Gary Malone, MD, is the Medical Director at 

Gary Malone, MD

Kratom, a plant native to Southeast Asia, has a long history of use in traditional medicine. However, its recent surge in popularity in the US raises serious concerns. Marketed as a safe and natural alternative to opioids or a treatment for various health problems, kratom's legal status and natural origins can create a dangerous false sense of security. Kratom may be legal, but it's not without serious risks, and people need to be warned about the dangers.

Kratom's widespread availability—online, in convenience stores, and even alongside CBD products—fuels the misconception that it is harmless. Its marketing as a natural remedy for various ailments, including pain, depression, anxiety, sleep issues, and opioid withdrawal, can cause misplaced confidence in kratom's efficacy and safety, leading many to believe that “natural” means safe. Consider this: arsenic, strychnine, and cobra venom are naturally occurring, yet they are each undeniably deadly.

Similarly, we should not underestimate kratom's potential for harm. Since it's unregulated by the FDA, doses may be inconsistent—even within the same bottle—increasing the risk of accidental overdose. Additionally, there's no guarantee that what’s being sold is pure kratom and does not contain harmful additives.

 While low doses may produce a mild stimulant effect, higher doses can lead to severe health outcomes. I’ve seen patients who used kratom suffer severe symptoms, such as seizures, arrhythmias, and psychosis.

To fully understand kratom’s risks, it helps to look back in time to consider that we are often wrong about what we consider safe. For example, up until the 1900s in the US, alcohol and laudanum were the primary treatments for pain, sleep problems, and anxiety. Of course, now we know the risks inherent in these “treatments,” and we do things differently. In the future, we’ll likely look back on the unregulated use of kratom similarly and wonder why we allowed it.

Kratom may appear relatively benign in low doses, but many people significantly escalate their doses over time. In my clinical practice, I've observed that people tend to take kratom until they feel the "click" in their head, pushing their doses higher and higher. And the higher the dose, the higher the risks.

Overdose isn’t the only concern. While high doses of kratom can produce dangerous effects, including irregular heart rhythms, hypertension, and liver toxicity, another cause for alarm is kratom’s addictive potential. Kratom tends to be advertised as a supplement or natural withdrawal remedy, and, in turn, many people use it with little to no understanding of its addictive potential.

The use of more kratom over time can quickly lead to dependence and 

. This is particularly concerning for those attempting to use kratom as a supposed "shortcut" to quit heroin, fentanyl, or other opioids, a strategy that doesn’t work in the long run.

People in recovery often try to bargain with themselves. They think, "I'll just use something less dangerous," convincing themselves that kratom is a "safer" option. This is a dangerous misconception. Kratom itself is highly addictive, and the brain doesn't distinguish between substances in the way we might imagine. Addiction is a serious, progressive illness, and any addictive substance, such as kratom, used regularly can lead a person to relapse back to their drug of choice.

The allure of substances like alcohol, marijuana, and kratom often rests in their ability to make us feel good, but it's a perilous illusion. While alcohol may initially make you feel good, that feeling is masking the damage being inflicted on your brain and liver.

Similarly, kratom, despite claims of its benefits, offers no real long-term advantages. These substances deceive us into believing that we're okay when, in reality, we're steadily compromising our health, damaging the brain and other vital organs, and only getting temporary relief from issues that require long-term solutions.

Kratom's deceptive allure and widespread availability underscore the urgent need for stricter regulations and heightened public awareness. While it may seem like a quick fix, the potential ramifications of kratom use are far-reaching and severe. We must make the risks of kratom clear and ensure that those struggling with substance use disorders get the evidence-based and proven help they deserve.

Kratom. National Institute on Drug Abuse. 

https://nida.nih.gov/research-topics/kratom#safe

Kratom Neurotoxicity. American Journal of Neuroradiology. 

https://www.ajnr.org/ajnr-case-collections-diagnosis/kratom-neurotoxicity#:~:text=Kratom%20stimulates%20%C2%B5%20opioid%20receptors,seizures%2C%20hepatotoxicity%2C%20and%20rhabdomyolysis

Articles

Kratom, a plant from Southeast Asia, is gaining popularity in the US as a natural remedy, but it poses significant health risks. Despite its legal status, kratom is unregulated, leading to inconsistent dosages and potential contamination. High doses can cause severe health issues, including seizures and psychosis, and kratom's addictive potential is concerning, especially for those using it to quit opioids. The misconception of kratom as a safe alternative underscores the need for stricter regulations and increased public awareness to prevent misuse and addiction.

Kratom poses serious addiction risks despite its natural appeal, misleading many into believing it's a safe alternative for pain and withdrawal relief.