What Is Kratom: effects, overdose risk and legal status
Kratom acts on opioid receptors and can cause dependence, liver injury and seizures. Overdose signs, what to do, and where kratom and 7-OH are banned.
Kratom comes from the leaves of Mitragyna speciosa, a Southeast Asian tree. Its main compounds, mitragynine and 7-hydroxymitragynine (7-OH), act on the same brain receptors as opioids. The FDA warns against using it because of risks such as liver damage, seizures and substance use disorder. As of October 2026, kratom is not federally controlled in the US, but nine states and Australia ban it.
What is kratom?
Kratom refers to the Mitragyna speciosa tree and to products made from its leaves, NIDA explains. Its best-studied compounds are mitragynine and 7-OH. Mitragynine breaks down into 7-OH in the body, and both act on mu-opioid receptors, the same targets as oxycodone and heroin.
The effects only partly resemble those of opioids. People report more energy and alertness as well as opioid-like and sedative effects. Products are sold as powders, capsules, tablets, gummies, drink mixes and shots. The FDA has approved no kratom medicines and says kratom cannot be lawfully sold as a drug, dietary supplement or food additive.
Why do people use kratom?
People report using kratom to ease pain, manage anxiety and depression, cut back on opioids or other substances, and manage withdrawal and cravings, according to NIDA. About 1.7 million people aged 12 or older in the US used kratom in the past year in 2021, and about 1.9 million in 2022, according to national survey data cited by NIDA and the DEA.
The FDA warns against using kratom to treat any medical condition, including pain or opioid withdrawal. If you want to stop using opioids, a doctor can talk with you about proven treatments, and our guide to opioid overdose covers the warning signs.
What is 7-OH, and why are regulators worried about it?
7-OH is found naturally in kratom leaves, and the body also makes it from mitragynine. The FDA calls 7-OH “a concentrated byproduct of the kratom plant” and says it acts much more strongly on mu-opioid receptors than morphine.
In a July 29, 2025 announcement, the FDA said 7-OH tablets, gummies, drink mixes and shots are sold online and in gas stations, corner stores and vape shops, and that some “may be especially appealing to children and teenagers.” It said it was “not focused on natural kratom leaf products.”
The DEA has also acted on lab-made relatives of 7-OH. Its toxicology program counted at least 56 overdoses involving one of them, mitragynine pseudoindoxyl, from February 2025 to May 2026, and 48 were fatal. That compound and two others became Schedule I drugs on August 26, 2026.
What are the risks of kratom?
The FDA lists liver toxicity, seizures and substance use disorder as serious risks. NIDA lists milder effects such as nausea, constipation, dizziness and drowsiness, and Health Canada adds vomiting and a very fast heartbeat.
Dependence and withdrawal
The FDA has seen cases of kratom-related substance use disorder, including physical dependence and withdrawal when people stop. NIDA says people may have mild to moderate withdrawal symptoms when they stop regular use. Newborns whose mothers used kratom have shown withdrawal signs such as jitteriness, irritability and muscle stiffness, the FDA reports.
Liver injury and seizures
Regular, long-term use may be linked to serious liver problems that appear unpredictably in a small number of people, NIDA says. Doctors have also reported drug-induced hepatitis (liver inflammation) after kratom use. Other rare but serious problems include confusion, tremors and seizures, plus heart, lung and stomach problems. The FDA says kratom can slow breathing, which may lead to death.
Mixing kratom with other drugs
In the CDC’s study of overdose deaths where kratom was detected, fentanyl was listed as a cause of death in 65.1% and heroin in 32.9%. StatPearls, a clinical reference, notes that mitragynine appears to block liver enzymes that break down some other drugs, which may raise the risk of harm. Tell your doctor or pharmacist if you use kratom.
Contamination
The FDA has warned the public when kratom products were contaminated with Salmonella or concerning levels of heavy metals. In a 2017 to 2018 outbreak, the CDC linked kratom to Salmonella infections in 199 people in 41 states, and 50 of 132 people with information were hospitalized.
