With over 16 million users and a booming $2 billion market, kratom is emerging as both a popular remedy and a regulatory flashpoint in America’s opioid crisis.
At a Glance
- Kratom use in the U.S. now exceeds 16 million individuals annually
- The market for kratom-related products has surpassed $2 billion
- FDA warns of serious health risks including liver damage and addiction
- Experts highlight misuse for non-specific ailments like anxiety and fatigue
- Johns Hopkins researchers call for better screening and individualized treatment
Natural Remedy or Legal Morphine?
Kratom, a botanical derived from Mitragyna speciosa, is being hailed by some as a natural tool for easing opioid withdrawal—but it’s also sparking alarm among health professionals. Used for its ability to activate opioid receptors, kratom contains psychoactive compounds including 7-hydroxymitragynine (7-OH), a powerful metabolite associated with seizures, liver toxicity, and addiction.
Despite being unregulated at the federal level, kratom products are flooding the U.S. market. While users often self-medicate for pain, anxiety, or withdrawal, the FDA has taken a hard stance. “There are no FDA-approved kratom drug products,” the agency reiterated, warning that consumers face serious adverse events from unsupervised use.
Watch a report: 7-Hydroxymitragynine (7-OH) is NOT Kratom.
Dr. Petros Levounis, president of the American Psychiatric Association, noted, “People feel that it may be a good treatment for opioid use disorder which is only partially true and not all that evidence-based.” He also warned that Americans are turning to kratom for vague discomforts: “They just take a little bit of kratom and feel better… but at what cost?”
Experts Call for Caution—and Research
Medical institutions like Johns Hopkins are pushing to bring science to the forefront. A team led by researcher Kirsten Smith has proposed an algorithm to help clinicians identify Kratom Use Disorder (KUD). Their studies aim to fill gaps in how kratom interacts with other treatments and how withdrawal symptoms manifest.
“There is little specific information on whether patients with comorbid KUD/OUD benefit from behavioral therapies like contingency management,” Smith’s team concluded. The researchers emphasize the need for individualized care, especially as no FDA-approved treatments for kratom addiction currently exist.
Even detecting kratom use can be tricky—“Kratom,” Smith explained, “cannot be tested for as a whole botanical.” This complicates clinical oversight and underlines the urgent need for diagnostic tools and treatment standards.
A Market Outpacing Regulation
The regulatory vacuum has allowed kratom to thrive, with products available in smoke shops, gas stations, and online vendors across much of the country. Yet, some states have moved to restrict or ban its sale. As the substance continues to gain popularity, experts fear a new wave of dependence may be building beneath the radar.
The kratom debate is far from over. Proponents argue it offers an alternative to opioids; opponents warn it’s an underregulated addictive substance masquerading as a wellness trend. With usage skyrocketing, the clock is ticking for public health officials to catch up.
