Understanding Kratom: Effects, Risks, and Regulations

In this post I discuss Kratom, a psychoactive herbal substance, gaining attention for its potential use in managing opioid withdrawal, pain, and anxiety. Despite its popularity, it is not FDA-approved, with growing scrutiny due to concerns over safety and increased regulation at state levels.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

What is Kratom?

Before I read the following article, I knew little about kratom, other than it is a psychoactive drug that is popular with young people. I was thinking along the lines of the substances used in vaping.

But this article made me pause and realize I needed to learn more.

According to NIDA, the National Institute on Drug Abuse, an agency of the NIH, National Institutes of Health,

“Kratom” commonly refers to an herbal substance that can produce opioid- and stimulant-like effects. Kratom and kratom-based products are currently legal and accessible in many areas of the world.

While there are no uses for kratom approved by the U.S. Food and Drug Administration, people report using kratom to manage drug withdrawal symptoms and cravings (especially related to opioid use), pain, fatigue, and mental health problems.

 NIDA supports and conducts research to evaluate potential medicinal uses for kratom and related chemical compounds.

NIDA also supports research towards better understanding the health and safety effects of kratom use. Rare but serious effects have been reported in people who use kratom, including psychiatric, cardiovascular, gastrointestinal and respiratory problems.

 Compared to deaths from other drugs, few deaths have been linked to kratom products and nearly all cases involved other drugs or contaminants.

More info from NIDA at this link

Kratom (Mitragyna speciosa) Mitragynine. Drugs and Narcotics

Kratom (Mitragyna speciosa) is a tree in the coffee family, found in Thailand and neighboring countries. Traditionally, in Southeast Asia, people have chewed its leaves or made them into a tea that is used to fight fatigue and improve work productivity

Kratom faces increasing scrutiny from states and the feds

by Amanda Hernández, Oklahoma Voice
August 11, 2025

For years, state lawmakers have taken the lead on regulating kratom — the controversial herbal supplement used for pain relief, anxiety and opioid withdrawal symptoms. Some states have banned it entirely. Others have passed laws requiring age limits, labeling, and lab testing.

At least half of the states and the District of Columbia have enacted some form of regulation on kratom or its components — building a patchwork of policies around a product largely unaddressed by the federal government.

But that may soon change. The U.S. Food and Drug Administration is pushing to ban 7-hydroxymitragynine, or 7-OH — a powerful compound found in small amounts in kratom and sometimes concentrated or synthesized in products sold online, at smoke shops, or behind gas station counters.

Federal health officials announced last month that the compound poses serious public health risks and should be classified as a Schedule I controlled substance, alongside heroin and LSD.

The move marks a significant shift in how federal regulators are approaching kratom, which they attempted to ban in 2016. It has sparked debate about how the change could impact the growing 7-OH industry and its consumers.

This year, at least seven states have considered bills to tighten kratom regulations, including proposals for bans, age restrictions, and labeling requirements.

Kratom and 7-OH differences

Kratom, which originates from the leaves of a tree native to Southeast Asia, can have a wide range of mental and bodily effects, according to federal officials, addiction medicine specialists, and kratom researchers. Reports of fatal kratom overdoses have surfaced in recent years, though kratom is often taken in combination with other substances.

Kratom and 7-OH are distinct products with separate markets, but they are closely connected. 7-OH is a semi-synthetic compound derived from kratom and only emerged on the market in late 2023, while kratom itself has been available for decades.

Leading kratom researchers say more research is needed to fully understand the long-term effects of using both substances.

“There’s much we don’t know, unfortunately, on all sides,” said Christopher R. McCurdy, a professor of medicinal chemistry at the University of Florida. McCurdy is a pharmacist and has studied kratom for more than 20 years.

Research suggests kratom may help with opioid withdrawal and doesn’t seem to cause severe withdrawal on its own. Smaller amounts seem to act as a stimulant, while larger doses may have sedative, opioidlike effects.

Very little is known about the risks of long-term use in humans, according to McCurdy.

