Kratom Safety

Kratom and the law

Federally, kratom is not scheduled for botanical use but is also not FDA-approved as a drug, supplement, or food additive. At the state level, some states ban it and others regulate it under consumer-protection laws with a 21+ age floor.

Availability depends on where you live, and local city or county rules can be stricter than the state. See our state-by-state legality guide before ordering.

Dependence and withdrawal

Regular use can lead to tolerance and dependence, and stopping can produce withdrawal symptoms. Kratom is not intended for daily or long-term use.

If you are increasing your serving to get the same effect, that is a sign of tolerance — not a reason to use more.

Interactions to avoid

Do not combine kratom with alcohol, sedatives or benzodiazepines, opioids, cocaine, yohimbine, or MAOIs. These combinations raise the risk of serious outcomes.

People taking prescription medication should speak with a healthcare professional before using kratom.

Reported risks

The FDA has warned consumers not to use kratom, citing liver toxicity, seizures, substance use disorder, rare deaths (usually with other substances), and neonatal abstinence syndrome. Kratom products have also been recalled for Salmonella and heavy metals.

Kratom is not approved to diagnose, treat, cure, or prevent any disease.

Harm reduction basics

Start low, keep the product and serving consistent so you can judge it, and do not escalate quickly. Avoid combining kratom with other substances, especially alcohol, sedatives, and opioids.

If you use regularly and want to stop, taper gradually rather than stopping abruptly, and speak to a healthcare professional if you have been a heavy daily user.

Recognising a problem

Warning signs of dependence include needing more for the same effect, using more than intended, and continuing despite negative consequences. Withdrawal on stopping — restlessness, low mood, body aches — can also occur.

If any of that sounds familiar, tapering gradually and talking to a clinician is safer than quitting abruptly or escalating. Kratom is not intended for daily, long-term use.

Talking to a doctor

Tell your clinician about any kratom use, especially before surgery or if you are prescribed other medications. Kratom can interact with a range of drugs and may not be on a standard screening panel.

If you are using kratom to self-manage a condition, that is a conversation worth having with a professional rather than something to rely on a botanical for.

Who should avoid it

Anyone under 21, and anyone who is pregnant or nursing, should avoid kratom. Those with heart, liver, or blood-pressure conditions should consult a physician first.

Sources & further reading

References used across this site:

• U.S. FDA — FDA and Kratom
• Mitragyna speciosa — botanical overview
• American Kratom Association