Kratom, Addiction, and the Cost of Unregulated Access
- Jonathan Russell
- 9 hours ago
- 5 min read
March 16, 2026
Jonathan Russell, Author & Therapist
Reviewed by Tim Lineaweaver, Subject Matter Expert
A Case Study: Adam
When I first met Adam (name changed for privacy), he had already survived more than most people ever will. Heroin. Cocaine. Crack. Years of addiction followed by years of doing the hard work of recovery. Sobriety did not come easily, but he earned it. What lingered after the substances were gone, however, was pain. Persistent physical pain that never fully subsides. Alongside it came the drawn-out aftermath of coming off Suboxone and methadone. The post-acute withdrawal symptoms lasted far longer than he expected, wearing him down in quiet and relentless ways.
Adam was not trying to escape reality or chase a high. He was looking for relief.
Someone suggested kratom, a plant-based product sold openly in smoke shops and online. It was described as natural, legal, and safe—a harmless over-the-counter option. Compared to the drugs that had nearly destroyed his life, kratom seemed insignificant. It felt like harm reduction, not relapse.
One year later, Adam is still taking kratom every day.
He has tried to stop. Each attempt brings withdrawal symptoms. Restlessness. Anxiety. Worsening pain. Insomnia. Irritability.
Along with a familiar fear he knows too well. He tells me he feels trapped again, dependent on something he never thought could hook him. What started as a solution now feels like another cage.
Adam's story is not unique. It is simply one of many stories unfolding quietly alongside kratom's growing popularity.
What is Kratom?
Kratom comes from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. In the United States, it has become increasingly common and is marketed as a remedy for pain, anxiety, depression, fatigue, and opioid withdrawal. Its appeal lies not only in its effects but also in its framing. Natural. Legal. Separate from real drugs. That framing matters because it shapes how people assess risk.
Pharmacologically, kratom is far from inert. Its primary active compounds, mitragynine and 7-hydroxymitragynine, interact with the same mu opioid receptors targeted by drugs such as morphine and heroin. At lower doses, kratom may produce stimulant-like effects. At higher doses, sedative and opioid-like effects become more prominent. This dual action is often cited as evidence of safety. Yet, it is precisely why kratom can suppress pain and withdrawal and also why it can lead to tolerance, dependence, and withdrawal of its own.
Is Kratom Legal and Is It Safe to Use?
The United States Food and Drug Administration has repeatedly stated that kratom is not approved for any medical use and has warned about its opioid-like properties and addiction potential. Despite this, kratom products remain widely available and largely unregulated. Kratom and kratom-based products are currently legal and accessible in many areas, though U.S. and international agencies continue to review emerging evidence to inform kratom policy.
As use has expanded, reports of harm have followed. Case reports and surveillance data link kratom to liver toxicity, seizures, cardiovascular complications, and dangerous interactions with other substances. Some kratom products have been found to contain heavy metals or bacterial contaminants such as Salmonella. Because there is no standardized manufacturing or quality control, potency can vary widely between products and even between batches of the same product.
This variability creates danger. Users have no reliable way to determine the dose they are taking or the product's actual strength. What feels manageable one week may become overwhelming the next.
Withdrawal from kratom is no longer hypothetical. Emerging clinical research describes a withdrawal syndrome that closely resembles opioid withdrawal, including insomnia, muscle aches, gastrointestinal distress, anxiety, irritability, and cravings. For individuals with a history of opioid use disorder, these symptoms can be especially destabilizing. Many turn to kratom specifically to avoid returning to opioids, only to find themselves managing a new dependency that is often dismissed or minimized by society.
Further Research and Regulation Is Needed
Acknowledging these risks does not mean denying that kratom has drawn scientific interest. Some early studies and user surveys suggest it may have analgesic properties or potential utility in managing opioid withdrawal under carefully controlled conditions. Researchers have noted that kratom's pharmacology is complex and worthy of further investigation. The National Institute on Drug Addiction (NIDA) promotes research towards a better understanding of the health and safety effects of kratom use.
Potential, however, is not proof, and it is certainly not a justification for unrestricted access.
At present, kratom exists in a regulatory gray zone. It is not approved as a medication, yet it is sold as casually as supplements or energy drinks. There are no federal standards for dosing, purity, labeling, or age restrictions. Consumers are left to self-experiment, often without understanding kratom's mechanism of action or long-term risks. For people with chronic pain, trauma histories, or substance use disorders, this environment is particularly hazardous.
Adam did not make a reckless choice. He made an understandable one.
He trusted what was legal, accessible, and socially sanctioned. He trusted that something sold openly could not carry the same risks as the drugs he fought so hard to leave behind. That's where the system fails: in trust.
The problem is not that kratom exists. The problem is that it exists without guardrails.
Regulation need not entail prohibition. It entails standardized manufacturing, accurate labeling, clear dosing information, age restrictions, and quality testing to ensure that products are free of contaminants. It means funding independent and rigorous clinical research rather than allowing marketing and anecdotes to shape public understanding. It means honest public education that neither exaggerates nor minimizes risk.
Kratom should not be easier to access than evidence-based medical care. Until oversight catches up with availability, individuals like Adam will continue to fall into a gap in which harm is real, dependence is dismissed, and accountability is absent. Adam did not fail his recovery. The system failed him.
In Conclusion
If kratom is going to remain part of the public landscape, it must be treated with seriousness. Lives depend on understanding the difference between natural and safe. Right now, that difference is being ignored.
Selected References
National Center for Complementary and Integrative Health.
Kratom. What is known about safety, risks, and reported effects?https://www.nccih.nih.gov/health/kratom
Johns Hopkins Medicine.
Emerging use of kratom in the United States and characteristics of kratom use disorder.https://www.hopkinsmedicine.org/news/articles/2025/02/emerging-use-of-kratom-in-us-kratom-use-disorder-experts-propose-decision-making-algorithm-for-clinicians#:~:text=For%20some%2C%20kratom%20is%20used,have%20some%20mild%20physical%20dependence.
Prozialeck WC, Jivan JK, Andurkar SV.
Pharmacology of kratom. Effects, mechanisms, and abuse potential.
Drug and Alcohol Dependence.https://pubmed.ncbi.nlm.nih.gov/23212430/
Post S, Spiller HA, Chounthirath T, Smith GA.
Kratom exposures reported to poison control centers.
Clinical Toxicology.https://pubmed.ncbi.nlm.nih.gov/30786220/
Henningfield JE, Fant RV, Wang DW.
The abuse potential of kratom according to established pharmacologic criteria.
U.S. National Institute on Drug Abuse.
Kratom drug facts and emerging research overview.
Author Jonathan Russell is a Therapist and Business Development Coordinator at BlueSky Behavioral Health in Danbury, CT, and a recovery Podcaster.
You can connect with Jon at jonrussell1882@gmail.com
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