What to do about kratom?

The NY Times recently ran an article on the growing problem of unregulated kratom and its aggressive marketing.

Kratom, long used by people seeking relief from addiction to prescription opioids and alcohol, is increasingly being pitched as a wellness product that purports to raise energy, sharpen focus and enhance athletic performance.

Tauber, O. (2026, November 2). They Tried Kratom for Its Health Benefits, Then They Became Addicted. The New York Times. https://www.nytimes.com/2026/11/02/well/kratom-wellness-marketing-addiction.html

‌The article explains what anyone working around addiction already knows — kratom is not just a low-risk supplement.

While estimates vary, some studies suggest between 29 and 40 percent of regular users of kratom become dependent, as was the case for Ms. Tesluck, who now works for a nonprofit focused on kratom addiction. Experts said they were concerned that many people trying kratom based on its wellness claims do not fully understand how dangerous it can be.

“The public deserves accurate, nuanced information rather than messaging driven primarily by commercial incentives,” said Dr. Cornel Stanciu, the director of addiction services at New Hampshire Hospital.

Tauber, O. (2026, November 2). They Tried Kratom for Its Health Benefits, Then They Became Addicted. The New York Times. https://www.nytimes.com/2026/11/02/well/kratom-wellness-marketing-addiction.html

The purveyors fail to convey the risks associated with the drug and engage in predatory marketing.

Dr. Stanciu and other experts noted that people who have previously struggled with alcohol or other drugs may be especially vulnerable to kratom addiction. He added that targeted marketing through podcasts, influencers and wellness branding gives consumers a false sense of safety, especially when audiences include young people or those with a history of substance abuse.

Tauber, O. (2026, November 2). They Tried Kratom for Its Health Benefits, Then They Became Addicted. The New York Times. https://www.nytimes.com/2026/11/02/well/kratom-wellness-marketing-addiction.html

In fact, some of the marketing tracks with 1980s D.A.R.E. and public service ads — the first one’s free.

Ms. Tesluck said she continues to hear from people who were introduced to kratom through free samples offered at gyms or on social media. She is concerned that the problem could become even worse if more potent products gain traction.

Tauber, O. (2026, November 2). They Tried Kratom for Its Health Benefits, Then They Became Addicted. The New York Times. https://www.nytimes.com/2026/11/02/well/kratom-wellness-marketing-addiction.html

CBS News also reported this week that a Baltimore man has been indicted for attempting to bribe customs officials to release a kratom shipment.

The charges stem from an alleged attempt by Aljufri to offer a bribe to a CBP officer to ensure that a shipment of “mitragyna speciosa” could be released from a hold that was placed on it at a port of entry. The investigation involved CBP’s Baltimore Field Office.

And, there’s reason to suspect that we are witnessing a case of regulatory capture with emerging federal regulatory models appearing to protect some manufacturers and restore their market share.

Three months ago, federal health officials announced that the government planned to ban a potent opioid that Health Secretary Robert F. Kennedy Jr. said “put American lives at risk.”…

This month, the government reversed course.

Mr. Kennedy announced Oct. 9 that his department had “followed the science” and decided to allow some levels of the compound….

“They’re not doing this because the science supports it,” said Dr. Andrew Kolodny, the medical director for the Opioid Policy Research Collaborative at Brandeis University, who reviewed the H.H.S. justification for eschewing the ban. “They’re doing this because the industry and the lobbyists are basically writing the policy.”…

The kratom industry has focused intensely on the second Trump administration from the start. A recent New York Times investigation described how one executive, Jerry W. Ross, whose company makes a popular natural kratom drink called Feel Free, encouraged allies in the administration to target synthetic kratom products that had taken market share. (Mr. Ross declined to comment at the time. The White House said it was not swayed by his advocacy.)

Jewett, C. (2026, October 28). Trump Administration Backs Down on an Opioid Ban After Kratom Industry Lobbying. The New York Times. https://www.nytimes.com/2026/10/28/us/politics/trump-opioid-kratom.html

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Why share all this?