As for 7-OH, it shows potential for treating pain, but hasn’t been studied in humans, and may carry a high risk of addiction. Researchers don’t yet understand how much is safe to take or how often it should be used, McCurdy told Stateline.

While some leading kratom experts agree that kratom and 7-OH should be regulated, they caution that placing 7-OH under a strict Schedule I classification would make it much harder to study — and argue it should instead be classified as Schedule II as are other opioids.

A federal survey from 2023 estimated that about 1.6 million Americans age 12 and older used kratom in the year before the study. The American Kratom Association, an industry lobbying group, estimated in 2021 that between 11 million and 16 million Americans safely consume kratom products each year.

Since gaining popularity in recent years, 7-OH is in a larger number of products. Some researchers and addiction medicine specialists say many consumers, especially those new to kratom, sometimes don’t understand the difference between products.

“It’s a pure opioid that’s available without a prescription, so it’s akin to having morphine or oxycodone for sale at a smoke shop or a gas station,” McCurdy said. “This is a public health crisis waiting to happen.”

Photo by Laryssa Suaid on Pexels.com

FDA targets 7-OH, not kratom

In late July, the U.S. Department of Health and Human Services recommended that the federal Drug Enforcement Administration place 7-OH in Schedule I, citing a high potential for abuse. The classification would not apply to kratom leaves or powders with naturally occurring 7-OH.

“We’re not targeting the kratom leaf or ground-up kratom,” FDA Commissioner Marty Makary said at a news conference. “We are targeting a concentrated synthetic byproduct that is an opioid.”

Makary acknowledged that there isn’t enough research or data to fully understand how widespread 7-OH’s use or impact may be. Still, he said the Trump administration wants to be “aggressive and proactive” in addressing the issue before it grows into a larger public health problem.

The Trump administration wants to be aggressive and proactive before the issue grows into a larger public health problem.

FDA head Marty Makary

While only small amounts of 7-OH occur naturally in the kratom plant, federal officials have raised concerns about U.S. products containing synthetic or concentrated forms of the compound because it’s more potent than morphine and primarily responsible for kratom’s opioidlike effects

the chemical formula for kratom products; credit NIDA

What will the DEA do with 7-OH?

The FDA’s recommendation to schedule 7-OH will now go to the DEA, which oversees the final steps of the process — including issuing a formal proposal and opening a public comment period.

If finalized, the rule could affect both companies selling enhanced kratom products and consumers in states where those products are currently legal.

The DEA backed off scheduling kratom compounds in 2016 after widespread public opposition.

Kirsten Smith, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University who is studying kratom’s effects in humans, said she was surprised by the FDA’s push to schedule 7-OH.

“We don’t really have a public health signal of a lot of adverse events for either kratom or for 7-OH at this time,” she told Stateline. “I was, frankly, always surprised that kratom was pushed toward scheduling at an earlier time point. … I don’t know that we have data to support scheduling even now.”

Pushback from advocacy groups

Still, some advocacy groups, including the Holistic Alternative Recovery Trust, argue the push to schedule 7-OH is driven more by corporate interests than public health, suggesting the kratom industry is trying to sideline competition from 7-OH products.

“We think that this is just happening because of the legacy kratom manufacturers losing market share and wanting to gin up a crisis with this,” said Jeff Smith, the national policy director for the group, who said he has used 7-OH for sleep and pain management.

While his organization supports regulation and safe consumption, members worry the federal government’s move could drive people to riskier substances or push the market underground.

“It’s made a profound difference in my life,” Smith said. “We think it would be tragic to cut it off based on such a paucity of data when there’s so much potential for this product to help people.”

Public health concerns 

Federal health officials say a key concern is the growing use of kratom and 7-OH products among teens and young adults.

Some officials and addiction medicine specialists have pointed out that these products often come in flavors and packaging designed to appeal to younger buyers, with few controls over where or how they’re sold. In some states without clear regulations, kratom and 7-OH products are available at gas stations or online, sometimes without any age verification.

