What is kratom and is it addictive? The controversial supplement, explained
Experts warn the herbal supplement kratom may be addictive like opioids as the FDA moves to restrict its potent compound 7-OH.
Gummies, shots, drink mixes and tablets made from a leafy tropical tree are a source of growing debate among Arizona lawmakers, business owners and consumers.
Kratom-related calls to Arizona and U.S. poison control centers are up, data shows, and so are deaths where one of the main psychoactive active compounds in kratom — mitragynine — is listed as a contributing cause.
Health concerns over kratom products, particularly a highly potent, synthetic version of kratom that has proliferated the marketplace in recent years, are the impetus behind a proposed kratom crackdown in Arizona.
However, some kratom users say products made from the kratom leaf are an essential and safe alternative to prescription painkillers. If people are getting addicted it’s because they’re misusing it and often using other potent substances at the same time.
Kratom products are easy to purchase in Arizona retail stores, including in gas stations and convenience stores, sometimes in clear cases labeled “Relaxation Station.”
Vape and smoke shops frequently advertise the fact that they have kratom with green neon window signs and products are often touted for their ability to boost mood, productivity and help with anxiety and chronic pain relief. Slang nicknames for the products include “gas station heroin” and “legal morphine,” according to the Arizona Attorney General’s Office.
Though kratom was first introduced to the United States by soldiers returning home after the Vietnam War, it became mainstream in the country in approximately the early 2000s, and its prevalence has since increased substantially, according to the Washington D.C.-based nonprofit Legislative Analysis and Public Policy Association.
Supporters of a crackdown say people are becoming addicted to products they believed to be harmless herbal supplements. Some critics argue that if Arizona is going to crack down on kratom, targeting only concentrated synthetic kratom products is confusing and not comprehensive enough. Others are fighting to keep all types of kratom legal.
“I think two things can be true. I think that you can have people who use this who are telling the truth that it has a legitimate therapeutic benefit for them, and it’s making their lives better,” said Steven Dudley, a pharmacist, clinical toxicologist and director of the Arizona Poison and Drug Information Center.
“But I also think it’s true that there are clear red flags with the addiction potential, even though it’s not as potent as fentanyl.”
There’s a saying in toxicology that the dose makes the poison and with kratom products, “if you do get enough you can have a very bad outcome,” Dudley said.
Small bottles of kratom shots cost about $9.99 and the prices of other products vary widely. Four-tablet packages of a highly concentrated and potent synthetic psychoactive compound in kratom called 7-hydromitragynine, or 7-OH, can cost upwards of $40. Synthetic 7-OH products have in the last few years become more available, according to industry experts.
“It’s pretty evil of the people who are really pushing this stuff,” said Paul Nichols, a 35-year-old Chandler optician, who is in recovery from an 18-month addiction to kratom products that he mainly purchased in small bottles of kratom extract from a smoke shop. At its worst, he says, his addiction was costing $1,000 per month.
The kratom he used initially gave him a focused energetic high, but ultimately, he said, left him feeling achy, feverish, sleepless and depressed, fueling a need for more just to feel okay.
“For some people, they feel relaxed, it helps them get through the work day. But it’s progressive. You go from once a week to twice a day,” Nichols said.
What is kratom and what are kratom effects? Natural kratom leaf vs synthetic 7-OH
The kratom leaf is a bitter-tasting botanical herb from the Southeast Asian Mitragyna speciosa tree.
It has been used in traditional medicine for hundreds of years in Southeast Asia, often in tea, to treat coughs and diarrhea, to increase productivity and combat fatigue, for pain relief, and as a substitute for opium. In low doses it’s a buzz similar to caffeine, and in higher doses it has the sedative effect of an opioid. Health risks include cardiovascular problems, high blood pressure, respiratory depression and seizures.
“The moment you get enough of kratom, it’s going to act exactly like an opioid, there’s really no difference whatsoever,” Dudley said. “It’s not sugar water. It’s not some placebo thing.”
Some of the more common side effects to kratom addiction include hair loss, dehydration, dry skin, numbness in the hands and feet, digestive problems and severe constipation, according to the nonprofit Quitting Kratom Support.
House Bill 2415, introduced this session by Rep. Quang Nguyen, a Prescott Valley Republican, targets the highly concentrated synthetic forms of 7-OH, which is a compound in kratom. Though 7-OH occurs naturally in the kratom leaf at very low levels, the potency is much higher in the synthetic form.
