Kratom use has spread rapidly outside Southeast Asia. New scientific reviews show its effects vary widely and call for measured regulation to protect public health (Kratom safety review).
Kratom is a tropical tree leaf that people chew, brew, or take as capsules. Many users report it helps pain, mood, energy and opioid withdrawal (Kratom safety review).
The surge in kratom use matters to Thai readers. Thailand has a long cultural history with kratom and new export and regulatory plans. The issue connects local traditions to global health and trade concerns (Kratom safety review).
Researchers estimate millions of Americans used kratom in recent years. Survey and market estimates range from under two million to more than ten million past-year users (Kratom safety review).
Users report many reasons for taking kratom. People use it for pain, mood, energy, focus and as a substitute for opioid painkillers and other drugs (Kratom safety review).
Kratom products vary widely in strength and composition. These range from dried leaf powder to concentrated extracts with variable alkaloid content (Kratom safety review).
Kratom’s main active alkaloid is mitragynine. Another compound, 7-hydroxymitragynine, appears at low levels in leaves but can form during metabolism (Kratom safety review).
Scientists say kratom has complex pharmacology. It acts at opioid receptors and at adrenergic, serotonergic, and other systems (Kratom safety review).
Laboratory animal studies show lower abuse-related effects for mitragynine than for heroin or morphine. These studies suggest kratom has weaker reinforcing effects in animals (Kratom safety review).
Human clinical studies remain limited. Small controlled studies show no major respiratory depression at typical consumer doses in observed settings (Kratom safety review).
Public health agencies report kratom-associated harms but emphasize polydrug use. Many fatal cases that mentioned kratom also contained other drugs, complicating causal conclusions (Kratom safety review).
The CDC said kratom appeared in some overdose deaths but rarely as the sole detected substance. Investigators often find additional substances on toxicology testing (Kratom safety review; CDC overdose data).
Poison center calls mentioning kratom increased over the last decade. Most reported adverse outcomes were mild to moderate, such as nausea and dizziness (Kratom safety review).
Forensic labs found mitragynine in many impaired-driving and postmortem cases. Experts caution that blood levels alone do not prove kratom caused impairment or death (Kratom safety review).
One large forensic analysis suggested blood mitragynine above about 1,000 ng/mL may indicate higher risk. The study also stressed many confounding factors in such cases (Kratom safety review).
Contamination and adulteration pose clear risks. Some kratom products have contained salmonella, synthetic opioids, and other dangerous additives (Kratom safety review).
Regulatory gaps drive many concerns. In the United States, kratom products marketed as dietary supplements lack uniform federal standards for purity or labeling (Kratom safety review).
The United States Food and Drug Administration warns consumers not to use kratom. The agency says kratom is not lawfully marketed as a dietary supplement and that deaths have sometimes involved kratom plus other drugs (FDA and Kratom).
Federal agencies differ on kratom’s public health risk. Some officials focus on potential harms while others stress possible benefits and the dangers of banning access (Kratom safety review).
The U.S. Department of Health and Human Services and the WHO found evidence mixed on kratom abuse liability. Both called for more research and surveillance rather than immediate scheduling (Kratom safety review).
Several U.S. states adopted Kratom Consumer Protection Acts. These state laws set product testing, labeling, and age limits to reduce contamination and adulteration risks (Kratom safety review).
Scientists urge an FDA-led national framework. They recommend standards for constituent limits, contaminant testing, labeling and warnings, and restrictions on adulteration (Kratom safety review).
Researchers call for more pharmacology studies. They want better data on multiple alkaloids, metabolites, and their interactions with medicines and other substances (Kratom safety review).
More clinical trials are also a priority. Experts recommend trials to define safe serving sizes, measure withdrawal, and test therapeutic potential under medical oversight (Kratom safety review).
Surveillance must improve. Public health systems should track product types, patterns of use, adverse events, and contamination to guide policy (Kratom safety review).
Researchers note potential for kratom-based medicines. Drug developers explore botanical pathways to create prescription therapies from kratom alkaloids (Kratom safety review).
Experts warn against abrupt bans. They cite concerns that banning kratom could push people back to more dangerous opioids and cause greater harms (Kratom safety review).
