Kratom: Effects, Risks, Withdrawal & Getting Help
Kratom is a Southeast Asian plant whose leaves contain alkaloids — mainly mitragynine and 7-hydroxymitragynine (7-OH) — that act on the brain's opioid receptors. People use it for energy, pain, or to self-treat opioid withdrawal, but regular use can cause dependence, an opioid-like withdrawal syndrome, and, especially when mixed with other depressants, overdose.
What kratom is
Kratom comes from Mitragyna speciosa, a tree native to Thailand, Malaysia, and Indonesia. Its leaves contain more than 40 alkaloids. Two matter most clinically: mitragynine, the most abundant compound, and 7-hydroxymitragynine (7-OH), a minor alkaloid that is far more potent at the mu-opioid receptor. Plain leaf powder usually contains very little 7-OH, but newer concentrated extracts and tablets sold as “7-OH” products deliver doses many times higher than anything found in nature.
How people use it
Traditional use in Southeast Asia involves chewing fresh leaves or brewing them into tea. In the United States, kratom is sold as loose powder, capsules, liquid “shots” at gas stations and smoke shops, and increasingly as concentrated 7-OH tablets. Because products are unregulated, the actual alkaloid content of any given package can vary widely from what the label claims.
Effects at low and high doses
Low doses tend to produce mild stimulant effects: alertness, talkativeness, and reduced appetite. Higher doses shift toward opioid-like effects — sedation, pain relief, itching, nausea, and constipation. The dividing line is not predictable, especially with extracts. Concentrated 7-OH products skip the stimulant phase and act much more like a classical opioid from the first dose. For a side-by-side breakdown, see our comparison of kratom and prescription opioids.
Dependence and withdrawal
Daily use of kratom — even at moderate doses — can lead to physical dependence within a few weeks. When someone stops, an opioid-like withdrawal usually begins within 12 to 24 hours and peaks over the next two to four days. Common symptoms include anxiety, restlessness, muscle aches, sweating, runny nose, stomach upset, and insomnia. Concentrated 7-OH users often describe withdrawal that is faster, sharper, and harder to ride out than plain leaf withdrawal. Read more about what to expect during kratom withdrawal and the case for medically supervised detox.
Overdose and polysubstance risk
The FDA has documented deaths involving kratom. In most reported fatal cases, kratom was combined with another depressant — alcohol, a benzodiazepine, gabapentin, or another opioid — or the person used a high-potency extract. Mixing kratom with any of these substances can suppress breathing and turn a manageable dose into a fatal one. See our overview of kratom overdose warning signs for what to watch for and when to call 911.
When to seek help on Long Island
If you are using kratom or 7-OH every day to function, taking it to avoid withdrawal, hiding use from family, or combining it with other substances, it is worth talking to a clinician. Long Island has detox programs, outpatient counseling, and buprenorphine (Suboxone) options for kratom use that can shorten withdrawal and reduce relapse risk. For a clinician's view of how these medications compare, see kratom versus methadone and kratom versus Suboxone.
Topics in this guide
Continue reading with focused pages on the most common kratom questions we hear from Long Island callers:
Frequently asked questions
References
- U.S. Food and Drug Administration. FDA and Kratom. Updated public health communications.
- National Institute on Drug Abuse (NIDA). Kratom DrugFacts.
- Drug Enforcement Administration. Kratom Drug Fact Sheet.
- Substance Abuse and Mental Health Services Administration (SAMHSA). National Helpline.
- Kruegel AC, Grundmann O. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant. Neuropharmacology. 2018;134(Pt A):108-120.
- Henningfield JE, Grundmann O, Garcia-Romeu A, Swogger MT. We need better estimates of kratom use prevalence. Am J Prev Med. 2022;62(1):132-133.
Talk to someone on Long Island
The Long Island Rehab Helpline offers free, confidential guidance for kratom, 7-OH, and opioid use disorders across Nassau and Suffolk County. We are a navigator, not a treatment provider.
Call 844-338-6969