Dr. Grey AI

Kratom

Kratom is a Southeast Asian tree (Mitragyna speciosa) with leaves containing mitragynine and 7-hydroxymitragynine - partial opioid receptor agonists. Used traditionally as stimulant (low dose) or pain/opioid withdrawal relief (high dose). MAJOR SAFETY CONCERNS: causes physical dependence, withdrawal syndrome, and has been linked to deaths (often with other substances). FDA has issued warnings. NOT approved for any medical use. May be contaminated with salmonella or heavy metals. Legal status varies. High abuse potential.

Quick Answer

What it is

Kratom is a Southeast Asian tree (Mitragyna speciosa) with leaves containing mitragynine and 7-hydroxymitragynine - partial opioid receptor agonists. Used traditionally as stimulant (low dose) or pain/opioid withdrawal relief (high dose).

Key findings

  • Grade D: Physical Dependence and Withdrawal Risk
  • Grade D: Pain Relief
  • Grade D: Opioid Withdrawal Symptom Management

Safety

  • Pharmacodynamic interactions with other CNS depressants (opioids, benzodiazepines, alcohol) increase risk of respiratory depression.
ℹī¸ Quick Facts: Kratom

Quick Facts: Kratom

  • Best Evidence:Grade D
  • Conditions Studied:0
  • Research Outcomes:4
Outcomes by grade:
A0
B0
C0
D4
0 conditions ¡ 4 outcomes

Detailed Outcomes

D
Physical Dependence and Withdrawal Risk
Multiple reviews and case reports document that regular kratom use causes physical dependence and a withdrawal syndrome (anxiety, insomnia, irritability, pain) similar to opioid withdrawal. FDA has issued public health warnings. Deaths have been reported, typically involving polysubstance use.
large↑Worsens
D
Pain Relief
Mitragynine and 7-hydroxymitragynine act as partial mu-opioid receptor agonists, providing a clear mechanistic basis for analgesia. User surveys and narrative reviews report pain relief at higher doses (5-15g), but no rigorous clinical trials have evaluated kratom for pain in humans.
moderate↓Improves
D
Opioid Withdrawal Symptom Management
A case report of 2 pregnant women documented kratom-related opioid dependence and withdrawal (PMID:30204686). Narrative reviews note widespread self-use for opioid withdrawal management, but this is NOT an FDA-approved treatment and may substitute one dependence for another. No controlled trials exist.
moderate↓Worsens
D
Drug Interaction Risk
A 2025 review (PMID:40522665) analyzing published literature and FDA FAERS data found that kratom alkaloids inhibit CYP3A4 and CYP2D6 enzymes, creating pharmacokinetic interactions with co-administered medications. Pharmacodynamic interactions with other CNS depressants (opioids, benzodiazepines, alcohol) increase risk of respiratory depression.
moderate↑Worsens