By: Gary Kirkilas II, DO, FAAP & Christopher Buresh, MD, MPH, DTM&H, FAAP, FACEP
You may have seen Kratom products at gas stations, vape shops or online. Marketed as "natural" and often sold in appealing forms like powders, capsules and gummies, Kratom is gaining popularity in the U.S. among teens. But while it comes from a plant, that doesn't make it safe. Here's what you need to know to keep your family safe.
What is kratom?
Kratom comes from the leaves of the
Mitragyna speciosa tree,
native to Southeast Asia. Historically, kratom has been used in traditional medicines by brewing it in teas or chewing the leaves. Recently, though, kratom has grown into a large-scale industry in the United States. It is now mass produced in a variety of forms.
Kratom is most commonly sold as powdered leaf-filled capsules, or as a powder that is mixed into a drink. Newer kratom products are now being sold as candy gummies in a variety of flavors. Kratom is sometimes also called biak or biak-biak, herbal speedball, kakuam, ketum, thang or thom.
Is kratom legal, and where do kids get it?
Kratom is often sold in gas stations and smoke and vape shops. Many states have taken steps to make kratom illegal, but restricting its sale has proven difficult.
Even in states where kratom is illegal, minors may still find it being sold in gas stations and smoke and vape shops. Teens may also purchase Kratom online, since there are few age restrictions to viewing and purchasing these products.
If Kratom is dangerous, why is it so easily available in some places?
The U.S. Food and Drug Administration (FDA) is
concerned about kratom and continues to investigate it's health effects. The FDA has banned its import into the United States but did not have enough evidence to officially classify it as a controlled substance. So, it can still be manufactured and sold in the U.S.
How does kratom make you feel and what does it do to your body?
At low doses, Kratom can make you feel like you have more energy and make you more alert, like a stimulant. It can cause a temporary feeling of happiness or euphoria. But it can also make your blood pressure very high and cause a dry mouth.
At higher doses, kratom reduces anxiety and causes sleepiness, the way strong pain drugs like opioids (heroin or fentanyl) do. In fact, like opioids, it can cause people to stop breathing at high doses. It also can cause liver damage, hallucinations and convulsions or seizures. Kratom has caused or contributed to dozens of
deaths in the U.S. in the past decade.
If it is "natural" does that mean it is safe?
Natural does not always mean safe. Many naturally occurring substances, like lead or cyanide, can be toxic if consumed even in small amounts. Kratom is no different. It binds to the very same brain receptors that opioids including heroin or fentanyl do, so it can have similar, dangerous effects.
Kratom also can be addictive. People who use it regularly for a while and then quit have withdrawal symptoms, like those seen with opioids.
Kratom has more than 50 biologically active compounds in it. Some change the way that your body handles other medications. That means kratom can interact with prescription drugs and cause serious problems.
Can you get addicted to kratom?
Yes, Kratom can lead to addiction (substance use disorder), but science does not yet show how much or how long it takes for this to happen. People who become addicted to Kratom might start to feel sick if they suddenly stop taking it.
Some signs of withdrawal from kratom might include:
hot and cold flashes
nausea
vomiting or diarrhea
muscles and joints aches
feeling restless
runny nose
yawning a lot
Is there a safe way to use kratom?
No, there is no safe way to use kratom. Here's why:
Kratom products are not regulated, so you can't know how strong or pure they are.
Some kratom has been contaminated with harmful bacteria like
Salmonella, which can cause serious illness.
The FDA says kratom cannot be legally sold as a medicine, dietary supplement or food additive in the U.S.
Because of these risks, kratom use is never considered safe.
What should I do if I suspect my child is using Kratom?
If you suspect your child is using kratom it is best to choose a time when you can have a calm discussion with them. Focus on their safety and explain that kratom can cause very serious health problems.
Partnering with a pediatrician or therapist that specializes in substance use is great next step. A pediatrician or a therapist who understands substance use can guide you and your child toward safe treatment and support.
What should I do if I or someone I love may be addicted to kratom?
Addiction is a treatable illness. Medications and counseling can help people recover.
How to get started:
Call 988 to get local mental health and substance use resources. You can also search for treatment programs on FindTreatment.gov.
Talk to your pediatrician. They can refer you to a substance use counselor or other specialists for support if needed.
More resources
About Dr. Kirkilas
 Gary Kirkilas, DO, FAAP, is a general pediatrician at Phoenix Children's Hospital with a unique practice. His office is a 40-foot mobile medical unit that travels to various homeless shelters in Phoenix providing free medical care to families. He and his wife have four wonderful (most of the time) children and four cats.
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About Dr. Buresh
 Chris Buresh MD, MPH, DTM&H, FAAP, FACEP, is a general pediatrician and emergency medicine doctor working in the emergency rooms at the University of Washington and Seattle Children’s Hospital. He has been involved in education and drug user health for many years. He and his wife have four incredible kids and two big goofy dogs.
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