Can you overdose on kratom?
Yes. Kratom overdoses happen, and deaths have been reported, though most involve other substances. The FDA says deaths linked to kratom are rare and that kratom “was usually used in combination with other drugs.” In the CDC’s 27-state study, kratom was judged a cause of death in 91 of the 152 people who tested positive for it. It was the only substance found in 7, though the CDC notes others could not be ruled out. Our guide on what an overdose is explains what happens in the body.
What are the signs of a kratom overdose?
StatPearls reports that the most common symptoms after taking kratom are agitation, a fast heart rate, drowsiness and confusion. At higher amounts, a kratom overdose can look like an opioid overdose. Watch for:
- slow, shallow or stopped breathing;
- severe drowsiness;
- confusion or agitation;
- a racing heartbeat;
- tremors or seizures;
- vomiting.
Our guide to the signs of an overdose covers what to look for with any substance.
What should you do if someone overdoses on kratom?
- Call emergency services (911 in the US) if the person is hard to wake, is breathing slowly or not at all, or has a seizure. Otherwise, call Poison Control. The help box above lists numbers for all five countries.
- Give naloxone (Narcan) if breathing is slow or has stopped and you have it. Many kratom-related overdoses involve opioids like fentanyl, and in lab studies, naloxone reversed breathing problems caused by 7-OH. The CDC says naloxone won’t harm someone who is overdosing on drugs other than opioids.
- Stay with the person until emergency help arrives, or for at least four hours, as the CDC advises.
- If you’re trained, give rescue breaths or CPR if the person stops breathing.
- Bring the product or its package so hospital staff know exactly what was taken.
Naloxone is not a cure. StatPearls notes that how well it works for kratom overdose is not well established, so emergency care is still needed. Our guide to Narcan (naloxone) explains how it works and where to get it.
What happens at the hospital?
Staff first check and support the person’s airway, breathing and circulation. According to StatPearls, seizures are treated with standard anti-seizure medicines, and doctors have used an antidote called acetylcysteine in some cases of kratom-related liver injury.
Who is most at risk?
- People who mix kratom with other drugs. In the CDC study, benzodiazepines were listed as a cause in 22.4% of kratom-positive deaths and cocaine in 18.4%. See our guide to benzodiazepines and mixing dangers.
- Children and teens, because the FDA warns 7-OH gummies and similar products may appeal to them.
- Pregnant people and their babies, because newborns can go through withdrawal.
- People at risk of severe Salmonella infection, whom the CDC advises to avoid kratom.
Is kratom legal? Our five-country comparison
We checked official government sources in each of our five countries, and state government notices and the National Conference of State Legislatures (NCSL) for US states, in October 2026. Laws change quickly, so check your local rules.
| Country | Status | Key details | Official source |
|---|---|---|---|
| United States | Not federally controlled; banned in 9 states | FDA says kratom cannot be lawfully sold as a drug, dietary supplement or food additive. DEA proposed placing 7-OH in Schedule I on July 6, 2026; not final as of October 6, 2026. Three lab-made 7-OH relatives have been Schedule I since August 26, 2026. | Congressional Research Service; Federal Register; NCSL |
| Puerto Rico | Federal rules apply; no local ban found | A Senate bill (P. del S. 741, filed September 24, 2025) would ban sales to people under 21 and cap 7-OH. We found no record it has become law. | Senate of Puerto Rico |
| Canada | No kratom product authorized for sale | Health Canada “has not authorized the sale of any product containing kratom” and warns it may pose serious health risks when swallowed or inhaled. | Health Canada advisories (2018) |
| Australia | Prohibited (Schedule 9) | Mitragyna speciosa is a Schedule 9 prohibited substance in the Poisons Standard. Illegal imports can bring fines of up to 2,500 penalty units or 10 years in prison. | Australian Border Force (2024) |
| India | No national rule found | We found no kratom rule from India’s drug, food or narcotics regulators. | None found |
Which US states ban kratom or 7-OH?
