Kratom is a tropical tree native to Southeast Asia, with leaves that contain compounds known to have psychoactive effects, often used for pain relief, mood enhancement, and as an alternative to opioids. While some users report benefits such as reduced pain and improved energy, concerns about its safety, potential for addiction, and lack of regulation have led to ongoing debates regarding its legality and use in various countries, including the United States.

• Can improve:
  • pain relief [ b | c ]
• Can prevent:
• Reduces:
• Increases:
• Side-effects:
  • agitation [ a | d ]
  • confusion [ a | d ]
  • constipation [ c ]
  • drowsiness [ a | c | d ]
  • nausea/vomiting [ c | d ]
  • stomach irritability [ c ]
  • tachycardia [ a | d ]
• Safety profile (D):
  • Safe [ c ]
  • Negative:
    • a range of toxicities and adverse events associated with kratom use, including hepatotoxicity, seizure and coma, lung injury, kidney injury, and cardiotoxicity [ a ]
    • liver, neurologic, pulmonary, renal, and cardiac injury [ a | b ]
    • Pregnant patients who use kratom have an additional risk of their newborns developing neonatal abstinence syndrome [ a ]
    • Long-term cognitive impairment has also been seen in those with chronic kratom use [ a ]
    • kratom toxicity has been linked to death [ a | b ]
    • Mitragynine, a substrate of kratom, appears to inhibit glucuronidation by UDP-glucuronosyltransferases (UGT). This interaction is important as possible co-ingestions with other drugs with known UGT substrates, like buprenorphine or ketamine, can contribute to toxicities and lead to fatal supratherapeutic levels of drugs and their substrates. [ a | b ]
    • seizure [ d ]
    • respiratory depression [ d ]
    • respiratory arrest [ d ]
    • coma [ d ]
    • cardiac arrest [ d ]