“Whenever you go into a gas station and even though it’s behind the glass, it’s of eye level, and it has all of these bright colors — it has all of these things that really attract the visual of a kiddo,” said

Socorro Green, a prevention specialist with Youth180, a nonprofit focused on youth substance use prevention in Dallas.

Green added that kratom and 7-OH products may be even more accessible to young people in rural communities, where gas stations and convenience stores are often among the few available retailers.

Some researchers and experts say that certain products may not clearly or accurately disclose their 7-OH content and are sometimes marketed or mistaken for traditional kratom.

Some cities, counties and states have responded by banning kratom or raising the minimum purchase age to 18 or 21. But in many areas, enforcement remains inconsistent, and some addiction specialists say clearer federal and state guidance is needed — especially as more people are using kratom and 7-OH to manage pain, anxiety or withdrawal symptoms on their own.

“There needs to be some kind of oversight, including some way of maybe helping to ensure that people know what they’re getting,” said Terrence Walton, the executive director and chief executive officer of NAADAC, the Association for Addiction Professionals.

State regulations

At least seven states have considered or enacted legislation this year related to kratom — ranging from age restrictions and labeling requirements to outright bans.

In New York, lawmakers passed two bills: one requiring warning labels and prohibiting kratom products from being labeled as “all natural,” and another raising the minimum purchase age to 21. Neither has been sent to the governor.

In Colorado, a new measure, which was signed into law in May, prohibits kratom from being sold in forms that resemble candy or appeal to children, increases labeling requirements, limits concentrations of 7-OH, and bans the manufacture and distribution of synthetic or semi-synthetic kratom.

In Mississippi, a new law that took effect in July raised the minimum purchase age for kratom to 21. It also bans synthetic kratom extracts and products with high concentrations of 7-OH.

Lawmakers in Montana and Texas introduced similar legislation this year, but neither proposal advanced.

Louisiana is the latest state to enact a kratom ban.

Rhode Island became the first state to reverse its ban. The new law establishes a regulatory framework for the manufacturing, sale, and distribution of kratom products, set to take effect in April 2026.

As of this year, Washington, D.C., Alabama, Arkansas, Indiana, Louisiana, Vermont, and Wisconsin have banned kratom. At least half of U.S. states now regulate kratom or its components in some way.

Oklahoma Voice is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Oklahoma Voice maintains editorial independence. Contact Editor Janelle Stecklein for questions: info@oklahomavoice.com.

 

This story is republished under Creative Commons license CC BY-NC-ND 4.0.

Learn more about kratom products marketed as herbal supplements from the National Institutes of Health (NIH) National Center for Complementary and Integrative Health (NCCIH).

How will you respond to this information?

  1. Who do you need to share this information with?
  2. What more do you need to know about kratom?
  3. How do you feel generally about psychoactive drugs?
  4. What should our local governments do about kratom, if anything?

Images in this Post

The images of kratom are from the NIH website and in the public domain. The cover image was generated by AI on WordPress.

Exploring the HEART of Health

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Here is a related post for you to review

“Full Recovery” from addiction to recovery-book review

This post reviews Brian McAlister’s “Full Recovery” . It outlines a personal action plan for overcoming addiction through self-discovery and empowerment. Using personal anecdotes and principles from s successful figures, he emphasizes a moral foundation based on n a Higher Power. The book serves as a guide for transformation, encouraging positive life changes.

Donald Trump’s Healthcare Achievements 2016-2020

This post reviews healthcare during Donald Trump’s first presidential term, detailing his achievements from 2016 to 2020 and the political climate surrounding healthcare policies. It discusses the impact of the ACA, Trump’s various healthcare initiatives, and his reelection in 2024 against Kamala Harris after Biden dropped out.

updated November 26, 2024

This post looks back at healthcare under the first Trump administration from 2016 to 2020.

I originally wrote this post in 2020 during the Presidential campaign between incumbent Donald Trump, Republican, and Joe Biden, Democrat. Trump was not reelected.

In 2024 Trump again ran for President against the incumbent Biden, who unexpectedly dropped out of the race in the summer. His Vice President Kamala Harris became the Democratic candidate.