According to NCSL’s June 2026 review, at least 31 states and Washington, DC regulate kratom in some way, and 22 states set a minimum age to buy it. These states go further:
| State | What the law does | Source |
|---|---|---|
| Alabama, Arkansas, Indiana, Louisiana, Vermont, Wisconsin | Kratom and its compounds are Schedule I controlled substances | NCSL |
| Kansas | Kratom, its compounds and 7-OH placed in Schedule I (HB 2365, 2026) | NCSL |
| Tennessee | Possession, sale and distribution of kratom banned (Matthew Davenport’s Law, 2026) | NCSL |
| Connecticut | Kratom (leaves, stem and extracts) and 7-OH listed in Schedule 1 (2026) | Connecticut Department of Consumer Protection |
| Ohio | Synthetic kratom compounds such as 7-OH permanently banned by pharmacy rule | NCSL |
| Rhode Island | Kratom sales regulated; 7-OH products banned | NCSL |
| Colorado | Synthetic kratom alkaloids banned; 7-OH limited to 2% of total alkaloids | NCSL |
| Oklahoma | No sales of products where 7-OH is over 1% of total alkaloids; synthesized compounds banned | NCSL |
Kratom is banned outright in 9 of 50 states, and 4 more have rules aimed at 7-OH. At the federal level, the Congressional Research Service reported on October 6, 2026, that the DEA “has not finalized the temporary scheduling of 7-OH.” The proposal would cover 7-OH above a set level (0.05% of dry plant material), so ordinary kratom leaf below that level would not be affected.
Can a pill identifier tell you if a pill is kratom?
Kratom and 7-OH products are not FDA-approved medicines. If you found a tablet or capsule, try our pill imprint search. If it has no imprint, or the imprint doesn’t match a listed medicine, it could be an unapproved product, so don’t take it. See our guide to pills with no imprint.
A matching imprint doesn’t prove a pill is real, because fake pills can look identical to real medicines. Read how to spot fake pills and our fentanyl and fake pills guide.
How do you get help for kratom dependence?
Talk to a doctor if you want to cut back or stop. NIDA says there are no approved medicines specifically for kratom-related problems yet, but a doctor can help you manage withdrawal and look at options.
In the US, SAMHSA’s National Helpline at 1-800-662-HELP (4357) is free, confidential and open 24/7 in English and Spanish, with treatment referrals and information. In Canada, Australia and India, your doctor or local health service can point you to support.
How can you lower the risks?
- Avoid concentrated 7-OH products and lab-made kratom compounds.
- Don’t mix kratom with opioids, benzodiazepines, alcohol or other drugs.
- Don’t use alone, and keep naloxone nearby.
- Keep kratom and 7-OH products, especially gummies, locked away from children, and see how to dispose of unused medicines.
Common questions
Is kratom an opioid?
Kratom is a plant, not a classic opioid drug, but its main compounds, mitragynine and 7-OH, activate the same mu-opioid receptors that opioids do, according to NIDA. Its effects only partly resemble those of opioids.
Is kratom legal in the US?
As of October 2026, kratom is not a federally controlled substance, but the FDA says it cannot be lawfully sold as a drug or dietary supplement. Nine states ban it: Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Tennessee, Vermont and Wisconsin.
Does Narcan work on kratom?
It may help. In lab studies, naloxone (Narcan) reversed breathing problems caused by 7-OH, and many kratom-related overdoses also involve opioids like fentanyl. The CDC says naloxone won’t harm someone overdosing on non-opioid drugs. Always call emergency services too.
Is kratom addictive?
It can be. The FDA has seen cases of kratom-related substance use disorder, including physical dependence and withdrawal when people stop. In the US, SAMHSA’s National Helpline (1-800-662-4357) can help you find treatment.
What is 7-OH and is it banned?
7-OH (7-hydroxymitragynine) is a kratom compound sold in concentrated tablets, gummies and drinks. The DEA proposed listing it in Schedule I in July 2026, but that was not final as of October 6, 2026. Several states, including Connecticut, Kansas, Rhode Island and Tennessee, already ban 7-OH products.
