10 Things Nurses Should Know About Kratom

Kratom is certainly one of the newer psychoactive substances derived from natural elements and used to alleviate pain. It is an unscheduled opioid agonist, and even though it is banned by the Food and Drug Administration (FDA), it’s widely available and never very expensive. You might even see signs in your neighborhood promoting Kratom products with details about pain management, opioid addiction treatment, or opioid withdrawal treatment.

In addition to the results of the substance itself, there’s great concern that “the use of products with unsubstantiated claims may prevent people with opioid addiction from seeking treatments that have been shown to be safe and effective” (FDA, 2019). As nurses, we must remain educated, share our knowledge, and remain vigilant when using kratom and other products that make unsubstantiated claims of great health risks.

Here’s what it’s essential to know (O’Malley, 2018):

1. Kratom (is a tropical tree native to Southeast Asia, the Philippines and New Guinea.
2. There aren’t any FDA-approved uses for Kratom.
3. Kratom is commonly sold as a dietary complement.
4. Forms of Kratom include leaves, pills, capsules, powder, and tea.
5. Other names for Kratom include or
6. Small doses of Kratom produce stimulant effects like cocaine or amphetamine.
7. Large doses of Kratom are related to sedative-narcotic effects much like opioids.
8. Repeated use of Kratom may cause hypertension, kidney toxicity, cognitive and behavioral disorders, and liver damage.
9. Withdrawal symptoms include tremors, anorexia, weight reduction, decreased libido, insomnia, muscle cramps and pain, fever, diarrhea, and psychosis.
10. Kratom could be added to other products without being indicated on the label.
11. The lack of regulatory controls, standardization of production and sale of products contaminated with potentially toxic and infectious substances contributes to the danger related to this product.

It is very important for us to coach patients that the terms “legal” and “available” don’t mean protected. Claims that Kratom is a natural substitute for opioids are unsubstantiated. Share these facts, not sleep to this point with the most recent evidence, and report any antagonistic drug reactions FDA’s MedWatch program.

O’Malley, P. (2018). Do you think that Kratom is a protected substitute for opioids? Think Again!: History, Evidence, and Possible Future of the Mitragyna Species. doi: 10.1097/NUR.0000000000000392

US Food and Drug Administration. (2019). The FDA is warning firms selling illegal, unapproved Kratom-containing products for opioid cessation, pain management and other medical uses. Downloaded from https://www.fda.gov/news-events/press-announcements/fda-issues-warnings-companies-selling-illegal-unaproved-kratom-drug-products-marketed-opioid