Table 1.

Primary findings detailed in this review.

Key points
• Medical providers, addiction specialists, and substance use researchers should be aware of kratom as well as potential benefits and risks associated with using kratom—without co-use of other substances or when kratom is used concurrently, sequentially, or simultaneously with other substances.
• Case reports and human subject research have documented beneficial and adverse health effects associated with using this herb.
• Given currently published scientific literature and clinical reports, it is difficult to determine the role of kratom in more severe, adverse health effects associated with kratom use due to relatively high rates of polysubstance use.
• Polysubstance use is commonly reported in kratom-associated fatalities, and kratom alkaloids are not included in standard toxicological screenings for decedents, potentially resulting in underreporting of kratom-associated deaths.
• Kratom-related research for U.S. populations is still in its infancy; additional research, including cross-sectional and longitudinal surveillance as well as clinical studies, is needed to better identify health effects associated with using kratom alone and to create evidence-based treatment recommendations for people experiencing adverse, kratom-associated health effects.