Kratom may play a role in harm reduction for some people. Some users report kratom helped them reduce or stop opioid use and avoid overdose (Kratom safety review).
But kratom is not risk-free. A minority of users develop dependence or withdrawal symptoms. Most cases appear mild to moderate, but severe cases occur in some individuals (Kratom safety review).
Clinicians should ask patients about kratom use. Doctors need to screen for use, potential drug interactions, and signs of problematic use or withdrawal (Kratom safety review).
Hospitals and labs need better toxicology tools. Standard screening often misses novel psychoactive substances and some kratom alkaloids (Kratom safety review).
For public messaging, experts recommend clear warnings. Labels should warn about pregnancy, mixing with alcohol or opioids, and potential liver or seizure risks (Kratom safety review).
Thai policymakers face choices. Thailand can regulate kratom to protect consumers while supporting traditional and economic uses. The country reversed its kratom ban in 2021 and is exploring export and regulatory frameworks (Kratom safety review).
Thailand can learn from U.S. state models. State Kratom Consumer Protection Acts offer templates for testing, labeling, and retailer registration that Thailand can adapt (Kratom safety review).
Thai health authorities should strengthen surveillance. Adding kratom to poison control and mortality reporting will help identify true harms and contamination events (Kratom safety review).
Thai clinicians can benefit from training. Doctors and nurses must learn to ask about kratom and manage withdrawal or interactions with medicines and alcohol (Kratom safety review).
Public education should respect tradition. Messaging must balance cultural respect and factual warnings about risks, contaminants and polydrug harms (Kratom safety review).
Researchers recommend community engagement. Authorities should involve traditional users, producers, and exporters in designing quality standards and public health campaigns (Kratom safety review).
Kratom business opportunities exist for Thailand. The country can build an export industry with strict quality control and testing to avoid contaminated or adulterated products (Kratom safety review).
Investing in laboratory capacity would help. Thai labs need the ability to test for mitragynine, 7-hydroxymitragynine, and contaminants such as fentanyl and salmonella (Kratom safety review).
Regulators should require batch testing and traceability. These steps can curb adulteration and allow recalls when contamination occurs (Kratom safety review).
Schools and community health programs should include kratom in drug education. Programs must present balanced facts that do not stigmatize traditional practices (Kratom safety review).
Thai law should avoid criminalizing users. Criminal penalties could push people to unsafe markets and hinder harm-reduction efforts (Kratom safety review).
Researchers worldwide call for coordinated studies. International collaboration can clarify kratom’s therapeutic potential and safety profile (Kratom safety review).
The evidence supports a balanced policy. The goal should be to protect consumers while allowing safe access and continued research (Kratom safety review).
In practice, regulators can set maximum alkaloid limits. They can require testing for contaminants and ban adulteration with opioids and other drugs (Kratom safety review).
Healthcare providers should record kratom use in medical notes. This step helps identify interactions and patterns of problematic use over time (Kratom safety review).
Pharmacovigilance systems must include kratom. Reporting adverse events will inform labelling and safety standards as data accumulate (Kratom safety review).
Researchers urge funding for human pharmacokinetic studies. These studies will help set safe serving sizes and understand drug interactions (Kratom safety review).
Clinicians should use harm-reduction principles. They should help users reduce risky combinations and find safer alternatives when needed (Kratom safety review).
Public health officials should monitor markets for adulterants. Rapid testing at ports and markets can prevent contaminated products reaching consumers (Kratom safety review).
In short, kratom poses mixed signals. It offers benefits for many users and risks for a minority, often linked to contamination or polydrug use (Kratom safety review).
Thailand has an opportunity. The country can combine tradition, trade and science to create a safe, regulated kratom market (Kratom safety review).
Action steps for Thai authorities are clear. Strengthen surveillance, require product testing, educate clinicians, and involve communities in rule-making (Kratom safety review).
Consumers should choose tested products. They should avoid mixing kratom with alcohol or opioids and seek medical advice if they have liver or psychiatric conditions (Kratom safety review).
Health professionals should document and report adverse events. They should counsel patients on risks and safe use pending stronger regulatory standards (Kratom safety review).
Researchers and regulators must act together. Coordinated science, regulation and education can reduce harms while preserving therapeutic potential (Kratom safety review).