Penn State Research-to-Policy Collaborative Issues Framework for Smart Kratom Regulation

Why it matters

This research-to-policy brief provides actionable recommendations for policymakers balancing kratom access, public health, and evidence-based regulation. It highlights the need to distinguish between traditional whole-leaf kratom and high-potency 7-OH products—a critical policy distinction.

The big picture

Between 1–6 million Americans have tried kratom, with 0.6% current use prevalence. Kratom is easy to obtain online and at smoke shops, gas stations, and vape shops. While some users report benefits for pain, opioid withdrawal, and mood, concentrated products and 7-OH carry greater risks. Smart policy distinguishes product types, regulates quality and labeling, supports treatment for kratom use disorder, and collects data to inform evolving policy.

Key findings

• Kratom users report using for energy, alertness, pain relief, anxiety/mood management, and opioid withdrawal management
• Some evidence suggests kratom may reduce pain and opioid withdrawal symptoms
• Common side effects are mild (nausea, dizziness, constipation); serious harms are rare but include seizures, liver toxicity, heart rhythm problems
• High-potency extracts and 7-OH carry greater risks of serious harm and addiction than whole-leaf kratom
• Medication-assisted treatment (buprenorphine, methadone) is effective for kratom use disorder
• Unregulated products carry risks of heavy metal contamination, bacterial contamination (salmonella), mislabeling, and adulteration with opioids
• Policy should support naloxone co-distribution and harm-reduction strategies

What they say

"Policy approaches could differentiate between product types based on potency rather than treating all kratom-related products the same. Address product quality and consistency through regulation to decrease variability, improve labeling warnings, regulate product strength, and reduce contamination risk. Support health care and substance use disorder treatment providers in identifying use, understanding risks, and responding with evidence-based treatments." — Penn State Evidence-to-Impact Collaborative

Bottom line

Effective kratom policy should distinguish between whole-leaf and high-potency products, regulate quality and labeling, expand access to medication-assisted treatment, support naloxone distribution, and strengthen data collection on use patterns and outcomes.