“7-OH is much stronger. I’ve had people using 20-plus capsules at one time just to not get sick. … In the detox setting it presents just like heroin, Percocet and fentanyl withdrawal,” said psychiatric nurse practitioner Brittni Sunbury who treats patients with addictions to many types of kratom products at the Scottsdale Recovery Center in Arizona. “I would say the big uptick has been in the last two years.”
The Arizona Attorney General’s Office worked with Nguyen on the bill, which would give more teeth to the state’s 2019 kratom law by classifying synthetic 7-OH a as a narcotic drug, revising labeling and product standards, and raising the minimum age for buying kratom from 18 to 21.
The state House Judiciary Committee on Feb. 4 passed Nguyen’s bill 6-3.
State Reps. Lupe Contreras, D-Avondale, and Alma Hernandez, D-Tucson, both members of the House Judiciary Committee voted no on the bill. If Arizona is going to crack down on kratom, then it should prohibit all kratom products, not just synthetic ones, they said.
The nonprofit American Kratom Association, which supports Nguyen’s bill, is adamant that synthetic 7-OH products are the problem, not other kratom products from the natural leaf. Mac Haddow, who is the group’s national public policy director, says synthetic 7-OH products “masquerade” as natural kratom.
The spike in kratom-related calls to poison centers and in people showing up in hospitals with kratom-related illness is directly related to the introduction of 7-OH products into the marketplace in September 2023, Haddow said.
“When you take a 7-OH product, you are going to get that immediate high within 20 minutes, you are going to crash after about two hours and then you crave it. That is why the addiction liability of 7-OH is dramatically higher than natural kratom leaf products.”
Members of of the 7-OH industry from the Holistic Alternative Recovery Trust say the American Kratom Association is supporting synthetic 7-OH product bans to protect its own market share and to create a distraction from the fact that other kratom products are “far more dangerous” than 7-OH, a contention that Haddow disputes.
Kratom ban: ‘The gas station guy should not be your doctor’
Nichols said he’d like to see kratom products have government health warning labels, similar to the ones on alcohol and cigarettes.
He has quit kratom and relapsed more than once. As of Jan. 29 he’d been sober from cannabis for 50 days and from kratom for 59 days. When he first tried kratom he initially only used natural kratom leaf products in extract form. After he quit and relapsed, he tried synthetic 7-OH.
Stewart Adair, a 36-year-old Mesa resident and self-employed handyman, said his six-year kratom addiction started when he bought kratom powder in a health food store to improve his focus at work. Adair, who is a husband and father of three, said eventually he wanted more and more of the powder, which led him to try stronger products sold in smoke shops.
“If I didn’t have it I was going into withdrawals, kind of like flu symptoms. Oh, it was so uncomfortable,” Adair said. “When they declared a pandemic (COVID-19) my first thought was, will I still be able to get kratom? Will the smoke shops be open? … I absolutely would have bought it from a drug dealer.”
Adair, the Mesa resident, attends online meetings through a group called Quitting Kratom Support in order to stay off of the products.
“It’s not just the 7-OH synthesized stuff. … With just the addiction aspect, the kratom leaf is just as bad in my opinion,” Adair said. “Kratom needs to be seen in a different light.”
Kratom addiction problems are occurring with all types of kratom products, not just 7-OH, concurred Decima Davis, the Mississippi-based founder of the nonprofit Quitting Kratom Support. The online support group started out on Facebook in 2017, and now hosts up to four virtual “Kratom Quitters” support meetings per day.
Davis, 50, is three years sober from a kratom addiction that began because she thought it would be a benign way to help her to get off of opioids. She started by ordering plain kratom powder online in 2014, before kratom products were readily available in retail stores. She gave it up because of the health effects, which included three seizures in five months, she said.
“I didn’t want it to kill me,” she said. “I had to go through detox.”
Davis’ husband is a former kratom addict, too.
“My husband is a blue-collar ship fitter. He doesn’t do drugs, smoke or drink. He fell for the marketing,” Davis said. “He thought it was just like the five-hour energy shots. But it’s not the same. It’s almost like drugging people without their consent. … The gas station guy should not be your doctor.”
Kratom withdrawal called ‘miserable’
In Pima County there were nine kratom-related deaths in 2025, up from four in 2024. In Maricopa County, total deaths involving kratom more than doubled between 2024 and 2025 from from 13 to 32, county medical examiner records show.
