Kratom is a tropical tree in the coffee family, native to Southeast Asia, whose leaves contain compounds that act on the brain in ways similar to both stimulants and opioids. For centuries, people in countries such as Thailand, Malaysia, and Indonesia have chewed the leaves or brewed them into tea to boost energy, relieve pain, and fight fatigue. Today, kratom is sold across the United States as a powder, capsule, tablet, and concentrated liquid shot, and it has moved into the national spotlight after recent reports tied the substance to hospitalizations among college students — including at the University of Mississippi, better known as Ole Miss.

Despite its growing popularity, kratom remains one of the most debated herbal products on the market. The U.S. Food and Drug Administration (FDA) has not approved kratom for any medical use and has repeatedly warned about its risks, while advocates argue the plant offers a natural alternative for pain and opioid withdrawal. Here is what you need to know about how kratom works, what it does to the body, and why it is making headlines.

What Is Kratom? A Centuries-Old Plant in a Modern Package

Kratom (Mitragyna speciosa) is a tropical evergreen tree that grows in the humid lowland forests of Southeast Asia, particularly in Thailand, Malaysia, Indonesia, Myanmar, and Papua New Guinea. It is a relative of the coffee plant, which helps explain why small amounts can feel energizing. The leaves are the part of the plant that people use.

Traditionally, farmers and laborers in Southeast Asia chewed fresh kratom leaves to fight fatigue during long days of physical work. The leaves were also used in folk medicine to ease pain, treat diarrhea, and reduce coughs. In recent decades, kratom has been promoted in the West — mainly through online sellers and smoke shops — for pain relief, mood support, and as a do-it-yourself way to cope with opioid withdrawal.

On the U.S. market, kratom is typically sold as dried, ground leaf powder that users mix into drinks or swallow in capsules. More concentrated forms, including extracts, gummies, and small liquid shots, have become especially popular because they are convenient and deliver a stronger dose in a smaller package. This move toward higher-potency extracts is one reason health officials are increasingly concerned.

How Kratom Works in the Body

The key to kratom's effects lies in two chemical compounds found in the leaves: mitragynine and 7-hydroxymitragynine. These are alkaloids — naturally occurring plant chemicals that act on the human body. Mitragynine is the most abundant, while 7-hydroxymitragynine is present in much smaller amounts but is far more potent.

Both compounds interact with the same opioid receptors in the brain that are targeted by drugs such as morphine and oxycodone. This is why kratom can relieve pain and produce a feeling of calm or euphoria at higher doses. However, kratom does not affect these receptors in exactly the same way as prescription opioids, which researchers say may explain why its effects can feel milder at typical doses while still carrying a risk of dependence.

Kratom is unusual because the effects change with the amount consumed. At low doses, mitragynine appears to have a stimulating effect, increasing alertness and energy. At higher doses, the opioid-like activity dominates, producing sedation, pain relief, and a sense of well-being. The line between stimulant and sedative depends heavily on the dose, the specific product, and the person's own body chemistry and tolerance.

What Kratom Does: Effects by Dose

User reports and research describe a dose-dependent spectrum of effects.

Low doses (roughly 1 to 5 grams of raw leaf powder) tend to feel energizing. People report increased alertness, talkativeness, sociability, and physical energy, along with a mild mood lift. Some compare this feeling to drinking a strong cup of coffee.

Moderate to high doses (roughly 5 to 15 grams) shift toward opioid-like effects. Users often describe pain relief, relaxation, drowsiness, and a calm, euphoric state. At this level, kratom can feel sedating rather than stimulating.

Very high doses or concentrated extracts can produce strong sedation and, in some cases, nausea, vomiting, and confusion. Concentrated shots and extracts can contain far more active alkaloids than an equivalent weight of plain leaf, which makes accidental overconsumption easier.

It is important to note that there is no standardized, medically approved dosing for kratom. Because products vary widely in potency and purity — and because the FDA does not regulate kratom as a supplement or drug — users can rarely be sure exactly how much mitragynine they are actually taking.

Side Effects and Risks

Kratom is not harmless. Reported short-term side effects include nausea, constipation, dry mouth, itching, dizziness, drowsiness, loss of appetite, and increased urination. At higher doses or with concentrated products, more serious effects have been reported, including rapid heart rate, elevated blood pressure, hallucinations, seizures, and liver damage.

Regular, heavy use can also lead to dependence. When frequent users stop, they may experience withdrawal symptoms that resemble opioid withdrawal, including muscle aches, irritability, insomnia, runny nose, and intense cravings. The FDA has stated that kratom affects the same opioid brain receptors as morphine and carries risks of abuse, addiction, and dependence.

Safety officials are especially worried about two things. First, kratom is often used alongside other substances, which can amplify its depressant effects on breathing. Second, the unregulated market means products can be contaminated or laced with other drugs, and there have been recalls of kratom products contaminated with salmonella. The FDA has linked kratom to dozens of deaths, though in many of those cases other drugs or pre-existing conditions were also involved.

Because kratom is largely unregulated, medical organizations including the FDA and the National Institute on Drug Abuse (NIDA) advise caution and recommend talking to a healthcare provider before using it, particularly for people who are pregnant, have liver or heart conditions, or take other medications.

Kratom occupies a legal gray area in the United States. At the federal level, it is not a controlled substance, and it is not approved by the FDA for any medical use. In 2016, the Drug Enforcement Administration (DEA) announced plans to place kratom in Schedule I — the most restrictive category, reserved for drugs with no accepted medical use — but withdrew the proposal after a public outcry and a petition from supporters who argued the plant helped them manage pain and opioid withdrawal.

Since then, regulation has been left largely to the states. Kratom is banned in Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin, and a number of cities and counties have their own restrictions. Several other states regulate kratom by requiring age limits (often 18 or 21) or product labeling, under a framework known as the Kratom Consumer Protection Act. Internationally, the World Health Organization reviewed kratom and, in 2021, did not recommend international control, citing insufficient evidence of a public health threat at that time.

Why Kratom Is in the News Now

Kratom's most recent wave of attention comes from college campuses. Recently, reports emerged that several University of Mississippi (Ole Miss) students were hospitalized after using kratom, prompting the university to warn students about the substance and its unpredictable effects, particularly in concentrated extract form. The incident highlighted how kratom has moved from smoke shops and online forums into the mainstream, especially among younger adults who may underestimate its potency.

The Ole Miss episode is part of a broader pattern health officials have been tracking: as high-potency kratom extracts and gummies become more widely available, emergency calls and poison-control reports related to kratom have risen. Public health experts say the trend underscores the difference between traditional, low-dose leaf use and the modern, highly concentrated products now sold over the counter.

Key Takeaways

If you are trying to make sense of kratom, here are the essentials.

• Kratom is a tropical tree related to coffee, and its leaves have been used for centuries in Southeast Asia for energy and pain relief.
• Its active compounds, mitragynine and 7-hydroxymitragynine, act on opioid receptors in the brain, producing stimulant effects at low doses and opioid-like effects at higher doses.
• The FDA has not approved kratom for any medical use and warns about risks including addiction, dependence, and, in rare cases, serious harm.
• Kratom is legal at the federal level but banned in six states and regulated in several others.
• Recent hospitalizations among college students, including at Ole Miss, have renewed scrutiny of concentrated kratom products.
• Because products are unregulated, potency and purity vary widely, and medical experts advise caution.

If you or someone you know is considering kratom — or struggling with its use — the safest first step is to speak with a healthcare provider or contact a poison control center for guidance.