Kratom

Kratom is the common name for the leaves of a tree found in Southeast Asia called Mitragyna speciosa. Kratom can also refer to related compounds (specific chemicals found in substances) pulled out of the leaves or made in a lab; we describe this more below.

In Southeast Asia and other areas, kratom leaves have traditionally been used as teas or chewed. In the U.S., kratom is unregulated and widely accessible in locations such as smoke shops and gas stations where it’s sold as tablets, powders, and more.

Some products marketed as kratom have opioid-like properties. Overdose deaths caused by these products are rare. However, kratom use can lead to use disorder, physical dependency, and withdrawal symptoms. Prevention and treatment efforts can help individuals and communities address these issues.

There is limited information and research on kratom, such as use trends or impacts on population health. This webpage will be updated as we learn more about kratom.

Why People Use Kratom

Kratom is used for many reasons, such as: 

  • Pain
  • Energy
  • Anxiety
  • Mood 
  • Sleep 

People have also used it to help manage their opioid withdrawal or to help reduce or stop using opioids, such as fentanyl. If you need help with opioid use, there are effective medications and supports that can help. Learn more about Opioid Use Treatment, HCA. 

Although people report using kratom for these reasons, there are no FDA-approved kratom drug products in the U.S., as there is not enough evidence to show it is safe and effective to treat medical conditions. Additionally, there are no prescription, over-the-counter, or dietary supplements containing kratom legally marketed in the U.S. It has shown up in counterfeit versions of other legal herbal supplements.

If you want to reduce or stop your kratom use and need support, talk to your health care provider or call the WA Recovery Helpline at 1-866-789-1511 to discuss care options. 

Kratom and Related Substances

Different Kinds of Kratom

There is a difference between the various forms of products that can be found marketed or labeled as kratom in stores. The following forms are some of the most common. 

Whole-leaf Kratom

The naturally occurring leaf from the Mitragyna speciosa tree. The leaves have compounds that can affect the body. Whole-leaf kratom's main compound is mitragynine (MTG). It also naturally contains small amounts of 7-hydroxymitragynine (7-OH). They both naturally occur and can act like opioids in the body, as they partially activate opioid receptors.

Lab-made Compounds

The two sets of compounds listed below differ from whole-leaf kratom, as they are pulled out (extracted) or made in a lab. Products made from these compounds are highly concentrated, and their labels don’t always show their correct amounts. They interact with the opioid receptors in the body and can lead to kratom use disorder and physical dependency. See Health Effects section below for details and supports.

  • 7-hydroxymitragynine (7-OH) is a compound found in whole-leaf kratom in very small amounts, about 2% by weight. In 7-OH products, it is extracted from kratom leaves and is concentrated to over 100 times the amount found in the leaves. Although 7-OH is found naturally in whole-leaf kratom, 7-OH products are not (whole-leaf) natural kratom. Learn more from an article in the Society of the Study of Addiction, Not all kratom is equal: The important distinction between native leaf and extract products.
  • Mitragynine Pseudoindoxyl, MGM-15, and MGM-16 - These compounds are not created from the kratom plant. They are created in a lab to mimic aspects of the kratom plant, mainly the 7-OH compound.

Health Effects

General Health Effects of Use

Kratom products can affect the body differently depending on how much is taken or how concentrated it is. Lower amounts and concentrations can produce a stimulant-like effect (increased energy and heart rate, alertness). Higher amounts and concentrations can produce a depressant effect (relaxation, pain relief, sedation). 

Some effects on the body can include:

  • Nausea and vomiting
  • Sweating
  • Constipation
  • Drowsiness 
  • Loss of appetite

Whole-leaf Kratom

Whole-leaf kratom typically produces a stimulant-like effect (increased energy and heart rate, alertness) as the concentration of opioid-like compounds is very low. 

Lab-made Compounds

Lab-made compounds contain higher amounts and concentrations of the opioid-like compounds and can produce a depressant effect (relaxation, pain relief, sedation). 

These compounds partially activate opioid receptors and can lead to a use disorder, physical dependency, withdrawal, and, in rare situations, overdose. 

Kratom Use Disorder, Physical Dependency, and Withdrawal

A use disorder (harmful and uncontrolled use) can develop from use of kratom products and is a form of opioid use disorder because of the way the kratom products interact with opioid receptors in the body. This may be treated with medications for opioid use disorder (MOUD). 

Physical dependency (the body gets used to a drug) is different than a use disorder, but both can lead to withdrawal symptoms, which can be treated with medication. Withdrawal symptoms can include anxiety, diarrhea, watery eyes/nose, body aches, chills, sweating, headache, dizziness, trouble sleeping, and nausea. 

If you want to reduce or stop your kratom use and need support, talk to your health care provider or call the WA Recovery Helpline at 1-866-789-1511 to discuss care options.   

Visit the Washington State Recovery Helpline’s MOUD locator to help you find a MOUD treatment provider.

Overdose

Kratom overdose deaths are rare. Per the most current data, between 2020–2025, 1 in 1,000 of all drug overdose deaths in Washington were kratom-only. Kratom-only means there were no other drugs in the body. The risk of overdose death increases when kratom is used with other substances like fentanyl, methamphetamine, and alcohol.

Contact the Washington Poison Center at 1-800-222-1222 for questions or treatment advice or to receive alerts on emerging or harmful substances. For immediate medical emergencies, call 911.

Naloxone can help reverse the opioid-like effects, like slowed breathing, caused by these compounds. Learn more about Kratom and 7-hydroxymitragynine poisoning, Washington Poison Center.

Laws and Regulation

Federal

On August 26, 2026, the United States Drug Enforcement Administration (DEA) temporarily scheduled three lab- made compounds as Schedule 1 controlled substances, making it illegal to have or sell for two years:

  • Mitragynine pseudoindoxyl
  • MGM-15
  • MGM-16

On July 1, the DEA proposed to classify 7-OH as Schedule I for 2 years. 7-OH is still unscheduled as of October 27, 2026.

The DEA has not announced plans to schedule other forms of kratom, including whole-leaf kratom. There are no FDA-approved kratom drug products in the U.S. There are no prescription, over-the-counter, or dietary supplements containing kratom legally marketed in the U.S.

Washington

In Washington, whole-leaf kratom and other kratom products, like 7-OH, that have not been scheduled by the DEA are still legal and largely unregulated. This means there are no age restrictions, labeling and packaging standards, or ingredient testing requirements on unscheduled kratom products. Some local governments and Tribes have banned the sale and distribution of various forms of kratom, including whole-leaf kratom. There have been several recent efforts from Washington lawmakers to regulate kratom in different ways at the state level; to date, none have passed.

Resources

Information and Fact Sheets

Clinical Resources for Health Care Providers

Data