Both medical examiner’s offices listed kratom-related deaths are listed as mitragynine, which is the main chemical compound found in kratom. The medical examiners offices do not separate synthetic 7-OH from mitragynine in their data,
The age range for those who died was 20 to 69 and the vast majority were male. A majority of kratom-related deaths list other drugs as being present, too, often fentanyl, methamphetamine and cannabis. A 2019 federal analysis of 91 kratom-involved deaths over 18 months found that in approximately 80% of those deaths, the decedents had a history of substance misuse.
In a July 29, 2025, warning about synthetic 7-OH, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. said the FDA was taking action to make it a Schedule 1 controlled substance. He said the U.S. Drug Enforcement Administration was reviewing the recommendation and has final authority. To date, the DEA has not taken any action.
The FDA’s education materials say that more strictly regulating 7-OH products is a way of averting a fourth wave of the opioid crisis (the first three waves were prescription drugs, heroin and fentanyl.) Unlike opioids, kratom is not derived from the opium poppy, but is sometimes referred to as an opioid because of its opioid-like effects on the brain.
The Holistic Alternative Recovery Trust, the 7-OH industry group, did not respond to queries from The Arizona Republic about the Arizona bill, but the organization’s national policy director Jeff Smith on Feb. 3 issued a written statement on its website reiterating opposition to the DEA making synthetic 7-OH a Schedule 1 controlled substance.
“Instead of pursuing a misguided ban, regulators should focus on consumer protection through consistent, science-based standards applied equally across all kratom products,” Smith said in a written statement.
The U.S. Department of Defense in September said it would ban the use of all kratom products among active members of the U.S. military, as well as its reserves, because the products (not just synthetic 7-OH) pose a health danger and for that reason are a threat to “combat readiness and national security.”
On Dec. 9, Arizona Attorney General Kris Mayes, a Democrat, issued a consumer alert that says Arizonans should be skeptical of products sold in gas stations, convenience stores, or online that promise quick fixes for pain, anxiety, focus, or energy but especially if they are labeled as kratom or 7-OH.
Synthetic 7-OH products are most commonly available in vape shops and online as flavored tablets, capsules, and gummies in colorful packaging with names such as Blues, Perks and Lemmons.
“Typically they start in detox. It’s a miserable withdrawal,” said Sunbury, the Scottsdale Recovery Center nurse practitioner. “Vape shop employees likely don’t even know the impact.”
Younger patients will often first find out about 7-OH products in vape shops, Sunbury said, and patients are frequently caught unaware when they develop a dependence.
“A lot of it is lack of knowledge. They have no idea this product they are buying is going to be addictive,” she said. “The 7-OH product is stronger than morphine and it’s being sold over the counter. They want more and more each day and it goes quickly from, ‘I want to do this’ to ‘I can’t stop’.”
Kratom addiction: ‘Anything can be addictive if you take too much’
Some countries and several U.S. states and jurisdictions including Ireland, Sweden, Vermont, Rhode Island, Alabama, the city of San Diego in California and Sarasota County in Florida, already have prohibitions on all kratom products, but some users and members of the kratom industry argue such actions are overreach.
“Anything can be addictive if you take too much,” said Jill Sugarman, who owns several kratom businesses in Arizona, including the Kratom Kafe northwest of Tucson, which has a kratom coffee bar and a kratom vending machine for people who want to purchase the product outside of business hours.
The Kratom Kafe, which includes a Pac-Man game console, couch, plants and a coffee bar, has disclaimers and information about kratom posted on its the walls and by the front counter.
A sign in the Kratom Kafe says that kratom is “more akin to tea and coffee than any other substance,” and indeed, the kratom leaf is part of the coffee family.
In small doses, kratom is marketed as a mood booster and alternative to alcohol. The more concentrated 7-OH kratom products are touted as pain relievers and often include the label “alkaloid” and “plant alkaloids,” which refers to to naturally occurring compounds.
A slew of social media posts on platforms such as TikTok and Instagram describe the negative effects of using kratom products, including using 7-OH for pain relief, with some people claiming it ruined their lives.
Sugarman is a former competitive gymnast who began using kratom for back and neck pain relief in 2015 and began selling it out of her home. Her business grew because of ongoing demand, she said, and described her customer base as “regular people” with jobs and families. Construction workers often use the kratom vending machines early in the morning at the start of their work day, she said.
During the 90 minutes while a reporter visited the Kratom Kafe Jan. 31, more than a dozen people came in to buy kratom gummies, powder, seltzer and a popular product called “feel free” that comes in small, blue bottles.
Many were regular patrons who knew Sugarman by name. Everyone who works for Sugarman uses kratom, too, which she says helps with consumer education. That’s something customers don’t get if they buy the products in a smoke or vape shop, she said. She only buys from vendors she trusts, she emphasized.
