds are in a product.
Kratom and opioid use disorder
Some people use kratom to self-manage opioid withdrawal because they believe it is safer, more natural, or easier to access than medical treatment. That motivation often comes from a real desire to feel better or avoid returning to opioid use. However, kratom is not FDA-approved to treat opioid use disorder, and it can create dependence of its own.
Kratom and opioids are connected because kratom compounds act on opioid receptors. This is why kratom may temporarily reduce some opioid withdrawal symptoms for certain people, but it is also why regular use may lead to tolerance, withdrawal, and addiction.
Evidence-based medications for opioid use disorder include buprenorphine, methadone, and naltrexone. These medications are used as part of medically supervised care and may reduce overdose risk, improve treatment retention, and support long-term recovery when clinically appropriate.9
If you or a loved one has been using kratom for opioid withdrawal, you do not have to navigate that alone. A medically informed treatment team can help you understand safer options, including medication-assisted treatment when appropriate.
Find kratom addiction treatment support in Asheville, NC
Recognizing that kratom may be a problem takes courage. Whether you are worried about your own use or concerned about someone you love, asking questions is a meaningful first step.
Insight Recovery offers compassionate outpatient treatment for substance use disorders, including kratom dependence, at our Swannanoa/Asheville, NC location. Our clinician-founded, small-group, trauma-informed setting gives clients individualized support while helping them build practical recovery skills.
Treatment options may include:
- Partial hospitalization program (PHP)
- Intensive outpatient program (IOP)
- Standard outpatient program (OP)
- Medication-assisted treatment when clinically appropriate
- Individual therapy
- Group therapy
- Dual diagnosis support
- Relapse prevention planning
If you or a loved one needs help for kratom addiction, call 828.826.1376 to speak with Insight Recovery today.
Call 828.826.1376 if you or a loved one need help for kratom addiction.
References
- National Institute on Drug Abuse. “Kratom.” National Institute on Drug Abuse, National Institutes of Health. Accessed June 2026.
- U.S. Food and Drug Administration. “FDA and Kratom.” U.S. Food and Drug Administration. Accessed June 2026.
- U.S. Food and Drug Administration. “7-Hydroxymitragynine (7-OH): An Assessment of the Scientific Data and Toxicological Concerns Around an Emerging Opioid Threat.” U.S. Food and Drug Administration. Accessed June 2026.
- National Center for Complementary and Integrative Health. “Kratom.” National Center for Complementary and Integrative Health, National Institutes of Health. Accessed June 2026.
- Schwensohn, Colin, et al. “A Multiple-Serotype Outbreak of Salmonella Infections Linked to Kratom, United States, 2017–2018.” Foodborne Pathogens and Disease. Accessed June 2026.
- North Carolina General Assembly. “House Bill 468: Regulate Kratom Products.” 2025–2026 Session. Accessed June 2026.
- Drug Enforcement Administration, Diversion Control Division. “Kratom.” U.S. Department of Justice. Accessed June 2026.
- Substance Abuse and Mental Health Services Administration. “Medications for Substance Use Disorders.” U.S. Department of Health and Human Services. Accessed June 2026.