NIDA March 2026 Update: Kratom Affects 0.6% of U.S. Adults; Research Shows Opioid-Like Properties and Potential Risks

Why it matters

NIDA's comprehensive overview highlights that while kratom has not been approved for any medical use by FDA, the institute is actively funding research to understand its mechanisms, health effects, and potential therapeutic applications—particularly for opioid use disorder treatment. This positions kratom as an emerging area of scientific inquiry with both potential and significant safety concerns.

The big picture

Kratom use in the United States has expanded over the past two decades from a substance with traditional use in Southeast Asia to a widely available product in gas stations, convenience stores, and online. NIDA estimates about 0.6% (1.7 million) of Americans aged 12+ used kratom in the past year (2021 data). The most well-studied compounds are mitragynine and 7-hydroxymitragynine (7-OH), which activate mu-opioid receptors but produce only partial agonist activity compared to traditional opioids.

Key findings

• Approximately 1.7 million Americans (0.6% of population aged 12+) reported kratom use in past 12 months; Kratom effects are dose-dependent: stimulant effects at lower doses, opioid/sedative effects at higher doses; Neither kratom leaves nor mitragynine appear to cause respiratory depression characteristic of overdose, but 7-OH can cause respiratory depression reversible by naloxone; Case reports document mild side effects (nausea, constipation) and rare serious adverse effects (seizures, liver problems, cardiomyopathy); Kratom products vary widely and may contain contaminants; Very few deaths attributed to kratom alone; NIDA is funding research on therapeutic potential for opioid use disorder and chronic pain.

What they say

While there are no uses for kratom approved by the U.S. Food and Drug Administration, people report using kratom to manage drug withdrawal symptoms and cravings (especially related to opioid use), pain, fatigue and mental health problems. NIDA supports and conducts research to evaluate potential medicinal uses for kratom and related chemical compounds. — NIDA (March 2026 update)

Bottom line

NIDA recognizes kratom's opioid-like pharmacology and emerging health concerns while actively researching whether isolated kratom compounds might become therapeutically useful medications, but currently no approved medical uses exist.