Kratom, or Mitragyna speciosa, a psychoactive herb native to Southeast Asia, is sold at smoke shops and gas stations across the United States. It enjoys a reputation as a safe, “natural” supplement with medical and therapeutic benefits. That reputation is misleading.
Last year, after struggling with addiction and multiple seizures induced by the drug, my cousin died from an accidental kratom overdose. His death was not an isolated case. According to a 2024 Washington Post report, from 2020 to 2022, the supposedly harmless herb contributed to or caused at least 4,100 deaths in 44 states and the District of Columbia. Because technicians rarely screen for the substance in autopsy examinations, kratom-associated fatalities may go underreported.
The herb has grown increasingly popular despite these risks. More than 1.6 million Americans use kratom annually, according to the Substance Abuse and Mental Health Administration. Survey data suggest that in the states where kratom is legal, the drug is sold in over 80 percent of smoke shops. Even in the states where kratom is illegal, some stores continue to sell it; almost half of Rhode Island’s surveyed smoke shop owners, for example, admitted to selling it despite the state’s ban. Specialty bars have even popped up across the country offering kratom-infused herbal teas.
Kratom’s effects are highly dose-dependent. In small amounts, the drug induces stimulant-like effects, making people more talkative and alert. Taken in larger doses, it generates euphoria like that associated with opioids. Kratom’s chief chemical components—mitragynine and 7-hydroxymitragynine—bind to the same brain receptors as do heroin and codeine, which explains its addictiveness. Evidence suggests that 7-hydroxymitragynine is thirteen times more potent than morphine. Some evidence suggests that even casual kratom users can develop severe dependency, acquire a tolerance over time, and, if they abruptly cease using, experience symptoms similar to those associated with opioid withdrawal. The symptoms and biological mechanisms involved in kratom and opioid withdrawal are so alike that some researchers have suggested treating them with similar protocols.
The herb hasn’t always evaded regulatory scrutiny. In August 2016, the Drug Enforcement Administration attempted to classify kratom temporarily as a Schedule I drug, the category for substances with a high potential for abuse and without accepted medical uses. The DEA’s notice of intent outlined the substance’s adverse effects, ranging from poor concentration to death, and noted that the agency had “received correspondences from public/state officials which indicate that there were a significant number of overdoses and traffic fatalities directly, or indirectly, involving kratom.”
The DEA campaign failed, however. After intense public backlash, including a petition sent to the White House with over 100,000 signatures, the agency rescinded its notice of intent two months later. The DEA today considers the herb a “drug of concern,” but it does not subject kratom products to standardized federal requirements. In the absence of federal action, only a few states have imposed their own regulations.
Kratom’s continuing legality owes in part to a well-funded and formidable lobbying network. The American Kratom Association spent nearly $400,000 through the first three quarters of 2024. AKA and other advocacy organizations frame access to the herb as a matter of “consumer rights,” arguing that adults have the right to make informed decisions about what they put in their bodies. But policymakers regularly prohibit people from putting addictive, harmful substances in their bodies, and many kratom users don’t know about the herb’s effects.
Lobbyists like the AKA’s C. McClain “Mac” Haddow downplay the herb’s dangers, blaming irresponsible consumers for kratom-associated illness and death. Other advocates maintain that the drug has legitimate therapeutic applications, ranging from mental health to helping people overcome opioid addiction. No clinical evidence supports these claims. Kratom itself carries a non-negligible risk of addiction and withdrawal and, according to some researchers, may worsen mental-health issues.
Because Kratom exists in a legal gray area, sellers can engage in deceptive marketing tactics. The Food and Drug Administration has repeatedly warned of embellished, sometimes entirely baseless claims, including that the herb can reduce cancer risk. The absence of federal regulation also means that kratom products are not required to include dosage information or display warning labels. In one egregious case, a federal judge awarded $11 million to the family of 39-year-old Krystal Talavera, who died after consuming a kratom product cryptically labeled “Space Dust,” which contained no warnings or instructions for proper use.
It’s time for policymakers to respond. Congress should devise legislation regulating the manufacture, labeling, and distribution of kratom at the federal level, requiring companies to inform consumers about the herb’s health risks and safe dosing protocols. The FDA and the DEA should temporarily classify kratom as Schedule I to permit more in-depth research into its safety profile and potential medical applications. State and local legislators should discuss measures to protect consumers and to restrict the herb’s sale.
Americans need to see kratom for what it truly is: a dangerous and addictive substance responsible for the deaths of thousands of people. Our leaders should act before more families suffer such devastating consequences.
Photo by Lauren DeCicca/Getty Images
