# Kratom

Source: https://onco.cc/technologies/kratom/  
OnCo record `kratom` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Kratom is a Southeast Asian leaf with opioid-like effects, sold online for pain, mood and energy. The FDA has warned against it because of addiction, overdose, contaminated products and deaths, and Memorial Sloan Kettering advises that it should not replace prescribed pain medicines.

## Summary

Kratom leaves contain mitragynine and 7-hydroxymitragynine, which act on opioid receptors; low doses are stimulant and higher doses sedative and pain-relieving. Memorial Sloan Kettering's About Herbs summary describes human data on use and safety as very limited, reports that users can develop dependence and withdrawal, and states that because of interactions and side effects kratom should not be used in place of prescription pain medicines. The FDA has issued repeated statements citing adverse events, possibly related deaths, addiction and overdose risks similar to other opioids, and recalls of powdered products contaminated with salmonella; the Drug Enforcement Administration lists it as a drug of concern, and several countries and US states have banned it. Reported harms include seizures, liver and kidney injury, psychosis, cardiac arrest and deaths, some in combination with other drugs. Kratom also changes how other drugs are handled: it can speed clearance of drugs processed by CYP450 and UGT enzymes, may inhibit CYP2D6, and inhibits P-glycoprotein in the laboratory. People with cancer pain who are drawn to it are better served by a palliative care or pain team, who can adjust prescribed opioids and other painkillers.

## Fields

- Kind: Technology
- Status: negative
- Last checked: 2026-11-04
- Also known as: Mitragyna speciosa; Mitragynine
- Tags: complementary; supportive-care; evidence:harm
- Principle: Partial agonist activity at mu-opioid receptors produces analgesia, dependence and withdrawal; product strength and contamination are uncontrolled.
- Strengths: None established for cancer pain
- Limitations: Addiction, withdrawal and overdose; Contaminated products and deaths reported; Drug-handling interactions

## Sources

- MSK About Herbs: Kratom (page last updated 1 April 2020): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/kratom

## Connected records

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- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- bottlenecks: [Misinformation and unproven therapies](https://onco.cc/bottlenecks/b-misinformation/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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