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If you read health news or visit vitamin stores, you may have heard about kratom, a supplement that is sold as an energy booster, mood enhancer, pain reliever and antidote for opioid withdrawal. However, the truth about kratom is more complicated, and the safety problems related to its use are concerning.

Kratom is an herbal extract that comes from the leaves of an evergreen tree (Mitragyna speciosa) grown in Southeast Asia. Kratom leaves can be chewed, and dry kratom can be swallowed or brewed. Kratom extract can be used to make a liquid product. The liquid form is often marketed as a treatment for muscle pain, or to suppress appetite and stop cramps and diarrhea. Kratom is also sold as a treatment for panic attacks.

Kratom is believed to act on opioid receptors. At low doses, kratom acts as a stimulant, making users feel more energetic. At higher doses, it reduces pain and may bring on euphoria. At very high doses, it acts as a sedative, making users quiet and perhaps sleepy. Some people who practice Asian traditional medicine consider kratom to be a substitute for opium.

Some people take kratom to avoid the symptoms of opioid withdrawal and because kratom may be bought more easily than prescription drugs.

Kratom is also used at music festivals and in other recreational settings. People who use kratom for relaxation report that because it is plant-based, it is natural and safe. However, the amount of active ingredient in kratom plants can vary greatly, making it difficult to gauge the effect of a given dose. Depending on what is in the plant and the health of the user, taking kratom may be very dangerous.