Caution: Safety Information for Kratom Products
Kratom (Mitragyna speciosa) is an herb from Southeast Asia that may be used for its stimulant and analgesic (pain relief) effects. It binds to the opioid receptor and can act in a way similar to other opioids, leading to tolerance, physical dependence, and withdrawal symptoms. Generally, kratom consumers use kratom for pain relief, to address anxiety, for opioid withdrawal, and for pleasure. Kratom's safety has been questioned because of reports that it has been found in people who have died of an overdose. However, its role in such cases is typically unclear due to the presence of other, more lethal substances.
Kratom is sold mainly in smoke shops and online, although it is also available through mainstream shops. FDA's safety concerns include liver toxicity, seizures, and substance use disorder (FDA and Kratom). Medication for opioid use disorder can relieve dependence and withdrawal.
Kratom's toxicity may be worsened when an element of the kratom leaf is concentrated and consumed, particularly when the product is made extra-strong by the concentration of 7-hydroxymitragynine (7-OH). Kratom's active ingredients are mitragynine and its derivative 7-OH. 7-OH is more potent and potentially more dangerous than other kratom products. 7-OH can be produced semi-synthetically from mitragynine and marketed as 7-OH or included as an additive to kratom products for extra analgesic or opioid-like effect without labeling. Even products labeled as "all natural" or "natural leaf" Kratom can still contain added 7-OH or other materials such as heavy metals. Naloxone can be effective in reversing overdoses and should always be used when an overdose is suspected. [i]
It is important to be aware that kratom is not well studied and research on 7-OH is even sparser. NYS will continue to update this warning as new information emerges.
Kratom: What Clinicians Need to Know
References
- [i] Hill K, Boyer EW, Grundmann O, Smith KE. De facto opioids: Characterization of novel 7-hydroxymitragynine and mitragynine pseudoindoxyl product marketing. Drug Alcohol Depend. 2025 Jul 1;272
