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What is kratom, the herbal product with a complicated reputation?

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by Addy Bink - 04/19/26 11:00 AM ET

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by Addy Bink - 04/19/26 11:00 AM ET

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(NEXSTAR) – Roughly 18 months ago, kratom, an herbal product, was banned in six states. One of those states has since rolled back its ban, while more have pushed bans forward.

This comes amid a rise in reported adverse effects linked to kratom, including deaths, as well as efforts to regulate a product commonly associated with the natural substance.

What is kratom?

The herbal substance comes from tropical trees in Southeast Asia and can cause “opioid- and stimulant-like effects,” according to the National Institute on Drug Abuse (NIDA). It contains chemical compounds that can affect the body, two of which are well-studied: mitragynine and 7-hydroxymitragynine (7-OH).

You can find kratom sold in capsule and powder form. The latter can be mixed into foods and beverages, such as a “euphoric seltzer.” Kratom products are frequently advertised as being able to improve your mood, focus, and energy levels.

In this July 30, 2019, photo, officers gather illegally-grown kratom plants in Phang Nha province, Thailand. Thailand decriminalized the possession and sale of kratom in 2021. (AP Photo)

The substance can interact with the same brain receptors that chocolate, coffee, and exercise impact, the American Kratom Association notes.

The U.S. Food and Drug Administration has not approved any uses of kratom. However, NIDA explains that some people have reported using the substance to “manage drug withdrawal symptoms and cravings” as well as pain, fatigue and mental health problems.

More than 1.8 million people over the age of 12 reported using kratom within the previous 12 months in a 2024 survey.

“It really deals with the normal stresses of daily life and the aches and pains related to it,” Mac Haddow, senior fellow on public policy for the American Kratom Association, told Nexstar’s WPRI.

Is it safe?

Research into the short- and long-term effects of kratom continues.

NIDA warns that some have reported feeling nauseous, constipated, dizzy or drowsy after using kratom, while health care providers have reported tremors, seizures, high blood pressure and liver problems among patients. Similar reactions have been reported among those who use cannabis, and any reactions may vary based on the person, product and amount consumed.

Last month, California Gov. Gavin Newsom reported that more than 240 deaths in the state between 2020 and 2022 had been linked to kratom, with the substance being listed as the sole cause in 27. (For comparison, more than 1,300 people were killed in alcohol-related deaths in California in 2023.)

A county coroner in South Carolina earlier this month said that kratom, many times mixed with other substances, was a contributing factor in multiple deaths in his community, Nexstar’s WSPA reported.

A recent report from the CDC showed an increase in poison center calls regarding kratom products, with a spike in last year’s cases coinciding “with the emergence of high-potency, semisynthetic formulations, including 7-hydroxymitragynine.”

What is 7-OH?

While 7-OH is naturally occurring with kratom, there has been a growing focus on synthetically produced 7-OH. Considered an opioid, the non-natural form of 7-OH can be far more potent and addictive.

A 2025 report from the FDA said 7-OH can be 13 times more potent than morphine, a Schedule II narcotic in the U.S. The agency last summer recommended that certain 7-OH products, not natural kratom products, be scheduled under the Controlled Substances Act.

The Missouri Department of Health & Senior Services warns that use of isolated 7-OH, sometimes called “7-hydroxy,” can cause the user to stop breathing, potentially leading to an overdose that can be reversed with naloxone.

Health care experts have reported using buprenorphine, an FDA-approved medication used to treat those addicted to heroin, fentanyl, oxycontin and other opioids, to help those who become addicted to 7-OH.

Gabriel Phillips, who told Nexstar’s KSNW that he has used kratom daily for 15 years, started taking it because of the physical strain associated with his job in the aerospace industry. While he conceded that 7-OH “should probably be better regulated or banned,” he argued that the natural forms or those with lower levels of 7-OH should remain easily accessible.

Some states, including Phillips’ home state of Kansas, disagree.

Where do states stand?

Multiple states — Alabama, Arkansas, Indiana, Vermont, and Wisconsin — have banned mitragynine and 7-OH, the active alkaloids in kratom, Congressional data shows.

Connecticut’s kratom ban took effect in March after the state classified it as a Schedule I contro