What does kratom do? A Comprehensive Look at its Effects and Risks

October 5, 2025 •

3 min read

Originating from the leaves of the Southeast Asian Mitragyna speciosa tree, kratom has gained popularity for its dual stimulant and opioid-like effects. But what does kratom do to the human body, and what are the significant health risks involved?

Quick Summary

Kratom's psychoactive alkaloids trigger dose-dependent stimulant and opioid-like effects by acting on opioid receptors and other neurotransmitter systems, posing risks of addiction and serious side effects.

Key Points

Dose-dependent effects: At low doses, kratom acts as a stimulant, increasing energy and alertness; at high doses, it produces opioid-like effects such as sedation and pain relief.
Alkaloid action on receptors: The main alkaloids, mitragynine and 7-hydroxymitragynine, interact with the brain's mu-opioid receptors, along with adrenergic and serotonergic systems.
Risk of addiction and dependence: Regular kratom use can lead to physical and psychological dependence, with withdrawal symptoms similar to those of opioids.
Potential for organ damage: Chronic kratom use has been associated with significant side effects, including liver toxicity, psychosis, and seizures.
Dangerous drug interactions: Kratom can inhibit critical enzymes (CYP450), leading to potentially dangerous interactions with other medications.
Unpredictable and unregulated: Due to a lack of FDA approval and regulatory oversight, kratom product potency is inconsistent, and contamination with harmful substances is a risk.

Kratom is a botanical substance derived from the leaves of a tropical evergreen tree native to Southeast Asia. Historically, it has been used in traditional medicine for its analgesic and stimulant properties. However, the substance has become popular in Western countries, where it is often sold as a powder, in capsules, or as a tea. Concerns about its safety and potential for abuse have been raised by government agencies like the U.S. Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA).

The Dual Effects: Stimulant and Opioid-Like

One of kratom's notable characteristics is its dose-dependent effect, resulting in different sensations based on the quantity consumed. At low doses (1-5 grams), effects can include increased energy, alertness, sociability, and rapid heart rate. At high doses (5-15 grams), effects tend towards sedation, euphoria, analgesia, and possible confusion.

Pharmacological Mechanism: How Kratom Works

Kratom's effects are driven primarily by two indole alkaloids, mitragynine and 7-hydroxymitragynine, which interact with various receptors. They bind to mu-opioid receptors, similar to traditional opioids. They also affect adrenergic and serotonergic receptors, impacting energy, mood, and pain.

Addiction, Dependence, and Withdrawal

Kratom use carries a risk of dependence and addiction, leading the DEA to label it a "drug of concern". Chronic users may develop a substance use disorder and tolerance. Stopping kratom after developing physical dependence can result in withdrawal symptoms resembling those of opioid withdrawal. These symptoms can include anxiety, depression, muscle aches, insomnia, nausea, runny nose, and drug cravings.

Short-Term and Long-Term Side Effects

Using kratom is associated with several health risks. Short-term adverse effects can include nausea, vomiting, constipation, dry mouth, itching, sweating, dizziness, drowsiness, and loss of appetite. Long-term adverse effects may include weight loss, insomnia, liver toxicity, skin darkening, psychosis, tremors, and seizures. Severe liver toxicity and psychosis are serious concerns.

Potential for Drug Interactions

Kratom can interact dangerously with other drugs, especially CNS depressants like alcohol, opioids, and benzodiazepines. Kratom alkaloids inhibit cytochrome P450 (CYP) enzymes, which are crucial for metabolizing many medications. This interference can alter the levels of other drugs in the body, potentially leading to toxic or lethal outcomes.

Comparison: Kratom vs. Traditional Opioids


Feature	Kratom (Whole-Leaf)	Traditional Opioids (e.g., Morphine)
Mechanism of Action	Partial agonist at mu-opioid receptors; also acts on adrenergic, serotonergic, and dopaminergic systems.	Full agonist at mu-opioid receptors; primarily targets opioid system.
Potency at Mu-Opioid Receptor	Mitragynine is less potent than morphine; its metabolite, 7-hydroxymitragynine, is significantly more potent.	High potency.
Addiction Potential	Possesses potential for physical and psychological dependence; chronic use can lead to addiction.	High potential for addiction and dependence.
Respiratory Depression Risk	Possibly lower risk due to "biased agonism," but still a serious concern, especially at high doses or when mixed with other drugs.	High risk, a major cause of fatal overdose.
Regulatory Status (U.S.)	Unregulated by the FDA; legal in most areas, but with local restrictions.	Heavily regulated Schedule II substances.
Availability	Widely available online and in retail stores.	Requires a prescription.

Conclusion: The Unregulated Reality

What kratom does to the body involves complex, dose-dependent pharmacological interactions that are not fully understood. Claims of benefits for pain or withdrawal lack sufficient clinical evidence, and the product remains unregulated. Significant risks exist, including addiction, dangerous drug interactions, and potential toxicity to organs like the liver. Due to the unpredictable nature of unregulated products, including varying potencies and potential contamination, consulting a healthcare provider is essential for anyone considering or using kratom to understand the health concerns involved. You can find more information about the potential dangers of unregulated substances from reputable health organizations.

Link to FDA resource on Kratom

Frequently Asked Questions

Kratom is not an opioid in the traditional sense, but its main psychoactive compounds, mitragynine and 7-hydroxymitragynine, bind to and activate the brain's opioid receptors, producing opioid-like effects. This makes it functionally similar to opioids in many ways.

Yes, chronic or long-term kratom use can lead to physical and psychological dependence. Users who stop taking it may experience withdrawal symptoms, reinforcing its potential for addiction.

Withdrawal symptoms can resemble those of opioid withdrawal and include anxiety, depression, muscle aches, insomnia, nausea, irritability, cravings, and runny nose.

Yes. While milder side effects include nausea and constipation, more severe health problems have been reported, such as liver toxicity, seizures, psychosis, and in rare cases, death, especially when combined with other substances.

In the United States, kratom's legal status varies by jurisdiction. It is not federally regulated or approved by the FDA, and while it is legal in many areas, some states and cities have banned or restricted its sale.

Overdose on kratom alone is considered rare, but it is possible. The risk of a fatal overdose increases significantly when kratom is combined with other drugs, particularly CNS depressants like opioids, alcohol, or benzodiazepines.

Standard drug screenings do not typically test for kratom or its alkaloids. Specialized testing is required to detect kratom in urine or blood, which is not routinely performed.