What Kratom Is — and Why Patients Use It

Kratom (Mitragyna speciosa) is a plant native to Southeast Asia. Its main alkaloids—mitragynine and 7‑hydroxymitragynine—have opioid‑like activity, particularly at higher doses.

Patients commonly report using kratom for:

  • Anxiety or mood symptoms
  • Chronic pain or fatigue
  • Self‑management of opioid withdrawal
  • Energy or focus

At low doses it may feel stimulating; at higher doses, it produces opioid‑like and euphoric effects.

Risks Clinicians Should Recognize

Although often marketed as “natural” or “safe,” kratom is associated with dependence, withdrawal, and serious adverse effects:

  • Withdrawal symptoms include anxiety, sweating, nausea, malaise, myalgias, and insomnia
  • Reported adverse effects include agitation, tachycardia, vomiting, drowsiness, seizures, hallucinations, and respiratory depression
  • Kratom‑related substance use disorder has been documented, including tolerance, cravings, continued use despite harm, and withdrawal
  • The CDC has identified overdose deaths where kratom was detected, most often alongside fentanyl, heroin, benzodiazepines, or other substances—highlighting its role as a risk amplifier, especially in polysubstance use

Regulatory Reality Patients Often Don’t Know

Kratom is not FDA‑approved for any medical indication and is not lawfully marketed as a drug, dietary supplement, or food additive in the U.S. The FDA continues to warn about risks including liver toxicity, seizures, neonatal abstinence syndrome, and contamination with heavy metals or Salmonella.

Treatment Approach: What Actually Helps

There is no one‑size‑fits‑all treatment, but effective care starts with nonjudgmental assessment and meeting patients where they are.

Clinical management may include:

  • Screening for kratom use when patients present with anxiety, chronic pain, insomnia, or “failed” anxiety/OUD treatment
  • Assessing for opioid‑like dependence and withdrawal patterns
  • Symptom‑guided withdrawal support
  • Medication‑assisted treatment when clinically indicated
  • Treating co‑existing anxiety, depression, or chronic pain appropriately
  • Harm‑reduction counseling and close follow‑up

Many patients using kratom are seeking relief, not intoxication, and respond well when their underlying needs are addressed.

Care Is Available Locally

We are opening a new office soon in Cecil County, Maryland, and we are currently seeing patients in Claymont, Delaware.

If you or someone you care for needs help understanding kratom use, tapering safely, or navigating treatment options, we provide supportive, evidence‑informed care without stigma.

You’re not alone, and help is closer than you think.