Yes, Kratom can be addictive. The U.S. Food and Drug Administration (FDA) has expressed concerns about Kratom use due to its impact on opioid brain receptors, similar to morphine. Kratom contains properties that can expose users to the risks of addiction. Regular use of Kratom has been known to lead to dependence and addiction in some individuals, and withdrawal symptoms may occur when usage is discontinued. These symptoms can include muscle pain, insomnia, irritability, nervousness, mood swings, aggression, fever, diarrhea, and unsteady movements.

How long does Kratom stay in your system?

The detection of kratom in a person’s system can be complex because it is not typically included in standard drug panels. However, specialized tests, such as a 10-panel drug test for kratom and its metabolites, can detect its presence in urine for up to seven days. Several variables can affect the length of time kratom is detectable in the system. These include body weight, as mitragynine (the active compound in kratom) is fat-soluble and tends to stay longer in the systems of individuals with more body fat. The dosage of kratom used, age (as older individuals metabolize drugs more slowly), and the combination of other drugs, especially alcohol, can also impact the elimination rate of kratom from the body. Additionally, a person’s health, individual metabolism, and certain medical conditions can influence the duration of kratom in the system.

Kratom is currently legal in the United States, but it is important to note that its legality varies across different countries and states. In the United States, some states have implemented the Kratom Consumer Protection Act (KCPA) to regulate its sale and use, while others have taken steps towards a legal but regulated approach. However, Kratom is illegal in Thailand, Australia, Malaysia, and several European Union countries. Additionally, certain states in the U.S. have enacted the Controlled Substances Act (CSA) to protect consumers against unregulated products, which may include synthetic Kratom or other dangerous substances.

While Kratom has risks associated with its use, including the potential for dependence and addiction, it is also important to be aware of other safety concerns. The FDA has identified that certain Kratom products may contain dangerous levels of metals. According to the Centers for Disease Control and Prevention (CDC), Kratom has been linked to 91 deaths out of over 27,000 overdose deaths in 27 states between July 2016 and December 2017. The National Institute on Drug Abuse (NIDA) attributes many of these deaths to dangerous interactions with other substances, including opioids. Moreover, as the active ingredient in Kratom can vary widely by plant, the effects can be unpredictable, leading to an increased risk of overdose and serious side effects such as seizures, hallucinations, chills, vomiting, liver damage, or even death. The FDA has also taken measures to address the sale of Kratom as a treatment for opioid addiction and other conditions, warning the public about potential contamination with harmful bacteria or other dangerous substances.

What Is Kratom? Uses, Effects, Risks & Treatment Options

Kratom (Mitragyna speciosa) is a tropical plant native to Southeast Asia.¹ Its leaves contain compounds that act on the brain’s opioid receptors, and people have used it for centuries in traditional and ceremonial settings.¹ Today, kratom is widely sold online and in stores in the United States—available as dried leaf, powder, capsules, tablets, liquid extracts, and resin.¹

The FDA has not approved kratom for any medical use, and kratom is not lawfully marketed in the U.S. as a drug product, dietary supplement, or food additive.²

Some people use kratom for pain, low energy, or to manage opioid withdrawal on their own. But there isn’t enough clinical research yet to know what the long-term effects of kratom are.²

Eleanor Health can assess and manage most kratom withdrawal through outpatient care, including medication when appropriate, therapy, and care coordination. You don’t need to determine what level of care you need on your own.

If a higher level of care is needed, our team can help you get connected and remain part of your care team after discharge for continuity of care. Dependence is a treatable medical condition, not a moral failing or a sign of weakness.

Reach out to Eleanor Health for an assessment. That’s the first step, whatever level of care you ultimately need.

How Kratom Affects the Body

Kratom’s two main compounds, mitragynine, and 7-hydroxymitragynine (7-OH), interact with opioid receptors in the brain (mu-opioid receptors), the same receptors as opioid drugs such as codeine.^1,3 Beyond opioid receptors, mitragynine also interacts with brain signaling systems involving serotonin, dopamine, and norepinephrine, although researchers are still studying the significance of those interactions.³

However, the effects of kratom are dose-dependent:

Lower doses tend to produce stimulant-like effects, including increased alertness, sociability, and energy.¹
Higher doses tend to produce sedative-like effects, including calmness and dulled sensation.¹

Kratom ingested even in low doses can cause serious side effects like hallucinations and lack of appetite.¹ It is also known to have potentially deadly interactions when consumed along with other drugs, medications, or alcohol.²

Side Effects of Kratom

Reported side effects of kratom use include constipation, nausea, decreased appetite, weight loss, insomnia, muscle tremors, sweating, dry mouth, and dizziness.¹

Because kratom products aren’t standardized or regulated the way prescription medications are, the amount of active compound in a given product can vary widely, which can make effects less predictable.²

Mixing Kratom and Alcohol

Combining alcohol with kratom may increase the risk of serious side effects because both substances can affect the central nervous system in different ways. Alcohol is a depressant that slows down the central nervous system, while kratom can act as a stimulant or a sedative depending on dose. Combining any depressant with a stimulant or sedative raises the risk of a harmful reaction.²

Signs of a possible overdose or severe reaction include slow or shallow breathing, irregular heartbeat, nausea and vomiting, confusion or agitation, pale or clammy skin, loss of consciousness, and seizures. If you or someone you’re with shows these signs, call 911 right away.

