Is Kratom Deadly, Or Is It Hype?
There are several cases where kratom has been detected post-mortem of bodies of individuals who have died from substance overdose.
These findings have been fueling the FDA in their vendetta against herbal supplements, including kratom. They claim that kratom use is deadly.
But are these claims accurate?
The short answer is kratom can be dangerous — but it isn’t if you’re careful (which isn’t hard). 
In almost every death where kratom was implicated, patients either had an underlying health issue that would contraindicate the use of kratom; or they were using medications or other substances that have known negative interactions with kratom.
A recent study published in 2019 reported that kratom was 1000 times less likely to result in overdose than opioid painkillers.
With that said, kratom can still be dangerous if used irresponsibly. Here are four ways in which kratom can result in harm:
Kratom Danger #1: Drug Combinations
The most concerning issue with kratom is drug interactions — it’s metabolized by cytochrome P450 (CYP450), acting as an inhibitor of CYP2D6 and CYP3A, as well as P-glycoprotein–mediated efflux activity . This is how many other drugs — prescription, OTC, illicit, and herbal — are also metabolized.
Using kratom with certain substances can increase the risk of adverse effects, some of which are deadly. Opioids, stimulants, and alcohol are among the most dangerous.
Besides metabolic competition, kratom can cause interactions in other ways.
Kratom is an atypical opioid, so when taken with opioids, the resulting effects will be substantially stronger — potentially leading to an overdose. Kratom is unlikely to cause an overdose by itself, but the chances increase substantially if you use it with opioids .
Alcohol is similar — those who use kratom and alcohol together are at a significantly higher risk of experiencing side effects. Some of these side effects could prove lethal.
Kratom Danger #2: Overuse
Over-use of kratom can deteriorate the body for decades, as was discovered by studies that observed habitual long-term abusers of the substance .
Even in these cases, the combination of alcohol, tobacco, and illegal substances such as heroin, etc., were found to be contributing factors to the death of the individuals.
Kratom Danger #3: Underlying Health Issues
Kratom has potent pharmacological effects, some of which can cause severe reactions in people with underlying health issues such as heart disease, liver disease, or kidney disease .
Always speak to your doctor before using kratom if you’ve been diagnosed with a health condition.
Kratom Danger #4: Adulteration
Unsafe kratom is a problem in the industry — anything unregulated will have unethical vendors trying to make quick money by selling impure, adulterated, or low-quality products . Only reputable companies with ties to Southeast Asia can maintain a reliable connection on high-grade kratom powder.
To make up for low-grade kratom, some unethical vendors will mix opioid pain medications into their kratom. Others will mix stimulants or any number of substances to boost the effects of the powder.
This is dangerous and highly unethical. The best way to avoid this is to order from reputable brands only and check for the stamp of approval from the American Kratom Association before you buy.
Related: Top 10 Kratom Vendors
Common Side Effects of Kratom
Kratom use might cause side effects in some individuals, as observed in individual cases.
Through improper dosing and unique physiologies, kratom use has been linked to several adverse effects, some of which are the very symptoms kratom is used to alleviate.
Common symptoms of kratom’s adverse side effects include abdominal pain, headaches, loss of appetite, diarrhea, jaundice-like symptoms (due to increased bilirubin levels), increased urination, itching, sweating, etc.
In some cases, psychosis and hallucinations have also been reported. However, these tend to be long-term users who go far beyond the normal doses of kratom.
Traditional Uses of Kratom
Kratom (Mitragyna speciosa) originates from Southeast Asia. It’s native to Thailand, Malaysia, and Indonesia. Traditionally, kratom is used as a medicinal plant to treat a diverse range of health problems , such as cough, fever, pain, diabetes, and hypertension, as well as help with fatigue.
Today, it’s used mainly by men and as part of socializing and religious ceremonies in these countries.
In these areas, kratom is mainly used in the manual laborer population, who use it to fight off fatigue. It also helps them with physical aches and pains.
In recent years, it’s estimated that as many as 10 to 15 million people are using kratom in the US alone.
