Kratom is an herbal supplement with stimulant-like effects. Why is it in wellness drinks?

A 12 oz. can of Mitra9 looks just like any other new-age drink. Marketed towards the sober-curious, a company spokesperson says Mitra9 fits a range of needs and their drinks are favored by “wellness enthusiasts” who are “looking for natural alternatives to traditional beverages” as well as “busy individuals who need focus and energy during the day but also want a way to unwind and relax in a healthy manner.”

But look closer at Mitra9’s ingredient list: the canned beverage’s buzzy powers come from kratom, an herbal supplement with stimulant properties. Mitra9 is just one of many kratom-infused products, including Jubi and Club13, claiming to be a better alternative to alcohol or even caffeine.

The health-forward branding is akin to the way nonalcoholic, functional beverage companies like Kin Euphorics and De Soi — which include adaptogen ingredients like ashwagandha and l-theanine — promote themselves. They even share similar packaging: Jubi, which comes in playful, bright containers, boasts that its products are “gluten-free” and “plant-based.”

But while some wellness companies using kratom may frame the ingredient as a safe way to enhance one’s mood and energy levels, there’s also a darker side — one that has earned kratom the nickname “gas station heroin.” In 2021, Texas man Dustin Hernandez died following a seizure after drinking kratom tea. Though Hernandez reportedly used kratom to manage anxiety, his family said he had been “in denial” about the addictive qualities of the substance. More recently in March 2023, a class action lawsuit was filed against the parent company of kratom drink Feel Free over allegations that consumers were not properly warned about the side effects of the ingredient. Then, there are the users like Lizzy Falls opening up about becoming dependent on kratom — which some were unaware was even possible when they first took the substance, given their lack of knowledge about the ingredient. “When I was first given kratom, I was told that it was as safe as coffee,” Falls shared on TikTok. “So that made it hard for me to realize that I had a problem.”

What is kratom?

Kratom is an herbal supplement made from the leaves of the Mitragyna speciosa tree, which is native to Southeast Asia. Typically, it’s sold and packaged as dried leaves, powders, capsules, tablets or liquid extracts, and can also be found in teas and now, canned beverages. In 2021, an estimated 1.7 million Americans 12 and older used kratom, per the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health.

Kratom is considered a natural product, which means that it falls outside of the Food and Drug Administration’s authority, and the FDA says that it cannot be “lawfully marketed in the U.S. as a drug product, a dietary supplement or a food additive in conventional food.” Yet kratom, in most states, can still be lawfully sold — and kratom specialty stores are even popping up around the country.

Kratom has stimulant properties, making you feel more awake and alert, and it also has properties of opioids, Jamie Alan, associate professor of pharmacology and toxicology at Michigan State University, tells Yahoo Life.

The latter is a “big concern,” Alan says. Kratom hits the same receptors as addictive substances like so-called painkillers such as morphine, codeine or fentanyl. That means you can also become dependent on kratom, the way you would with these medications.

“It's the same mechanism by which you become addicted to any sort of opioid, and you will get some of the opioid side effects,” Alan says.

While these impacts can include things like constipation, Alan says one of the “most concerning” side effects is respiratory depression. This means that, in some cases, your breathing can slow down to dangerous levels while using kratom — and it can even stop entirely. This is how people die of opioid overdoses and why Narcan, or naloxone, works to quickly block opioid receptors in the brain in order to restore their normal breathing. Though kratom overdose risk is low, naloxone will also work to treat a kratom overdose.

Alan says that while deaths from kratom alone are “pretty low,” the risk rises when it’s combined with other substances that slow down your respiratory rate, such as sedatives like Xanax or Ativan, as well as opioids.

And kratom addiction can cause major life problems in the same way other drug dependence does, Dr. David I. Deyhimy, founder and medical director of MYMATCLINIC and Pulse Addiction, tells Yahoo Life. He says that his clinic has seen a “dramatic uptick” in kratom users, some of whom were previously addicted to opioids but had since been in remission.

“Patients develop a pain-related condition and think kratom is a less dangerous alternative to opioids, then develop tolerance [and their use] escalates, and they can't stop — very similar to opioid addiction,” he explains. “Others are patients with opioid use disorder, and they try switching to kratom to wean off of opioids but are not successful in stopping kratom.”

Deyhimy says that he’s seen patients who try to stop taking kratom experience symptoms similar to opioid withdrawal, such as elevated blood pressure, heart rate, sleep disturbances, muscle aches, gastrointestinal disturbances, anxiety, dysphoria and depression. “Recently, we had a patient end up in the ICU on a ventilator from kratom,” he says.

Is kratom legal?

The spokesperson for Mitra9 says that they are well aware of the controversy surrounding kratom and that their brand prioritizes “education, transparency and safety” around the product.

“We do not consider a plant like kratom to be any more controversial than other plants found in our food supply,” they say. “Plants are complex and require you to take the time to thoroughly understand them. Unfortunately, some controversies were created prior to some groups not researching the plant. Mitra9 is directly involved with sourcing the highest quality kratom that is rigorously tested for purity and potency. We want customers to feel confident knowing what is in their drink has met the highest safety standards.”

As a natural substance, kratom is not regulated by the FDA — however, as of 2023, it is banned in the states of Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin. It’s also banned in certain jurisdictions within states: for example, while kratom is legal in the state of California, it’s banned in cities like San Diego and Newport Beach.

But just because kratom is legal in your area does not necessarily mean it’s a safe product.

“Because kratom is not regulated in the way that prescription and over-the-counter medications are regulated, you don't really know exactly what you're getting in that bottle,” she says. “Herbal medications and natural products are notorious for not having what they say they have in them, so there's always a risk that it is contaminated with something, or it has more than the label says, or less than the label says. I think this can be very dangerous.”

One concern with kratom, specifically, is the risk of it being contaminated with salmonella, as well as heavy metals — something the FDA warned consumers about in 2019.

Kratom and wellness

Supplements are becoming more and more popular for helping people manage health concerns, with more than 59 million Americans taking supplements regularly for wellness purposes. Functional drinks are becoming a bigger piece of that market, with $123.95 billion in sales in 2023 — but while many people may not overthink popping an adaptogen-filled beverage, or even a caffeinated energy drink, kratom calls for a bit more consideration.

If people are unaware of the potential addictive qualities of kratom — as many who claim to have developed an addiction kratom say they were — what starts as an opportunity to improve their health can have unwanted consequences.

There is potential for kratom to be used in beneficial ways in the future. In Southeast Asia, it’s been used to treat fatigue, diarrhea, muscle cramps and pain. While not enough research has been done into kratom to support health benefits, there is some evidence that it may have the potential to relieve pain and boost mood, and it may have potential as a treatment for opioid withdrawal symptoms.

“The FDA is supporting studies looking into the [potential] clinical utility of this substance, but we just don't know that yet,” Alan says. “So where we sit right now is that it's mostly all risk, because it's completely unregulated.”

But whether you pick up one of these kratom drinks, or other kratom-infused supplement, may depend on your risk tolerance — as there is a potential for becoming dependent. “There is probably little risk to someone who is an occasional user,” Alan says. “However, kratom does act like a weak opioid agonist and therefore carries a risk of dependence and addiction. It’s hard to say who will develop dependence and who will not.”