A CDC analysis of overdose deaths found kratom detected on toxicology in 152 decedents and listed as a cause of death in 91, across 27 states. Nearly all of those decedents also had other substances present.⁵

If You’re Thinking About Stopping Kratom

Stopping any substance you’ve been using regularly can come with real physical and emotional symptoms, and it’s not something you have to figure out alone.

Eleanor Health does not provide medically supervised detox. If you think you may need medical support to stop kratom safely, the SAMHSA National Helpline can help you find a detox provider: 1-800-662-4357 (free, confidential, available 24/7).⁶

Once you’ve been medically stabilized, Eleanor Health offers ongoing outpatient care for substance use disorders, including therapy and care coordination. Dependence is a treatable medical condition, not a moral failing or a sign of weakness.

When Should You Seek Help?

If kratom is affecting your health, work, relationships, or you’re finding it difficult to cut back on your own, it may be time to talk with a healthcare professional. If you’re concerned about your own kratom use, or a loved one’s, contact us today and Eleanor Health’s care team can talk with you about your options. Treatment may include medication for addiction treatment, therapy, peer support, and ongoing care based on your individual needs.

We provide outpatient care for adults with opioid, alcohol, and other substance use disorders across our current states of operation.

Quick Takeaways

• Kratom is a plant-derived substance that can produce stimulant or opioid-like effects depending on dose.

• Although marketed as a natural product, kratom can cause dependence, withdrawal symptoms, and serious health risks.

• Concentrated products containing 7-hydroxymitragynine (7-OH) are significantly more potent than traditional kratom products.

• If you’re struggling to stop using kratom, effective treatment and support are available.

Kratom FAQs

Is kratom addictive?

Yes, regular kratom use can lead to dependence, meaning the body adapts to the substance and a person may experience withdrawal symptoms if they stop or cut back.^1,2

If you’re experiencing kratom withdrawal or dependence, our Kratom Withdrawal guide covers what withdrawal can look like and how long it may last.

Is kratom safe?

Kratom carries real risks, including the potential for dependence, unpredictable effects due to unregulated dosing, and, in some products, contamination with heavy metals or bacteria such as Salmonella.^9,10

Researchers don’t fully agree on how kratom’s risk profile compares to other opioids. FDA warns that kratom’s compounds may produce classic opioid-related effects, including respiratory depression that can lead to death, while NIDA notes that some researchers have observed that the way kratom compounds activate opioid receptors may reduce the potential for addiction relative to traditional opioids.^1,2

How is 7-OH different from kratom?

7-OH (7-hydroxymitragynine) is one of the compounds naturally found in kratom — read our full guide to what 7-OH is for how it’s different from kratom itself and why it’s drawing regulatory attention.

Is kratom legal?

Regulatory information reviewed July 28, 2026.

Botanical kratom is not currently a federally scheduled controlled substance. Some states regulate its sale under a Kratom Consumer Protection Act (KCPA) framework.⁷ Other states have banned kratom products outright, and the details change often.

Because state rules on kratom, and especially on concentrated 7-OH, change frequently, check Eleanor’s states page for where we currently operate, and check your own state’s current law directly.

In addition to varying state laws, federal agencies are actively evaluating concentrated 7-OH products because they present different safety concerns than traditional kratom products.⁸

Sources

National Institute on Drug Abuse. Kratom. Updated March 11, 2026. Accessed July 28, 2026. https://nida.nih.gov/research-topics/kratom
US Food and Drug Administration. FDA and kratom. Accessed July 28, 2026. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: a preliminary discussion of a promising medicinal plant and analysis of its potential for abuse. Neuropharmacology. 2018;134(Pt A):108-120. doi:10.1016/j.neuropharm.2017.08.026
Olsen EO, O’Donnell J, Mattson CL, Schier JG, Wilson N. Notes from the field: unintentional drug overdose deaths with kratom detected—27 states, July 2016-December 2017. MMWR Morb Mortal Wkly Rep. 2019;68(14):326-327. doi:10.15585/mmwr.mm6814a2
Substance Abuse and Mental Health Services Administration. SAMHSA National Helpline. Accessed July 28, 2026. https://www.samhsa.gov/find-help/helplines/national-helpline
US Food and Drug Administration. Hiding in Plain Sight: 7-OH Products. Updated July 13, 2026. Accessed July 28, 2026. https://www.fda.gov/news-events/public-health-focus/hiding-plain-sight-7-oh-products
Congressional Research Service. Temporary Control of 7-Hydroxymitragynine (7-OH) and Related Substances Under the Controlled Substances Act. LSB11457. 2026. Accessed July 28, 2026. https://www.congress.gov/crs-product/LSB11457
Drug Enforcement Administration. Schedules of Controlled Substances: Temporary Placement of 7-Hydroxymitragynine Above a Specified Threshold in Schedule I; Notice of Intent. Federal Register. Published July 6, 2026. Document No. 2026-13580. Accessed July 28, 2026. https://www.federalregister.gov/documents/2026/07/06/2026-13580/schedules-of-controlled-substance-temporary-placement-of-7-hydroxymitragynine-above-a-specified
US Food and Drug Administration. Laboratory Analysis of Kratom Products for Heavy Metals. Published April 3, 2019. Accessed July 28, 2026. https://www.fda.gov/news-events/public-health-focus/laboratory-analysis-kratom-products-heavy-metals
Centers for Disease Control and Prevention. Advice to Consumers: Multistate Outbreak of Salmonella Infections Linked to Kratom. Updated May 24, 2018. Accessed July 28, 2026. https://archive.cdc.gov/www_cdc_gov/salmonella/kratom-02-18/advice.html

All About Kratom