Since 2019, the FDA has warned US consumers not to use kratom at all. That said, people can and do use kratom, both in traditional and modern ways.
People often use kratom leaves by chewing them, or by making them into tea. Kratom leaves are also or extracted into powder for other uses. Kratom is smoked only rarely.
In cultures where the kratom thrives natively, it is often part of traditional practices and seen as a medicinal herb. Kratom was recorded as a substitute for opium in Malaysia in 1836, and it was also used this way in nineteenth century Thailand.
Much like coca or khat, people chew kratom leaves to increase appetite, energy, and sexual desire, and to relieve musculoskeletal pain. Kratom extracts and leaves are used as a local anesthetic, to heal wounds, as intestinal deworming agents, and to treat diarrhea, coughs, and gastrointestinal infections.
In dull, difficult, and dangerous professions, workers often use kratom to enhance the mood, ward off pain, and stave off exhaustion. In fact, kratom had much higher traditional status in Thailand, and was seen as a treat for the ritual worship of gods and ancestors and receiving honored guests. Generally, even traditional users of kratom find it bitter and consume it with some sort of sweetener.
A 2021 study which analyzed YouTube user videos on kratom use found that the vast majority of people use kratom to manage opioid addiction and symptoms of opioid withdrawal. Another 2021 study has found that kratom alkaloids do ameliorate opioid withdrawal in mice. However, kratom is still not approved for this use, nor any other medical application, in the US.
Even so, many people are willing to try kratom, in part because traditional opioids are so dangerous, and in part because the withdrawal effects of kratom are typically less severe than those associated with traditional opioids. Research indicates that kratom can induce physical dependence but has less potential to do so. Kratom is also far less likely to cause death, and most kratom overdose cases are related to either polysubstance use or poorly sourced material.
Data on worldwide kratom use is lacking. However, as of 2021, in the United States less than one percent of people use kratom, although 10.3 percent of people with opioid use disorder use it.
At lower doses, kratom’s effects are similar to coca, with users describing alertness, increased sexual desire and work capacity, positive mood, sociability and talkativeness, and euphoria. At higher doses, kratom’s effects are much more like those of opioids, which is why it is such a popular choice for withdrawal symptoms—although treating anxiety, pain, and depression are also popular goals. Kratom effects generally start within five to ten minutes of taking it and last for up to five hours.
A 2007 survey of respondents aged 12 to 65 years in Thailand found that the lifetime, past year, and past 30 days’ rates of kratom use were 2.32 percent, 0.81 percent, and 0.57 percent, respectively, making kratom the most widely used drug in the country.
Kratom can and sometimes is mixed with other psychoactive drugs, such as codeine and caffeine—although this can be more dangerous. For example, a tea-based cocktail of kratom leaves, Coca-Cola, cough syrup, and ice called 4×100 has become popular in some parts of Thailand and Southeast Asia.
In the US, as of this writing, kratom is illegal in six states: Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. It is explicitly legal in Arizona, Georgia, Nevada, and Utah. It is not regulated but still technically legal at the federal level, so everywhere else it is basically the same. In most places where it is not explicitly illegal, it is sold online and in head shops.
How to Use Kratom Powder
There are several ways to use kratom powder. Kratom powder can be used to brew tea. This is a traditional method that is still popular, and this way you can choose the basic tea you already like and then just add kratom powder, honey, lemon, whatever you enjoy.
Smoothie, Juice, or Protein Shake
Since kratom has a distinct, bitter, plant-y taste, many people enjoy kratom powder more in dietary ingredients that mask the taste somewhat, like a glass of fruit juice, or for more active people, a protein shake or smoothie.
The easiest way to get your kratom powder in the exact right dose is in capsules. And many people buy capsules to ensure they have the right dose, and then open the capsule to use the kratom powder in other preparations.