Donald Trump won reelection with 50% of the popular votes to 48.4% for Kamala Harris. The electoral count was 312 to 226. (per the Associated Press).

(The last President to serve two non-consecutive terms was Grover Cleveland in 1893. )

Healthcare 2008-2016

Due to the pandemic caused by the SARS-CoV2 virus, health has been a major topic in both world and national news this year and will continue to be so for months if not years. And health is a major issue in this year’s United States presidential election in November 2020.

Health care was a major issue in the 2008 election and proved to be momentous. In his campaign, the Democratic candidate, Barack Obama, promised health care reform and as President he delivered with the passage of the Affordable Care Act, (ACA) the first time Americans have had universal health care.

The ACA sparked heated debate in the 2016 election with the Democratic candidate pledging to build upon it and Republican candidate vowing to dismantle it . This year the debate continues.

Healthcare and the Presidential Campaign 2020

In this and another post, I review and list what I think are some of the most important points in the health care philosophy of each major party candidate, according to information on their official websites.

I am not endorsing either of the candidates, their party ,or their healthcare plans. My intent is to present a non-partisan look at what they have done and propose. If it sounds otherwise, that is unintentional.

You should also review a post about the Republican Party healthcare platform.

How to become President inforgraphic
The Presidential pathway from USA.gov

The incumbent candidate-Republican- Donald J. Trump

Donald J. Trump, owner and former president of The Trump Organization, was elected the 45th U.S. president in 2016. He was born June 14, 1946. Mr. Trump is married to Melania Trump and has 5 children.

Official portrait of President Donald J. Trump, Friday, October 6, 2017. (Official White House photo by Shealah Craighead)

President Donald J. Trump Achievements

This information was adapted from a Trump-affiliated site that is no longer active.

The Trump Administration

  • expanded access to Association Health Plans (AHPs) allowing small business to pool risk across states.
  • launched a program to provide the HIV prevention drug PrEP to uninsured patients for free.
  • issued guidance expanding options for individuals with chronic conditions. High deductible plans can now cover products such as insulin, inhalers and statins pre-deductible.
  • issued a rule allowing health care workers to refuse to provide services like abortion, sterilization or assisted suicide, if they cite a religious or conscientious objection.
  • announced the launch of a new COVID-19 Uninsured Program Portal in an effort to cover testing and treatment for uninsured individuals.

As part of the landmark Tax Cuts and Jobs Act President Trump repealed the individual mandate, which forced people to buy expensive insurance and taxed those who couldn’t afford it.

The mandate disproportionately hurt the poor: 80% of those affected made less than $50,000.

As President, Mr. Trump
  • took executive action to strengthen Medicare and reform the Medicare program to stop hospitals from overcharging seniors on their drugs.
  • pressured China to close dangerous loopholes that allowed Chinese fentanyl manufacturers to legally ship the compound worldwide, much of which ended up in the U.S.
  • created a bipartisan opioid commission that issued 56 recommendations to help defeat the opioid crisis.
  • invoked the Defense Production Act, giving power to allocate health care supplies and increase production of necessary products to counter COVID-19. 
  • worked with Congress to stop surprise medical billing.
As President, Mr. Trump signed
  • the bipartisan Tobacco-Free Youth Act to raise the nationwide age for purchasing tobacco and vaping products to 21 years old.
  • the Families First Coronavirus Response Act, expanding the SNAP and WIC programs by adding $500 million, helping pregnant women and those who lost their jobs due to COVID-19.
  • an executive order to modernize flu vaccines and help protect more Americans by promoting new technologies to improve vaccine manufacturing and effectiveness.
  • a bill to extend Veterans Choice Health Care Law.
  • an executive order that increased price and quality transparency in American health care.
Oval Office replica
replica of the Oval Office at the Reagan Presidential Library, photo by Dr. Aletha

Exploring the HEART of healthcare election politics

I’d love for you to follow this blog. I share information and inspiration to help you turn health challenges into health opportunities.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

a group of lapel buttons, red, white and blue, saying VOTE

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Dr. Aletha