Kratom is being advertised on convenience store windows, smoke shop signs, and gas station shelves across the U.S. What, exactly, has crept up on us in the past few decades — are opioids being sold at convenience stores? Is this a new wonder drug that makes us happy, pain-free, and full of energy? What is kratom, and where does it come from?
Kratom is a plant called Mitragyna speciosa that originated in Southeast Asia. It is a tree with flat green leaves and small, white blossoms and is part of the coffee family. The tree’s leaves have been used for centuries in Southeast Asia, mainly by chewing on them or using them to prepare tea. Kratom use has recently been expanding to spread around the globe; however, this comes with a diversification of the forms of kratom that are used. Things like liquid extracts from kratom leaves, kratom leaf powder, and isolates have been turned into edibles, capsules, tea bags, and gummy candies. Kratom has now been available in the U.S. for at least two decades.
Traditionally, kratom leaves are chewed by farm laborers in Southeast Asia to relieve muscle pain and boost energy. Kratom contains many different alkaloids (naturally occurring bases that contain nitrogen), but the primary compounds responsible for its effects on the human body are mitragynine and corynantheidine. These have been shown to have analgesic effects (reducing pain), with mitragynine acting as a weak partial opioid, in addition to showing antipsychotic and antidepressant effects.
Consequently, one of the main positive effects kratom can have is that the alkaloids it contains act to reduce pain and opioid withdrawal symptoms. Current evidence indicates “therapeutic potential” as a drug for reducing use of morphine, heroin, or other addictive substances, and there was a self-report study published in 2024 in which many participants already reported using kratom as a replacement for opioids or for relief from withdrawal symptoms. At this moment, though, there is not enough research to support or reject this use of kratom; controlled clinical trials have not been done to evaluate how safe and how effective kratom actually is in treating substance use disorders. There is also the potential for dependence on mitragynine. There have been mild to moderate withdrawal symptoms in case reports on kratom by the Subjective Opioid Withdrawal scale (SOWs), but there is no officially defined kratom use disorder. The long-term effect of kratom use on organs has also not been studied much, although some laboratory studies have shown that mitragynine puts people with pre-existing heart conditions at cardiovascular risk.
The main issue is that most experiments done so far have been pre-clinical, not on humans. Furthermore, many experiments have tested just one or two specific compounds found in kratom, not all 40-plus alkaloids acting together.
Kratom is not an opioid. However, it can have opioid-like effects on the body. The question is how strong these effects are, and whether their benefits can outweigh costs in some cases. The problem is that we don’t really know yet. Meanwhile, kratom has been commercialized, especially since the COVID-19 pandemic, with a huge diversification of available products — similarly to the commercial cannabis market. The market’s desire for convenient and potent products has driven it to a state where capsules, compressed tablets, liquid extracts, edibles, and vaping products are being sold not only online, but also in gas stations and smoke shops.
Due to the novelty of so many kratom products and the need for more research, regulation of kratom in the United States is very inconsistent and largely nonexistent. Kratom is currently not recognized by the Food and Drug Administration (FDA) as a supplement. Seven states have recognized it as a Schedule I controlled substance, making it illegal to sell or purchase kratom, while other states have banned it entirely; some have age restrictions on purchasing it, and some have no restrictions at all. In New Jersey, there are no restrictions on purchase or consumption of kratom except that one must be 18 years old to buy it. “Gas station drug” is the term used for a psychoactive substance that is legal and often marketed as a safe dietary supplement but has the potential to become addictive. The problem with something like kratom becoming a gas station drug is that it conceals the possible potency of the drug and the lack of research behind the kratom market.