7-OH is a safe way to manage pain, petition says
The Kratom Kafe, which has an online presence, hands out cards with the headline “The Government is Trying to Ban 7-OH” with a QR code to scan leading to a national petition to “defend wellness, freedom and choice.”
The petition says federal lawmakers are pushing to ban 7-OH nationwide due to pressure from “misinformation and corporate interests.” As of Feb. 3, it had 35,276 signatures. Recurring comments are from people who say 7-OH saved their lives by providing pain relief, and a safe alternative to fentanyl and alcohol.
Sugarman said she uses synthetic 7-OH products and finds them effective for pain management.
“We have a sticker here that says ‘Kratom Saves Lives.’ It really does,” Sugarman said. “I would be afraid a ban or regulation could be a lot more dangerous and put people at risk for adulterated products.”
Arizona already has a kratom law, called the Kratom Consumer Protection Act, which took effect in 2019 before the proliferation of 7-OH products. Among other things, it bans retailers from selling synthetic kratom products, including synthetic 7-OH. But retailers seem to be ignoring the law because it’s easy to purchase in Arizona.
The impetus to strengthen the law came about after Mayes heard from families whose teenagers had become addicted to synthetic kratom products, spokesperson Richie Taylor wrote in an email. Another reason for the alert, Taylor wrote, was a rising number of calls about kratom withdrawals and abuse to Arizona poison centers; calls rose by 187% between 2024 and 2025.
The Phoenix-based Banner Poison and Drug Information Center and the Tucson-based Arizona Poison and Drug Information Center, which handles all Arizona calls from outside of Maricopa County, went from a combined 40 calls in 2024 to 115 calls in 2025. Nationally, there were 3,802 kratom-related poison calls 2025, which was more than double the 2024 number, Dudley said.
The kratom call numbers are significantly lower than the number of calls about fentanyl, said Bryan Kuhn, a pharmacist and clinical toxicologist who is the clinical educator for the Phoenix-based Banner Poison and Drug Information Center. Kuhn does not see signs that kratom has become a fourth wave of the opioid crisis, he said.
“The numbers for fentanyl are staggeringly larger,” he said. “The fentanyl wave has not crashed yet.”
Lack of regulation is a consumer safety concern
Kratom products’ lack of regulation poses a consumer safety concern, Kuhn said. The FDA has a consumer information page about kratom that says it is not appropriate for use as a dietary supplement, and that there are are no FDA-approved prescription or over-the-counter drug products containing kratom on the market in the U.S.
Kuhn cited a 2018 Salmonella outbreak in kratom products that sickened 199 people in 41 states, including in Arizona. The outbreak underscored the risks associated with botanical products of “indeterminant source and quality,” says a federal report on the outbreak published Sept. 2, 2022, in the journal Foodborne Pathogens and Disease.
“I’m not going to tell people not to do drugs. People will and people define drugs different ways,” Kuhn said. “It’s understanding the risks involved when you have an unregulated product whose dose for a particular benefit isn’t well defined.”
Responding to market demand, selective breeding and advanced cultivation techniques have made cannabis far more potent than it was in the 1970s, and that same increased potency could happen with kratom leaves, he added.
“This is definitely one of those scenarios where it’s user beware. This is not a market where the person you are buying the product from has a vested interest in your best outcome.”
The American Medical Association in a Jan. 12 report about the nation’s overdose crisis named kratom and the stimulants xylazine, tianeptine, and inhalants (such as glues, paints and cleaning agents) as emerging threats for “polysubtance abuse,” which means mixing and abusing multiple substances at the same time.
The report recommends states ban over-the-counter sales of kratom, and that regulatory entities evaluate kratom’s appropriateness for sale.
“At the end of the day, if you are selling more product, if your product is stronger than the next product, you are probably going to sell more,” Dudley said. “It’s all about making the cash grab. It’s an inherent risk in the supplement industry in general, and kratom is just one example among many.”Reach health-care reporter Stephanie Innes at stephanie.innes@usatodayco.com or follow her on X: @stephanieinnes or on Bluesky: @stephanieinnes.bsky.social
Toll-free poison help
Questions about kratom products and their effects may be directed to the Poison Control hotline at 800-222-1222. The line connects users to their local poison center. Callers will typically speak with a nurse, pharmacist, or doctor.
FDA adverse event reporting program
Negative reactions to kratom, listed as mitragynine or 7-hydroxymitragynine may be reported to www.fda.gov/medwatch