Because, as the NY Times story alludes to, I’ve seen many people in recovery harmed by kratom. It’s bad enough that this substance is available in gas stations and other retail checkout counters with no restrictions, but to make matters worse, they have a well-organized and very active lobbying and advocacy machine that uses prominent recovery advocates to baselessly claim that kratom is a “gateway drug into recovery” and promote concepts like “plant-based recovery” that use kratom as treatment for addiction and as a harm reduction tool.

They attempt to draw safety distinctions between natural kratom and synthetics, and there are differences, but I’ve witnessed plenty of harm to people in recovery from the plant-based products. These people assumed the products were safe because they are unregulated and/or because they heard claims online that they are safe, and they used them for pain, energy, or vague (common with supplements) perceived benefits. In some cases, kratom led to using other substances, and in other cases, they got trapped in an addictive cycle with kratom only.

I’ll share one story as an example. Several years ago, a friend had a very long history of drug addiction that caused catastrophic functional impairment, including prison and more than a dozen overdoses. After decades of addiction and many treatment attempts, he finally achieved stable recovery with the help of residential treatment and extended-release naltrexone. He was in stable recovery for years, working steadily, married, and played a key role in raising his step-grandchildren.

Over the years, he became less consistent with his extended-release naltrexone but never discontinued it, often getting his injection when his wife nudged him in response to stress.

One day, while at the hardware store for work supplies, he saw little bottles that looked very similar to energy drinks and consumed them the same way he had used energy drinks. He found that they seemed to provide energy and relax him at the same time, and also help with some of the aches and pains of being a 60-year-old man swinging a hammer for a living. The drinks became a regular part of his days. He had a vague sense that something wasn’t right because he felt like he had come to need them in a way he never needed energy drinks. We talked about discontinuing them, but I hadn’t understood the frequency and the difficulty he was going to have quitting them.

His wife was concerned about his stress and mood, and encouraged him to go see his addiction doctor and get a naltrexone injection.

He got his injection and started feeling very ill. He started feeling so ill that he went to the emergency department. While in the ED he started behaving irrationally, tried to leave against medical advice, and must have said something that indicated a threat to himself or others. He ended up getting involuntarily admitted to the psychiatric unit.

When we spoke afterward, he didn’t understand what had happened. It was clear to me that the naltrexone injection had precipitated kratom withdrawal, which suddenly made sense of everything for him.

Unfortunately, he has been unable to re-stabilize in recovery. He’s been unable to maintain employment and has been in and out of treatment multiple times.

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Would kratom bans be a disaster?

We’re seeing more and more municipalities and states ban kratom, some distinguishing between natural and synthetic products, others banning both. Kratom advocates argue that kratom is important medicine for a lot of people, that a ban would represents a return to failed war-on-drugs approaches, and even that we’ll worsen the opioid crisis by denying people a pathway to recovery. For the average person, it becomes very difficult to determine the motivations behind speakers and their arguments — science-based public health, ideology-based public health, commercial interests, personal philosophy, personal loss, etc.

Many of these intense debates about bans misdirect our attention. Even if we were to take a “safe supply” approach, that would require some form of law enforcement, right? How do you maintain a “safe supply” in the context of innovations that are driven by market forces, the desire for a better drug effect, or something else? For example, kratom has been totally legal, with very low thresholds for access, yet we have had innovations like 7-OH emerge. “Safe supply” approaches might impact the pace of innovation, but they won’t stop it.

So… the question on my mind is not whether to ban some substances but rather what a ban should look like. Does this look like a ban on leaded gasoline, a food additive, pesticide, or very large sugary drinks? Or, does it look like a war-on-drugs ban on cocaine and prohibition-era alcohol?

The legal status of a substance doesn’t dictate a repeat of mass incarceration or abandoning users of the substance. It also doesn’t dictate that ownership of the issue be delegated to law enforcement.

I don’t have a blueprint, but there are a lot of decisions to be made once a bill becomes law, and we shouldn’t assume that the law predetermines all of these matters.