These users tend to have a wide variety of health-related reasons. Kratom is slowly being recognized as a plant with many therapeutic properties. Thus scientists are urging for further research into the plant to establish standard practices and to understand its possible uses.
Kratom As a Painkiller
The alkaloids found within kratom are similar to common opioid-based painkillers such as morphine.
One study  found one of kratom’s alkaloids, 7-hydroxymitragynine, exhibited 13-fold higher potency than morphine. It’s important to note that the effects of these alkaloids are dependent on the dosage.
Opioids are extremely dangerous because of their addictive nature and potential for respiratory failure in high doses. The prevalence of opioid painkillers is in epidemic proportions in the United States, leading many people suffering from chronic pain to seek out alternatives for managing pain symptoms.
Because kratom is such an effective — and far safer — pain reliever, many people turn to it to get away from prescription painkillers.
Safe Kratom Dosage
One of the main reasons for experiencing adverse effects from kratom is the use of the plant in relatively high doses.
It’s important to start with low doses and then gradually move on to higher doses after observing the effects in isolation. Kratom should not be used with other pain medications, prescription or otherwise.
Kratom dosage can vary from person to person, depending on their tolerance as well as physical attributes like body mass.
Two to six grams is the most commonly recommended dosage. Only users who are familiar with the effects of kratom and how it works on their bodies should experiment with doses over 6 grams of dried powder.
Is Kratom Addictive?
The onset of addiction is not as fast as something like heroin, but it seems that it is, in fact, possible to become dependent on kratom if it is abused. Using chronically high doses for an extended period is more likely to cause addiction.
Those who go through kratom withdrawal can expect to experience symptoms like muscle twitching, runny nose, emotional changes, irritability, and insomnia. These are usually self-treatable and mild enough to get through while being functional. 
How to Take Kratom
The traditional methods of taking kratom in its native lands include — chewing on fresh leaves, consuming its dried powder form, and brewing it into a tea.
Modern, western ways of taking kratom are mainly in the form of dried leaf powder, capsules, and homemade tinctures.
The most common way people take kratom is to mix the dried powder into a cup of water or juice (not grapefruit juice). This method is often referred to as the “toss and wash” method.
Tips for Using Kratom Safely
Here are a few factors to consider before starting on kratom to minimize your risk of experiencing adverse effects:
1. Are You on Pain Medications?
Do not use kratom with other medications. Finish the prescribed course and then wait a few days for the drugs to completely leave your system before starting on kratom. Always speak to your doctor first if you’re using any prescription medications.
2. Do You Have Any Preexisting Conditions?
If yes, you should consult a doctor or your primary healthcare provider before starting on kratom. Liver disease, kidney disease, and heart disease all contraindicate the use of kratom for any reason.
3. Start Low & Go Slow
Start with a small daily dose (such as 2 grams) and observe how your body responds before increasing the dose. If you feel nauseous, you’ve taken too much — reduce the dose next time.
Be patient and wait for the effects to accumulate and start showing up in your body. Stop immediately if you experience any adverse reactions.
4. Do Your Research
Millions of users are sharing their experiences and recommendations online. Read about it and also read what the experts have to say. It’s still a divisive topic, so you will have to make up your mind.
5. Always Order from Reputable Vendors
One of the most dangerous aspects of kratom use is adulteration from unethical vendors. There have been numerous accounts of companies adding prescription opiates or other substances to kratom powder to make it feel stronger.
This is extremely dangerous and has been linked to deaths in the past.
Key Takeaways: Is Kratom As Deadly As It’s Made Out to Be? No
Deaths where kratom has been found in the body are rare, and in most (if not all) cases, the cause is linked to other substances that were also present in the body.
Kratom’s use as an alternative to opioids and in the treatment of opioid addiction is often the cause of the popular misconception that the plant has the same addictive and potentially fatal properties as common narcotics.
Kratom has a long list of benefits and is being actively researched for its therapeutic properties. Before taking kratom, you should consult with your primary care professional, especially if you have an underlying health condition or are on any medications.